Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction: Clinical Correlates and Association with Standard Heart Failure Severity Indices

David Snipelisky, Jacob Kelly, James A. Levine, Gabriel A. Koepp, Kevin J. Anstrom, Steven E. McNulty, Rosita Zakeri, G. Michael Felker, Adrian F. Hernandez, Eugene Braunwald, Margaret M. Redfield

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background - Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and correlates with established measures of HF severity in HF with preserved ejection fraction. Methods and Results - In this ancillary study of the NEAT-HFpEF trial (Nitrate's Effects on Activity Tolerance in HF With Preserved Ejection Fraction), average daily accelerometer units (ADAU) and hours active per day were assessed during a 14-day period before starting isosorbide mononitrate or placebo (n=110). Baseline ADAU was negatively associated with age, female sex, height, and body mass index, and these variables accounted for 28% of the variability in ADAU (P<0.007 for all). Adjusting for these factors, patients with lower ADAU were more likely to have had an HF hospitalization, orthopnea, diabetes mellitus and anemia, be treated with β-blockers, have higher ejection fraction, relative wall thickness and left atrial volume, and worse New York Heart Association class, HF-specific quality of life scores, 6-minute walk distance, and NT-proBNP (N-terminal pro-B-type natriuretic peptide; P<0.05 for all). Associations between hours active per day and clinical characteristics were similar. Relative to baseline, there were no significant associations between changes in ADAU or hours active per day and changes in standard functional assessments (New York Heart Association, quality of life, 6-minute walk distance, and NT-proBNP) with isosorbide mononitrate. Conclusions - Daily activity is a measure of HF-related and global functional status in HF with preserved ejection fraction. As compared with intermittently assessed standard HF assessments, change in daily activity may provide unique information about the impact of HF interventions on functional status.

Original languageEnglish (US)
Article numbere003878
JournalCirculation: Heart Failure
Volume10
Issue number6
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

Fingerprint

Heart Failure
isosorbide-5-mononitrate
Quality of Life
Brain Natriuretic Peptide
Nitrates
Anemia
Diabetes Mellitus
Hospitalization
Body Mass Index
Placebos
Exercise

Keywords

  • anemia
  • body mass index
  • diabetes mellitus
  • functional capacity
  • heart failure
  • lifestyle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction : Clinical Correlates and Association with Standard Heart Failure Severity Indices. / Snipelisky, David; Kelly, Jacob; Levine, James A.; Koepp, Gabriel A.; Anstrom, Kevin J.; McNulty, Steven E.; Zakeri, Rosita; Michael Felker, G.; Hernandez, Adrian F.; Braunwald, Eugene; Redfield, Margaret M.

In: Circulation: Heart Failure, Vol. 10, No. 6, e003878, 01.06.2017.

Research output: Contribution to journalArticle

Snipelisky, D, Kelly, J, Levine, JA, Koepp, GA, Anstrom, KJ, McNulty, SE, Zakeri, R, Michael Felker, G, Hernandez, AF, Braunwald, E & Redfield, MM 2017, 'Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction: Clinical Correlates and Association with Standard Heart Failure Severity Indices', Circulation: Heart Failure, vol. 10, no. 6, e003878. https://doi.org/10.1161/CIRCHEARTFAILURE.117.003878
Snipelisky, David ; Kelly, Jacob ; Levine, James A. ; Koepp, Gabriel A. ; Anstrom, Kevin J. ; McNulty, Steven E. ; Zakeri, Rosita ; Michael Felker, G. ; Hernandez, Adrian F. ; Braunwald, Eugene ; Redfield, Margaret M. / Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction : Clinical Correlates and Association with Standard Heart Failure Severity Indices. In: Circulation: Heart Failure. 2017 ; Vol. 10, No. 6.
@article{7bfe370a7d144fae9964e2904ce3f593,
title = "Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction: Clinical Correlates and Association with Standard Heart Failure Severity Indices",
abstract = "Background - Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and correlates with established measures of HF severity in HF with preserved ejection fraction. Methods and Results - In this ancillary study of the NEAT-HFpEF trial (Nitrate's Effects on Activity Tolerance in HF With Preserved Ejection Fraction), average daily accelerometer units (ADAU) and hours active per day were assessed during a 14-day period before starting isosorbide mononitrate or placebo (n=110). Baseline ADAU was negatively associated with age, female sex, height, and body mass index, and these variables accounted for 28{\%} of the variability in ADAU (P<0.007 for all). Adjusting for these factors, patients with lower ADAU were more likely to have had an HF hospitalization, orthopnea, diabetes mellitus and anemia, be treated with β-blockers, have higher ejection fraction, relative wall thickness and left atrial volume, and worse New York Heart Association class, HF-specific quality of life scores, 6-minute walk distance, and NT-proBNP (N-terminal pro-B-type natriuretic peptide; P<0.05 for all). Associations between hours active per day and clinical characteristics were similar. Relative to baseline, there were no significant associations between changes in ADAU or hours active per day and changes in standard functional assessments (New York Heart Association, quality of life, 6-minute walk distance, and NT-proBNP) with isosorbide mononitrate. Conclusions - Daily activity is a measure of HF-related and global functional status in HF with preserved ejection fraction. As compared with intermittently assessed standard HF assessments, change in daily activity may provide unique information about the impact of HF interventions on functional status.",
keywords = "anemia, body mass index, diabetes mellitus, functional capacity, heart failure, lifestyle",
author = "David Snipelisky and Jacob Kelly and Levine, {James A.} and Koepp, {Gabriel A.} and Anstrom, {Kevin J.} and McNulty, {Steven E.} and Rosita Zakeri and {Michael Felker}, G. and Hernandez, {Adrian F.} and Eugene Braunwald and Redfield, {Margaret M.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1161/CIRCHEARTFAILURE.117.003878",
language = "English (US)",
volume = "10",
journal = "Circulation: Heart Failure",
issn = "1941-3297",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Accelerometer-Measured Daily Activity in Heart Failure with Preserved Ejection Fraction

