Heart Failure Symptoms Improve With More Intense Physical Activity.

Background: Little is known about how changes in physical activity (PA) over time may influence symptoms in people with heart failure (HF).

Methods: A secondary analysis was conducted with data from an RCT of an exercise intervention in patients with ICDs (implantable cardioverter defibrillator) and a HF diagnosis (n = 96). Data were collected at baseline and 2 months of PA intervention. Physical activity (PA Steps = mean steps/day; PA Intensity = mean steps/min for most intense 30 minutes/day) were measured over 5 days at each timepoint. Physical symptoms were measured using the Patient Concerns Assessment, the SF-36 Vitality, and Bodily Pain subscales for fatigue and pain. Psychological symptoms were assessed using the Patient Health Questionnaire-9, and the State-Trait Anxiety Index. Associations between PA and physical and psychological symptoms were analyzed with multivariate regression.

Results: Patients (n = 96) were predominately male (83%) and Caucasian (79%), aged 55.8 ± 12.3 years, BMI of 29.7 ± 5.1, with heart failure with reduced ejection fraction (HFrEF; 30.9 ± 9.9%). An increase in PA Steps was associated with improvement in anxiety (β = -1.178, p = .048). An increase in PA Intensity was associated with significant reductions in depression (β = -0.127, p = .021), anxiety (β = -0.234, p = .037), and fatigue (β = 0.528, p = .022). Decreases in PA Steps and PA Intensity were not associated with changes in any symptoms.

Conclusion: For HF patients with an ICD, more intense PA over 2 months was associated with improved psychological symptoms and reduced fatigue. Decreases in PA (total and intensity) were not associated with changes in symptoms. Interventions promoting increasing the intensity of PA over time may be an effective approach to reduce some HF symptoms.