{"id":"4337b13237ef","type":"article","url":"https://hartvaat.nl/2026/03/03/c-mic-ii-hartfunctie-inspanningscapaciteit-en-kwaliteit-van-leven-zijn-verwante-/","title":"C-MIC II: hartfunctie, inspanningscapaciteit en kwaliteit van leven zijn verwante maar aparte domeinen","title_en":"Association between functional status and cardiac function in chronic heart failure: insights from the C-MIC II Trial","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","empagliflozine","hfmref","hfpef","nt-probnp","step-hfpef"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag102","source_url":"https://doi.org/10.1093/eschf/xvag102","authors":["Marat Fudim","Tamara Kovacevic-Preradovic","Marija Zdravkovic","Sasko Jovev","Nermir Granov","Tanja Popov","Igor Rudez","Petar Vukovic","Velibor Ristic","Annette Holtdirk","Muhammad Shahzeb Khan","Faouzi Kallel","Miodrag Peric","Javed Butler","Stefan D Anker","Dragana Kosevic","J Eduardo Rame"],"significance":5,"published":"2026-03-03","source_date":"2026-03-03","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/transthoracale-echocardiografie/","https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/"],"congress":"","summary_en":"In heart failure, the relationship between changes in cardiac function, exercise capacity and patient-reported health is incompletely defined — relevant to endpoint selection in trials. In this post-hoc analysis of the randomised C-MIC II trial (65 ambulatory patients with non-ischaemic dilated cardiomyopathy, NYHA III-IV, LVEF 25-35%), the six-month associations between the KCCQ questionnaire, 6-minute walk distance (6MWD), left ventricular ejection fraction (LVEF) and peak oxygen uptake (peak VO2) were examined. Changes in KCCQ and 6MWD correlated strongly with each other (r=0.63) but only modestly with LVEF (both r=0.39) and not significantly with peak VO2. LVEF correlated more closely with peak VO2 (r=0.41, rising to 0.56 at six months). Cardiac function, exercise capacity and perceived health are thus related but distinct domains — supporting multidimensional assessment in heart-failure trials.","created":"2026-07-03T10:32:20Z","updated":"2026-07-03T18:39:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bij hartfalen is de samenhang tussen veranderingen in hartfunctie, inspanningsvermogen en de door de patiënt ervaren gezondheid onvolledig gedefinieerd — relevant voor de keuze van eindpunten in trials. In deze post-hocanalyse van de gerandomiseerde C-MIC II-trial (65 ambulante patiënten met niet-ischemische gedilateerde cardiomyopathie, NYHA III-IV, LVEF 25-35%) werd over zes maanden de samenhang onderzocht tussen de KCCQ-vragenlijst, de 6-minutenlooptest (6MWD), de linkerventrikel-ejectiefractie (LVEF) en de piek-zuurstofopname (piek-VO2). De veranderingen in KCCQ en 6MWD hingen onderling sterk samen (r=0,63) maar slechts matig met de LVEF (beide r=0,39) en niet significant met de piek-VO2. De LVEF correleerde nauwer met de piek-VO2 (r=0,41, oplopend tot 0,56 na zes maanden). Hartfunctie, inspanningscapaciteit en ervaren gezondheid zijn dus verwante maar aparte domeinen — wat pleit voor een multidimensionale beoordeling in hartfalentrials.","abstract_original":"INTRODUCTION: Relationship between changes in cardiac function, functional capacity, and patient-reported health status in heart failure (HF) remains incompletely defined, which may help inform endpoint selection and clarify how distinct clinical domains reflect treatment response. METHODS: This post hoc analysis of the randomized cardiac microcurrent (C-MIC) II trial, which evaluated the efficacy and safety of C-MIC therapy in patients with chronic HF with reduced ejection fraction on optimal guideline-directed medical therapy, included 65 ambulatory patients with non-ischaemic dilated cardiomyopathy, New York Heart Association (NYHA) Class III-IV symptoms, and baseline left ventricular ejection fraction (LVEF) 25-35%. Correlations between changes in Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS), 6-minute walk distance (6MWD), core lab-assessed LVEF (primary measure) and site-assessed LVEF, and peak oxygen uptake (peak VO2) were evaluated at 4 weeks, 2 months, 3 months, 4 months, and 6 months using Pearson coefficients with 95% confidence intervals (CI). RESULTS: The mean age was 60.0 ± 9.7 years and baseline LVEF was 29.8 ± 3.3%. Baseline 6MWD was 291.4 ± 61.6 m and KCCQ-OSS was 42.6 ± 22.7. From baseline to 6 months, changes in KCCQ-OSS (n = 63) and 6MWD (n = 61) showed modest correlations with core lab-assessed LVEF (r = 0.39; 95% CI: 0.16-0.58; P = .0015 and r = 0.39; 95% CI: 0.15-0.58; P = .0022, respectively). Changes in KCCQ-OSS and 6MWD correlated strongly (n = 62; r = 0.63; 95% CI: 0.46-0.76; P < .0001). Changes in KCCQ-OSS and 6MWD did not correlate significantly with changes in peak VO2 (P = .06 and P = .30, respectively). Changes in LVEF and peak VO2 (n = 55) demonstrated modest correlation (r = 0.41; 95% CI: 0.16-0.61; P = .002). Baseline correlations with peak VO2 were weak to modest but increased at 6 months for LVEF (n = 59; r = 0.56; 95% CI: 0.35-0.71; P < .0001). CONCLUSION: In advanced HF, improvements in health status and submaximal functional capacity associate modestly with LVEF, while LVEF correlates more closely with peak VO2. Cardiac function, functional capacity, and health status represent related but distinct domains, supporting multidimensional assessment in HF trials."}