Wearable Accelerometer-Derived Measures of Physical Activity in Heart Failure: Insights From the DETERMINE trials.

Autor: Docherty KF; BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK., Buendia Lopez R; Data Science, Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden., Folkvaljon F; HTA Statistics & Data Science, Biopharmaceuticals BBU, AstraZeneca, Barcelona, Spain., Boer RA; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands., Chen J; AstraZeneca BioPharmaceuticals Research & Development, Late-stage Development, Cardiovascular, Renal and Metabolic, Gaithersburg, MD, USA., Hammarstedt A; Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals Research & Development, AstraZeneca, Gothenburg, Sweden., Kitzman DW; Sections on Cardiovascular Medicine and Geriatrics/Gerontology, Wake Forest University School of Medicine, Winston-Salem, NC, USA., Kosiborod MN; Saint Luke's Mid America Heart Institute, University of Missouri, Kansas City, MO, USA., Langkilde AM; Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals Research & Development, AstraZeneca, Gothenburg, Sweden., Reicher B; AstraZeneca BioPharmaceuticals Research & Development, Late-stage Development, Cardiovascular, Renal and Metabolic, Gaithersburg, MD, USA., Senni M; University of Milano-Bicocca, Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy., Wilderäng U; Late Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals Research & Development, AstraZeneca, Gothenburg, Sweden., Verma S; Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Cowie MR; Late-Stage Development, Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca, Boston, MA, USA., Solomon SD; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA., McMurray JJV; BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. Electronic address: john.mcmurray@glasgow.ac.uk.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2024 Nov 26. Date of Electronic Publication: 2024 Nov 26.
DOI: 10.1016/j.cardfail.2024.10.439
Abstrakt: Introduction: Wearable accelerometers allow continuous assessment of physical activity during normal living conditions and may be useful in evaluating the effects of treatment for heart failure. We explored the relationships between accelerometer measures of physical activity and 6-minute walk distance and patient-reported measures of functional limitation in participants across the entire spectrum of left ventricular ejection fraction in the DETERMINE (Dapagliflozin EffecT on ExeRcise capacity using a 6-MINutE walk test in patients with heart failure) trials.
Methods: A subgroup of patients in the DETERMINE trials wore a waist-based accelerometer during 7-day periods at 3 points during the trial: between screening and randomization and during weeks 8 and 14. Patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ) and 6-minute walk distance (6MWD) at baseline and at weeks 8 and 16.
Results: Of the 817 patients randomized, 319 (39%) had adequate baseline accelerometer data. Patients with lower levels of physical activity had lower (ie, worse) KCCQ scores and 6MWD, higher NT-proBNP levels and BMIs, worse kidney function, and a greater likelihood of diabetes and atrial fibrillation. Baseline accelerometer values had weak correlations with KCCQ summary scores (Pearson r = 0.06-0.21) and weak to moderate correlations with 6MWD (Pearson r = 0.20-0.31). The change from baseline to 16 weeks in accelerometer-measured physical activity correlated weakly with the change in KCCQ summary scores (Pearson r = 0-0.18) and 6MWD (r = 0.01-0.10).
Conclusions: In the DETERMINE trials, accelerometer-based measures of physical activity correlated modestly with KCCQ summary scores and 6MWD. Accelerometer-based assessments of physical activity may provide additional information complementing that obtained from standard measures of functional limitation in patients with heart failure.
Competing Interests: Disclosures KFD reports that his employer, the University of Glasgow, has been remunerated by AstraZeneca for work relating to clinical trials. He has received speaker's honoraria from AstraZeneca, Pharmacosmos, Boehringer Ingelheim, Translational Medicine Academy and Radcliffe Cardiology, has served on an advisory board for Us2.ai and holds equity in the company, has served on an advisory board and served on a clinical endpoint committee for Bayer AG, and has received grant support from Boehringer Ingelheim, Roche Diagnostics and AstraZeneca (paid to his institution). RBL, FF, JC, AH, AML, BR, UW and MRC are employees of AstraZeneca and may own stock or stock options. RAB has had speaker engagements with and/or received fees from and/or served on advisory boards for Abbott, AstraZeneca, Bristol Myers Squibb, Cardior Pharmaceuticals, NovoNordisk, and Roche, and has received travel support from Abbott, Cardior Cardior Pharmaceuticals, and NovoNordisk. The institution of RAB has received research grants and/or fees from AstraZeneca, Abbott, Boehringer Ingelheim, Cardior Pharmaceuticals, Novo Nordisk, and Roche. DWK has been a consultant for AstraZeneca, Pfizer, Corvia Medical, Bayer, Boehringer-Ingleheim, NovoNorDisk, Rivus, and St. Luke's Medical Center, has received grant support from Novartis, AstraZeneca, Bayer, Pfizer, Novo NorDisk, Rivus, and St. Luke's Medical Center, and owns stock in Gilead Sciences. MNK has received research grant support from AstraZeneca and Boehringer Ingelheim‚ has served as a consultant or on an advisory board for Amgen, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Esperion Therapeutics, Janssen, Merck (Diabetes and Cardiovascular), Novo Nordisk, Sanofi, and Vifor Pharma‚ has received other research support from AstraZeneca‚ and has received honoraria from AstraZeneca, Boehringer Ingelheim, and Novo Nordisk. MS has received honoraria and/or consulting fees from Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Merck, MSD, Novartis, Novo Nordisk, and Vifor. SV holds a Tier 1 Canada Research Chair in Cardiovascular Surgery; and reports receiving grants and/or research support and/or speaking honoraria from Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Canadian Medical and Surgical Knowledge Translation Research Group, Eli Lilly, HLS Therapeutics, Humber River Health, Janssen, Merck, Novartis, Novo Nordisk, Pfizer, PhaseBio, S & L Solutions Event Management, and Sanofi. SDS has received research grants from Actelion, Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, Bristol Myers Squibb, Celladon, Cytokinetics, Eidos, Gilead, GlaxoSmithKline, Ionis, Lilly, Mesoblast, MyoKardia, National Institutes of Health/National Heart‚ Lung‚ and Blood Institute, Neurotronik, Novartis, NovoNordisk, Respicardia, Sanofi Pasteur, Theracos, and US2.AI and has consulted for Abbott, Action, Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi-Sankyo, GlaxoSmithKline, Lilly, Merck, Myokardia, Novartis, Roche, Theracos, Quantum Genomics, Cardurion, Janssen, Cardiac Dimensions, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, and Sarepta. JJVM reports receiving support from a British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217 and the Vera Melrose Heart Failure Research Fund; has received payments through Glasgow University for work on clinical trials, consulting and other activities from Amgen, AstraZeneca, Bayer, Cardurion, Cytokinetics, GlaxoSmithKline, KBP Biosciences and Novartis; has received personal consulting fees from Alnylam Pharma, Bayer, Bristol Myers Squibb, George Clinical PTY Ltd, Ionis Pharma, Novartis, Regeneron Pharma, and River 2 Renal; has received personal lecture fees from Abbott, Alkem Metabolics, AstraZeneca, Blue Ocean Scientific Solutions, Boehringer Ingelheim, Canadian Medical and Surgical Knowledge, Emcure Pharma, Eris Lifesciences, European Academy of CME, Hikma Pharmaceuticals, Imagica Health, Intas Pharma, J.B. Chemicals and Pharma, Lupin Pharma, Medscape/Heart.Org, ProAdWise Communications, Radcliffe Cardiology, SunPharma, The Corpus, Translation Research Group, and Translational Medicine Academy; and is a director of Global Clinical Trial Partners.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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