Sooyoon Shin PhD , Nathan Kowahl MS , Taylor Hansen PhD , Albee Y. Ling PhD , Poulami Barman MS , Nicholas Cauwenberghs PhD , Erin Rainaldi MS , Sarah Short MPH , Jessilyn Dunn PhD , Md Mobashir Hasan Shandhi PhD , Svati H. Shah MD, MHS , Kenneth W. Mahaffey MD , Tatiana Kuznetsova MD, PhD , Melissa A. Daubert MD , Pamela S. Douglas MD , Francois Haddad MD , Ritu Kapur PhD
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Douglas MD , Francois Haddad MD , Ritu Kapur PhD","doi":"10.1016/j.cardfail.2024.02.028","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Data collected via wearables may complement in-clinic assessments to monitor subclinical heart failure (HF).</div></div><div><h3>Objectives</h3><div>Evaluate the association of sensor-based digital walking measures with HF stage and characterize their correlation with in-clinic measures of physical performance, cardiac function and participant reported outcomes (PROs) in individuals with early HF.</div></div><div><h3>Methods</h3><div>The analyzable cohort included participants from the Project Baseline Health Study (PBHS) with HF stage 0, A, or B, or adaptive remodeling phenotype (without risk factors but with mild echocardiographic change, termed RF-/ECHO+) (based on available first-visit in-clinic test and echocardiogram results) and with sufficient sensor data. 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引用次数: 0
摘要
通过可穿戴设备收集的数据可以补充临床评估，监测亚临床心力衰竭（HF）。评估基于传感器的数字步行测量与心力衰竭分期的相关性，并描述其与早期心力衰竭患者的临床体能、心脏功能和参与者报告结果（PROs）的相关性。可分析的队列包括 "基线健康研究项目"（PBHS）的参与者，他们均为高血压 0、A 或 B 期或适应性重塑表型（无风险因素但有轻微超声心动图改变，称为 RF-/ECHO+）（基于可用的首次门诊测试和超声心动图结果），并有足够的传感器数据。我们计算了每位参与者每天的 18 项数字行走测量值，使用多叉逻辑回归法比较了高血压亚组与 0 期，并使用斯皮尔曼相关系数分析了与门诊测量值和 PROs 之间的关系，同时对所有分析进行了混杂因素调整。在可分析队列（N=1265；占 PBHS 队列的 50.6%）中，17/18 项步行指标每降低一个标准差，B 期或 A 期（多变量调整后的比值比 [ORs] vs 0 期，范围为 1.18-2.10）或 A 期（比值比 vs 0 期，1.07-1.45）的可能性就会增加，而 RF-/ECHO+ 的可能性则会降低（比值比 vs 0 期，0.80-0.93）。30 分钟峰值速度与 B 阶段（OR vs 阶段 0=2.10；95% CI：1.74-2.53）和 A 阶段（OR vs 阶段 0=1.43；95% CI：1.23-1.66）的关联性最强。与体能测试、超声心动图心脏重塑和功能障碍指数以及PROs相关性最强的是B期，其次是A期，最低的是0期。可穿戴传感器捕获的步行数字测量值可补充临床测试，以识别和监测症状前HF。
Real-world walking behaviors are associated with early-stage heart failure: a Project Baseline Health Study
Background
Data collected via wearables may complement in-clinic assessments to monitor subclinical heart failure (HF).
Objectives
Evaluate the association of sensor-based digital walking measures with HF stage and characterize their correlation with in-clinic measures of physical performance, cardiac function and participant reported outcomes (PROs) in individuals with early HF.
Methods
The analyzable cohort included participants from the Project Baseline Health Study (PBHS) with HF stage 0, A, or B, or adaptive remodeling phenotype (without risk factors but with mild echocardiographic change, termed RF-/ECHO+) (based on available first-visit in-clinic test and echocardiogram results) and with sufficient sensor data. We computed daily values per participant for 18 digital walking measures, comparing HF subgroups vs stage 0 using multinomial logistic regression and characterizing associations with in-clinic measures and PROs with Spearman's correlation coefficients, adjusting all analyses for confounders.
Results
In the analyzable cohort (N=1265; 50.6% of the PBHS cohort), one standard deviation decreases in 17/18 walking measures were associated with greater likelihood for stage-B HF (multivariable-adjusted odds ratios [ORs] vs stage 0 ranging from 1.18-2.10), or A (ORs vs stage 0, 1.07-1.45), and lower likelihood for RF-/ECHO+ (ORs vs stage 0, 0.80-0.93). Peak 30-minute pace demonstrated the strongest associations with stage B (OR vs stage 0=2.10; 95% CI:1.74-2.53) and A (OR vs stage 0=1.43; 95% CI:1.23-1.66). Decreases in 13/18 measures were associated with greater likelihood for stage-B HF vs stage A. Strength of correlation with physical performance tests, echocardiographic cardiac-remodeling and dysfunction indices and PROs was greatest in stage B, then A, and lowest for 0.
Conclusions
Digital measures of walking captured by wearable sensors could complement clinic-based testing to identify and monitor pre-symptomatic HF.
期刊介绍：
Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.
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