T2 - Clinical Correlates and Association with Standard Heart Failure Severity Indices

AU - Snipelisky, David

AU - Kelly, Jacob

AU - Levine, James A.

AU - Koepp, Gabriel A.

AU - Anstrom, Kevin J.

AU - McNulty, Steven E.

AU - Zakeri, Rosita

AU - Michael Felker, G.

AU - Hernandez, Adrian F.

AU - Braunwald, Eugene

AU - Redfield, Margaret M.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background - Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and correlates with established measures of HF severity in HF with preserved ejection fraction. Methods and Results - In this ancillary study of the NEAT-HFpEF trial (Nitrate's Effects on Activity Tolerance in HF With Preserved Ejection Fraction), average daily accelerometer units (ADAU) and hours active per day were assessed during a 14-day period before starting isosorbide mononitrate or placebo (n=110). Baseline ADAU was negatively associated with age, female sex, height, and body mass index, and these variables accounted for 28% of the variability in ADAU (P<0.007 for all). Adjusting for these factors, patients with lower ADAU were more likely to have had an HF hospitalization, orthopnea, diabetes mellitus and anemia, be treated with β-blockers, have higher ejection fraction, relative wall thickness and left atrial volume, and worse New York Heart Association class, HF-specific quality of life scores, 6-minute walk distance, and NT-proBNP (N-terminal pro-B-type natriuretic peptide; P<0.05 for all). Associations between hours active per day and clinical characteristics were similar. Relative to baseline, there were no significant associations between changes in ADAU or hours active per day and changes in standard functional assessments (New York Heart Association, quality of life, 6-minute walk distance, and NT-proBNP) with isosorbide mononitrate. Conclusions - Daily activity is a measure of HF-related and global functional status in HF with preserved ejection fraction. As compared with intermittently assessed standard HF assessments, change in daily activity may provide unique information about the impact of HF interventions on functional status.

AB - Background - Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and correlates with established measures of HF severity in HF with preserved ejection fraction. Methods and Results - In this ancillary study of the NEAT-HFpEF trial (Nitrate's Effects on Activity Tolerance in HF With Preserved Ejection Fraction), average daily accelerometer units (ADAU) and hours active per day were assessed during a 14-day period before starting isosorbide mononitrate or placebo (n=110). Baseline ADAU was negatively associated with age, female sex, height, and body mass index, and these variables accounted for 28% of the variability in ADAU (P<0.007 for all). Adjusting for these factors, patients with lower ADAU were more likely to have had an HF hospitalization, orthopnea, diabetes mellitus and anemia, be treated with β-blockers, have higher ejection fraction, relative wall thickness and left atrial volume, and worse New York Heart Association class, HF-specific quality of life scores, 6-minute walk distance, and NT-proBNP (N-terminal pro-B-type natriuretic peptide; P<0.05 for all). Associations between hours active per day and clinical characteristics were similar. Relative to baseline, there were no significant associations between changes in ADAU or hours active per day and changes in standard functional assessments (New York Heart Association, quality of life, 6-minute walk distance, and NT-proBNP) with isosorbide mononitrate. Conclusions - Daily activity is a measure of HF-related and global functional status in HF with preserved ejection fraction. As compared with intermittently assessed standard HF assessments, change in daily activity may provide unique information about the impact of HF interventions on functional status.

KW - anemia

KW - body mass index

KW - diabetes mellitus

KW - functional capacity

KW - heart failure

KW - lifestyle

UR - http://www.scopus.com/inward/record.url?scp=85021073894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021073894&partnerID=8YFLogxK

U2 - 10.1161/CIRCHEARTFAILURE.117.003878

DO - 10.1161/CIRCHEARTFAILURE.117.003878

M3 - Article

C2 - 28588021

AN - SCOPUS:85021073894

VL - 10

JO - Circulation: Heart Failure

JF - Circulation: Heart Failure

SN - 1941-3297

IS - 6

M1 - e003878

ER -