Abstract 15220: Accelerometer Measured Daily Activity in Heart Failure With Preserved Ejection Fraction: Clinical Correlates and Association With Standard Heart Failure Severity Indices
Introduction: Daily physical activity as assessed by patient worn accelerometers represents a novel endpoint for the evaluation of heart failure (HF) therapeutics. The clinical factors influencing daily activity and its association with standard measures of HF severity in HF with preserved ejection fraction (HFpEF) have not been described.
Hypothesis: Daily activity measures vary by patient characteristics and correlate with established measures of HF severity in patients with HFpEF.
Methods: In patients with HFpEF enrolled in the Nitrate’s Effects on Activity Tolerance in HFpEF (NEAT) trial, average daily accelerometer units (AAU) and hours active per day (HAPD) were assessed over a 14-day period prior to any intervention (baseline). NEAT enrolled stable (≥ 3 months since HF hospitalization) outpatients with NYHA class II-IV HFpEF.
Results: See Table. Baseline AAU was lower in older persons, women and obese persons. Adjusting for age, sex and body mass index, HFpEF patients with lower AAU were more likely to have a HF hospitalization 3-12 months prior to enrollment, diabetes, anemia, beta blocker use, orthopnea, NYHA class III/IV symptoms, worse KCCQ scores, lower six minute walk distance, higher NT-ProBNP, higher EF and more severe left atrial enlargement and concentric LV remodeling. AAU did not vary with baseline blood pressure, heart rate, race, coronary disease, depression, lung disease, renal function or other HF medication use. Findings were similar for HAPD.
Conclusions: Accelerometer assessed daily activity declines with age, female sex and obesity and reflects global clinical and HF specific functional status, severity of cardiac remodeling and comorbidity burden in HFpEF. These data endorse accelerometer assessed daily physical activity as a measure of both HF-related and global functional status in HFpEF and provide support for its use as a measure of the total clinical impact of therapeutic interventions in HFpEF.
Author Disclosures: D. Snipelisky: None. J. Kelly: None. J.A. Levine: None. G.A. Koepp: None. K.J. Anstrom: None. S.E. McNulty: None. R. Zakeri: None. G.M. Felker: None. A.F. Hernandez: None. E. Braunwald: None. M.M. Redfield: None.
- © 2016 by American Heart Association, Inc.