Measuring long-term physical activity in patients with heart failure and its relation to health-related outcomes.
Current physical activity guidelines often rely on self-reported or short-term device-based monitoring. We analysed long-term activity data via acceleration and continuous optical heart rate measurement and hypothesised a temporal association between volume and intensity and health-related outcomes in heart failure.
This prospective observational trial reanalysed longitudinal data from 156 patients with heart failure at baseline, 6 months, and 12 months. A multisensory activity tracker captured daily step count and continuous heart rate data over a 1-min sampling interval from patients with New York Heart Association (NYHA) Class I (n = 66) and Class II/III (n = 90) over 12 months. Linear mixed-effects models and univariate linear regression models were used to assess the associations between step count, moderate physical activity (MPA) and vigorous physical activity (VPA) and health-related outcomes [cardiorespiratory fitness, body composition, systemic inflammation levels, N-terminal pro brain natriuretic peptide (NTproBNP), and Kansas City Cardiomyopathy Questionnaire (KCCQ)].
Patients with NYHA I and NYHA II/III spent a median (interquartile range) of only 225 (105;412) vs 167 (72;326) min per week with MPA, 17 (7;44) vs 9 (4;23) min per week with VPA, and 8021 (6474;9910) vs 6438 (5181;8627) steps per day, respectively. VPA was positively associated with maximum oxygen uptake (ml/kg/min) (VO2max; β=3.815, 95% CI [1.430-10.186], P = .008), and MPA was inversely associated with NT-proBNP (pg/ml) (β=-0.189, 95% CI [-0.353 to -0.025], P = .024). For step count, a positive association with VO2max (ml/kg/min) (β=0.545, 95% CI [0.295-0.795], P < .001), and a negative association with fat mass (%) (β=-1.058, 95% CI [-1.441 to -0.674], P < .001), C-reactive protein (mg/l) (β=-0.057, 95% CI [-0.097 to -0.017], P = .005), and interleukin-6 (pg/ml) (β=-0.022, 95% CI [-0.043 to -0.001], P = .041) was observed. Absolute changes (Δ) for improved VO2max (ml/kg/min) (r = 0.197, P = .043) and reduced fat mass (%) (r = 0.205, P = .014) were associated with VPA between baseline and 12 months. No relationship was found with KCCQ.
Long-term device-based physical activity monitoring showed that patients with heart failure met recommendations for MPA, yet vigorous activity exceeding 60% of heart rate reserve was almost entirely absent. Higher aerobic physical activity was associated with greater VO2max, lower fat mass, reduced systemic inflammation (C-reactive protein and interleukin-6), and lower NT-proBNP, but not with KCCQ, whereas only VPA, unlike MPA, was associated with higher VO2max and lower fat mass.
This prospective observational trial reanalysed longitudinal data from 156 patients with heart failure at baseline, 6 months, and 12 months. A multisensory activity tracker captured daily step count and continuous heart rate data over a 1-min sampling interval from patients with New York Heart Association (NYHA) Class I (n = 66) and Class II/III (n = 90) over 12 months. Linear mixed-effects models and univariate linear regression models were used to assess the associations between step count, moderate physical activity (MPA) and vigorous physical activity (VPA) and health-related outcomes [cardiorespiratory fitness, body composition, systemic inflammation levels, N-terminal pro brain natriuretic peptide (NTproBNP), and Kansas City Cardiomyopathy Questionnaire (KCCQ)].
Patients with NYHA I and NYHA II/III spent a median (interquartile range) of only 225 (105;412) vs 167 (72;326) min per week with MPA, 17 (7;44) vs 9 (4;23) min per week with VPA, and 8021 (6474;9910) vs 6438 (5181;8627) steps per day, respectively. VPA was positively associated with maximum oxygen uptake (ml/kg/min) (VO2max; β=3.815, 95% CI [1.430-10.186], P = .008), and MPA was inversely associated with NT-proBNP (pg/ml) (β=-0.189, 95% CI [-0.353 to -0.025], P = .024). For step count, a positive association with VO2max (ml/kg/min) (β=0.545, 95% CI [0.295-0.795], P < .001), and a negative association with fat mass (%) (β=-1.058, 95% CI [-1.441 to -0.674], P < .001), C-reactive protein (mg/l) (β=-0.057, 95% CI [-0.097 to -0.017], P = .005), and interleukin-6 (pg/ml) (β=-0.022, 95% CI [-0.043 to -0.001], P = .041) was observed. Absolute changes (Δ) for improved VO2max (ml/kg/min) (r = 0.197, P = .043) and reduced fat mass (%) (r = 0.205, P = .014) were associated with VPA between baseline and 12 months. No relationship was found with KCCQ.
Long-term device-based physical activity monitoring showed that patients with heart failure met recommendations for MPA, yet vigorous activity exceeding 60% of heart rate reserve was almost entirely absent. Higher aerobic physical activity was associated with greater VO2max, lower fat mass, reduced systemic inflammation (C-reactive protein and interleukin-6), and lower NT-proBNP, but not with KCCQ, whereas only VPA, unlike MPA, was associated with higher VO2max and lower fat mass.
Authors
Leps Leps, Kwast Kwast, Pökel Pökel, Voß Voß, Falz Falz, Kramer Kramer, Lödding Lödding, Tegtbur Tegtbur, Busse Busse
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