Camilla Fuchs Andersen MD , Massar Omar MD, PhD , Julie Hempel Larsen MD , Caroline Kistorp MD, PhD , Christian Tuxen MD, PhD , Finn Gustafsson MD, PhD, DMSc , Lars Køber MD, PhD , Mikael Kjær Poulsen MD, PhD , Jan Christian Brønd PhD , Jacob Eifer Møller MD, PhD, DMSc , Morten Schou MD, PhD , Jesper Jensen MD, PhD
{"title":"加速度计测量的心力衰竭和射血分数降低患者的体力活动：决定因素及与患者自述健康状况的关系。","authors":"Camilla Fuchs Andersen MD , Massar Omar MD, PhD , Julie Hempel Larsen MD , Caroline Kistorp MD, PhD , Christian Tuxen MD, PhD , Finn Gustafsson MD, PhD, DMSc , Lars Køber MD, PhD , Mikael Kjær Poulsen MD, PhD , Jan Christian Brønd PhD , Jacob Eifer Møller MD, PhD, DMSc , Morten Schou MD, PhD , Jesper Jensen MD, PhD","doi":"10.1016/j.ahj.2024.08.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. We investigated the determinants of accelerometer-measured physical activity and the relationship with patient-reported health status.</p></div><div><h3>Methods</h3><p>Post-hoc analysis of the Empire HF trial, including outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. We investigated associations between activity level and clinical variables, including age, sex, and body mass index, as well as patient-reported health status assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ).</p></div><div><h3>Results</h3><p>Complete data were available in 180 (95%) patients (86% male, mean age 65 year). Baseline median physical activity level was 1,318 CPM (Q1-Q3 1,111-1,585). Age and anemia were independently associated with activity level (β-coefficients: −10 CPM per year age increase [95% CI −16 to −5.1], <em>P</em> = .00015, and −126 CPM for anemia [95% CI −9.1 to −244], <em>P</em> = .035). Significant independent associations were observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all <em>P</em> < .02). For 12-week changes in KCCQ-summary scores, only the KCCQ-CSS was associated with activity level; mean increase of 17.5 CPM [95% CI 1.5 to 34.0], <em>P</em> = 0.032, per 5-point increase in KCCQ-CSS. Associations were not modified by treatment allocation (interaction <em>P</em>-values > .05).</p></div><div><h3>Conclusions</h3><p>In patients with HFrEF, older age and anemia were independently associated with lower activity. Moreover, physical activity only weakly increased with better health status, suggesting that changes in physical activity reflect improvements in patients’ health status to a limited degree. This highlights the need to better understand the endpoint with regards to all other health parameters to ease interpretation in future HF trials.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 14-23"},"PeriodicalIF":3.7000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324002205/pdfft?md5=90ab1af541729a5f7e4c80e436878665&pid=1-s2.0-S0002870324002205-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: Determinants and relationship with patient-reported health status\",\"authors\":\"Camilla Fuchs Andersen MD , Massar Omar MD, PhD , Julie Hempel Larsen MD , Caroline Kistorp MD, PhD , Christian Tuxen MD, PhD , Finn Gustafsson MD, PhD, DMSc , Lars Køber MD, PhD , Mikael Kjær Poulsen MD, PhD , Jan Christian Brønd PhD , Jacob Eifer Møller MD, PhD, DMSc , Morten Schou MD, PhD , Jesper Jensen MD, PhD\",\"doi\":\"10.1016/j.ahj.2024.08.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. We investigated the determinants of accelerometer-measured physical activity and the relationship with patient-reported health status.</p></div><div><h3>Methods</h3><p>Post-hoc analysis of the Empire HF trial, including outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. We investigated associations between activity level and clinical variables, including age, sex, and body mass index, as well as patient-reported health status assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ).</p></div><div><h3>Results</h3><p>Complete data were available in 180 (95%) patients (86% male, mean age 65 year). Baseline median physical activity level was 1,318 CPM (Q1-Q3 1,111-1,585). Age and anemia were independently associated with activity level (β-coefficients: −10 CPM per year age increase [95% CI −16 to −5.1], <em>P</em> = .00015, and −126 CPM for anemia [95% CI −9.1 to −244], <em>P</em> = .035). Significant independent associations were observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all <em>P</em> < .02). For 12-week changes in KCCQ-summary scores, only the KCCQ-CSS was associated with activity level; mean increase of 17.5 CPM [95% CI 1.5 to 34.0], <em>P</em> = 0.032, per 5-point increase in KCCQ-CSS. Associations were not modified by treatment allocation (interaction <em>P</em>-values > .05).</p></div><div><h3>Conclusions</h3><p>In patients with HFrEF, older age and anemia were independently associated with lower activity. 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Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: Determinants and relationship with patient-reported health status
Background
Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. We investigated the determinants of accelerometer-measured physical activity and the relationship with patient-reported health status.
Methods
Post-hoc analysis of the Empire HF trial, including outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. We investigated associations between activity level and clinical variables, including age, sex, and body mass index, as well as patient-reported health status assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ).
Results
Complete data were available in 180 (95%) patients (86% male, mean age 65 year). Baseline median physical activity level was 1,318 CPM (Q1-Q3 1,111-1,585). Age and anemia were independently associated with activity level (β-coefficients: −10 CPM per year age increase [95% CI −16 to −5.1], P = .00015, and −126 CPM for anemia [95% CI −9.1 to −244], P = .035). Significant independent associations were observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all P < .02). For 12-week changes in KCCQ-summary scores, only the KCCQ-CSS was associated with activity level; mean increase of 17.5 CPM [95% CI 1.5 to 34.0], P = 0.032, per 5-point increase in KCCQ-CSS. Associations were not modified by treatment allocation (interaction P-values > .05).
Conclusions
In patients with HFrEF, older age and anemia were independently associated with lower activity. Moreover, physical activity only weakly increased with better health status, suggesting that changes in physical activity reflect improvements in patients’ health status to a limited degree. This highlights the need to better understand the endpoint with regards to all other health parameters to ease interpretation in future HF trials.
期刊介绍：
The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.
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