Conference Coverage

Short Physical Performance Battery Decline Is Linked to Recurrent HF Hospitalization in Patients With Transthyretin Amyloid Cardiomyopathy

Edited by:
Ashton L. Stahl

Key Highlights

  • Each 1-point decline in SPPB score was associated with a 46% increased hazard of recurrent heart failure (HF) hospitalization (HR, 1.46; 95% CI, 1.19-1.78; P<.001).
  • Each 35-meter decline in 6-minute walk test (6MWT) distance was associated with a 25% increased hazard of recurrent HF hospitalization (HR, 1.25; 95% CI, 1.05-1.49; P=.015).
  • Among 242 patients with ATTR-CM, 35% experienced SPPB decline and 28% experienced worsening 6MWT performance.

Declining physical performance was associated with an increased hazard of recurrent heart failure (HF) hospitalization among patients with transthyretin amyloid cardiomyopathy (ATTR-CM), according to findings from a retrospective study scheduled for presentation at the American Heart Association's (AHA) Scientific Sessions 2026.

The study found that worsening Short Physical Performance Battery (SPPB) scores and 6-minute walk test (6MWT) performance were associated with recurrent HF hospitalization. Researchers investigated whether the SPPB, which assesses gait speed, balance, and lower-extremity strength, could provide prognostic information in patients with ATTR-CM.

Investigators retrospectively identified 242 patients with ATTR-CM from the Columbia University Amyloid Registry who underwent baseline and follow-up SPPB and 6MWT assessments, with the 2 tests performed within 30 days of each other. Functional decline was evaluated as a 1-point decrease in SPPB score or a 35-meter reduction in 6MWT distance between assessments.

Researchers used the Lin-Wei-Yang-Ying recurrent-event model with cluster-robust standard errors to evaluate non-elective HF hospitalizations following functional reassessment. Analyses also examined associations after adjustment for NAC stage.

Study Findings

The study population had a mean age of 76.8 years, and 89.7% were male. Most participants were White (74.4%) and had New York Heart Association (NYHA) functional class I or II symptoms (83.8%).

The median interval between baseline and follow-up functional testing was 6.9 months (interquartile range [IQR], 6.0-12.8). Following reassessment, patients were observed for a median of 21.6 months (95% CI, 18.1-23.7), representing 396 person-years of follow-up.

SPPB scores declined in 85 patients (35%), while 68 patients (28%) experienced worsening 6MWT performance. During follow-up, 35 HF hospitalizations occurred among 20 patients, corresponding to an event rate of 8.84 per 100 person-years.

In univariate recurrent-event analysis, each 1-point decline in SPPB score was associated with a 46% increased hazard of recurrent HF hospitalization (hazard ratio [HR], 1.46; 95% CI, 1.19-1.78; P < .001). Each 35-meter reduction in 6MWT distance was associated with a 25% increased hazard (HR, 1.25; 95% CI, 1.05-1.49; P = .015).

Both associations persisted after adjustment for NAC stage. Patients with worsening functional assessments accounted for most recurrent HF hospitalizations.

Clinical Implications

According to the study authors, declining SPPB performance may help identify patients with ATTR-CM at increased risk for recurrent HF hospitalization. As a brief, multidimensional in-office assessment, the SPPB may offer additional prognostic information for clinical care and research involving patients with ATTR-CM.

Expert Commentary

“SPPB decline on follow up assessment is associated with recurrent HF hospitalization in ATTR-CM. SPPB, a brief and multidimensional in-office assessment, may be useful for prognostic enrichment in clinical care and research for ATTR-CM,” the researchers concluded.

Reference

Ansari B, Barrera NI, Ravalli F, et al. Short physical performance battery decline on follow-up is associated with recurrent heart failure hospitalization in transthyretin amyloid cardiomyopathy. Abstract Sa1013. Presented at: American Heart Association Scientific Sessions 2026; November 7, 2026.