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. 2024 Nov 7.
doi: 10.1007/s00392-024-02564-6. Online ahead of print.

Association of daily physical activity with pulmonary artery pressure in HFpEF and HFmrEF NYHA class III patients: a pilot trial-feasibility and first results

Ester J Herrmann  1 , Denise Lange  2 , Jennifer Hannig  3 , Gina Zimmer  1 , Dimitri Gruen  4 , Till Keller  4   5 , Albin Edegran  6 , Linda S Johnson  7 , Samuel Sossalla  1   4   5 , Michael Guckert  2   3 , Birgit Assmus  8   9   10
Affiliations

Association of daily physical activity with pulmonary artery pressure in HFpEF and HFmrEF NYHA class III patients: a pilot trial-feasibility and first results

Ester J Herrmann et al. Clin Res Cardiol. .

Abstract

Introduction: Supervised physical exercise has been shown to benefit patients with heart failure with preserved/mildly reduced ejection fraction (HFpEF/HfmrEF) by improving symptoms and diastolic function. This study aimed to investigate the correlation between unsupervised daily physical activity and changes in daily pulmonary artery pressure (PAP) in patients with stable NYHA class III heart failure (HF) and left ventricular ejection fraction (LVEF) of 45% or higher.

Methods: Daily physical activity was monitored over a 3-month period using a Holter-ECG with an accelerometer that calculated an activity-associated, heart rate-derived metabolic equivalent of task (MET) score. PAP was measured using an implanted sensor in 17 patients.

Results: During 3 months of PAP monitoring in parallel with Holter ECG in our HF patients (median age 77 [IQR 72-79.5] years, LVEF 55 [49-56] %, mean cardiac index 1.9 ± 0.3), mean, diastolic, and systolic PAP remained unchanged. Patients engaged in unsupervised daily activity with a mean MET score of 5.0 ± 1.2 and a median daily duration of 41 [13-123] minutes. Intensity of daily activity was associated with a higher diastolic PAP on the following day (R2 = 0.017, p = 0.003), particularly in female patients and those with pulmonary hypertension (PH) (female: R2 = 0.044, p = 0.002; PH: R2 = 0.024, p = 0.004). Patients with longer daily activity durations had lower systolic and mean PAP (p = 0.038 and p = 0.048) and a similar diastolic PAP (p = 0.053) after 3 months.

Conclusions: Tracking changes in daily PAP based on intensity and duration of unsupervised daily activity using implanted sensors and a PocketECG® is feasible. While daily activity duration was not directly linked to diastolic PAP on the first day after daily activity, intensity, especially in female and PH patients, was associated with increased diastolic PAP. In addition, longer daily activity, rather than higher intensity, might be more important for lowering PAP in the long term. Further research in larger trials is warranted to confirm these findings.

Keywords: Daily activity; Heart failure with preserved ejection fraction; MET score; Pulmonary artery pressure.

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References

    1. Dunlay SM, Roger VL, Redfield MM (2017) Epidemiology of heart failure with preserved ejection fraction. Nat Rev Cardiol 14:591–602 - DOI - PubMed
    1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW (2020) Heart disease and stroke statistics—2020 update: a report from the american heart association. Circulation 141:e139–e596 - DOI - PubMed
    1. Pandey A, LaMonte M, Klein L, Ayers C, Psaty BM, Eaton CB, Allen NB, de Lemos JA, Carnethon M, Greenland P, Berry JD (2017) Relationship between physical activity, body mass index, and risk of heart failure. J Am Coll Cardiol 69:1129–1142 - DOI - PubMed - PMC
    1. Ho JE, Enserro D, Brouwers FP, Kizer JR, Shah SJ, Psaty BM, Bartz TM, Santhanakrishnan R, Lee DS, Chan C, Liu K, Blaha MJ, Hillege HL, Harst P van der, Gilst WH van, Kop WJ, Gansevoort RT, Vasan RS, Gardin JM, Levy D, Gottdiener JS, Boer RA de, Larson MG. Predicting Heart Failure With Preserved and Reduced Ejection Fraction: The International Collaboration on Heart Failure Subtypes. Circ Heart Fail 2016;9.
    1. Kitzman DW, Little WC, Brubaker PH, Anderson RT, Hundley WG, Marburger CT, Brosnihan B, Morgan TM, Stewart KP (2002) Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA 288:2144–2150 - DOI - PubMed

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