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加速度计与射血分数保留的心力衰竭中其他活动测量指标的比较:VITALITY-HFpEF 试验。

Accelerometer vs. other activity measures in heart failure with preserved ejection fraction: the VITALITY-HFpEF trial.

机构信息

Baylor Scott and White Research Institute, Dallas, TX, USA.

University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

ESC Heart Fail. 2024 Feb;11(1):293-298. doi: 10.1002/ehf2.14572. Epub 2023 Nov 20.

Abstract

AIMS

The relationship between accelerometry data and changes in Kansas City Cardiomyopathy Questionnaire-Physical Limitation Score (KCCQ-PLS) or 6 min walk test (6MWT) is not well understood.

METHODS AND RESULTS

VITALITY-HFpEF accelerometry substudy (n = 69) data were assessed at baseline and 24 weeks. Ordinal logistic regression models were used to assess the association between accelerometry activity and deterioration, improved, or unchanged KCCQ-PLS (≥8.33 and ≤ -4.17 points) and 6MWT (≥32 vs. ≤ -32 m). KCCQ-PLS score deteriorated in 16 patients, improved in 34, and was unchanged in 19. 6MWT deteriorated in 8 patients, improved in 21, and was unchanged in 19. Mean accelerometer wear was 21.4 (±2.1) h/day. Changes in hours active from baseline to 24 weeks were not significantly different among patients who exhibited deterioration, improvement, or no change in KCCQ-PLS [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.71-1.18; P = 0.48] or 6MWT (OR 1.21, 95% CI 0.91-1.60; P = 0.18). Similar lack of association was observed for other accelerometry metrics and change in KCCQ and 6MWT. These findings were unaffected when KCCQ and 6MWT were examined as continuous variables.

CONCLUSIONS

Accelerometer-based activity measures did not correlate with subjective or objective standard measures of health status and functional capacity in heart failure with preserved ejection fraction. Further investigation of their relationships to clinical outcomes is required.

摘要

目的

加速度计数据与堪萨斯城心肌病问卷-体力限制评分(KCCQ-PLS)或 6 分钟步行试验(6MWT)变化之间的关系尚不清楚。

方法和结果

VITALITY-HFpEF 加速度计子研究(n=69)的数据在基线和 24 周时进行评估。使用有序逻辑回归模型评估加速度计活动与 KCCQ-PLS(≥8.33 和≤-4.17 分)和 6MWT(≥32 与≤-32 m)恶化、改善或不变之间的关联。16 名患者的 KCCQ-PLS 评分恶化,34 名患者改善,19 名患者不变。8 名患者的 6MWT 恶化,21 名患者改善,19 名患者不变。平均加速度计佩戴时间为 21.4(±2.1)小时/天。从基线到 24 周,在 KCCQ-PLS 显示恶化、改善或无变化的患者中,活动时间的变化与 6MWT 无显著差异[比值比(OR)0.91,95%置信区间(CI)0.71-1.18;P=0.48]。在 KCCQ 和 6MWT 作为连续变量检查时,也观察到其他加速度计指标和 KCCQ 和 6MWT 变化之间缺乏关联。这些发现不受影响。

结论

在射血分数保留的心力衰竭中,基于加速度计的活动测量与健康状况和功能能力的主观或客观标准测量没有相关性。需要进一步研究它们与临床结局的关系。

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Rationale and Design of the VITALITY-HFpEF Trial.VITALITY-HFpEF 试验的原理和设计。
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The Physical Activity Guidelines for Americans.美国人体育活动指南。
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