O'Donnell Johanna, Smith-Byrne Karl, Velardo Carmelo, Conrad Nathalie, Salimi-Khorshidi Gholamreza, Doherty Aiden, Dwyer Terence, Tarassenko Lionel, Rahimi Kazem
George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK.
Institute of Biomedical Engineering, University of Oxford, Oxford, UK.
Open Heart. 2020 Feb 19;7(1):e001099. doi: 10.1136/openhrt-2019-001099. eCollection 2020.
The impact of heart failure (HF) on perceived and objectively measured levels of physical activity (PA) can inform risk stratification and treatment recommendation. We aimed to compare self-reported and objectively measured PA levels in a large sample of participants with and without HF.
A validated PA questionnaire was used to estimate self-reported weekly PA among 1600 participants with HF and 387 580 participants without HF. Accelerometer data were studied in 596 participants with HF and 96 105 participants without HF for a period of 7 days. Using multivariable linear regression models, we compared the PA levels between participants with HF and without HF, focusing on both the average daily PA levels and the intensity of PAs throughout the day.
PA levels were significantly lower in participants with HF using both self-report (excess metabolic equivalent of task hours per week of 26.5 (95% CI 24.7 to 28.4) vs 34.7 (95% CI 34.5 to 34.9), respectively (p<0.001)) and accelerometer measures (mean accelerations of 23.7 milligravity (95% CI 23.1 to 24.4) vs 28.1 milligravity (95% CI 28.0 to 28.1), respectively (p<0.001)). Findings were consistent across different PA intensities. Hour-by-hour comparisons showed that accelerometer-derived PA levels of patients with HF were reduced throughout the day.
Perceived and objectively recorded PA levels of patients with chronic HF are significantly lower than those of individuals without HF. This difference is continuous throughout the different hours of the day, with individuals with HF being on average 16% less active than individuals without HF. In patients with HF, increases in everyday activity may be a potential alternative to structured exercise programmes.
心力衰竭(HF)对主观感受的和客观测量的身体活动(PA)水平的影响可为风险分层和治疗建议提供依据。我们旨在比较大量有和没有HF的参与者的自我报告的和客观测量的PA水平。
使用经过验证的PA问卷来估计1600名有HF的参与者和387580名没有HF的参与者每周自我报告的PA。对596名有HF的参与者和96105名没有HF的参与者的加速度计数据进行了为期7天的研究。使用多变量线性回归模型,我们比较了有HF和没有HF的参与者之间的PA水平,重点关注平均每日PA水平和全天PA的强度。
使用自我报告(每周代谢当量任务小时数分别为26.5(95%CI 24.7至28.4)对34.7(95%CI 34.5至34.9),p<0.001)和加速度计测量(平均加速度分别为23.7毫重力(95%CI 23.1至24.4)对28.1毫重力(95%CI 28.0至28.1),p<0.001),有HF的参与者的PA水平显著较低。在不同的PA强度下结果一致。逐小时比较显示,HF患者通过加速度计得出的PA水平全天都较低。
慢性HF患者主观感受的和客观记录的PA水平显著低于没有HF的个体。这种差异在一天中的不同时间持续存在,HF患者的活动量平均比没有HF的个体少16%。在HF患者中,增加日常活动可能是结构化运动计划的一种潜在替代方案。