Lachant Daniel, Gagermeier James, Seaman Scott, Wang Andrew, Broderick Meredith, White R James
Pulmonary & Critical Care Medicine, University of Rochester Medical Center, Rochester, New York.
Department of Medicine, Loyola University Medical Center, Maywood, Illinois.
JHLT Open. 2025 Jan 23;8:100219. doi: 10.1016/j.jhlto.2025.100219. eCollection 2025 May.
Pulmonary arterial hypertension (PAH) patients have low activity time. Actigraphy provides an objective quantification of movement outside of clinic visits (home, work, social activities). Summary actigraphy measures (total daily steps or activity time) have not been shown to increase after adding therapies in patients with PAH. We developed a novel treatment responsive metric, Peak Steps, to measure the 'capacity for movement' in patients with PAH. Using data from the ADAPT registry (NCT03045029), we calculated Peak Steps and used summary actigraphy measurements and correlated it with six-minute walk distance (6MWD) and emPHasis-10 quality of life scores. After exposure to oral treprostinil, we observed a significant increase in Peak Steps, but no change in total daily steps or activity time. Peak Steps correlated strongly with 6MWD and emPHasis-10 scores. We propose that Peak Steps is a more sensitive marker of treatment response than traditional actigraphy parameters, which can have large behavioral influences.
肺动脉高压（PAH）患者的活动时间较短。活动记录仪可客观量化门诊就诊之外（家庭、工作、社交活动）的运动量。在PAH患者中，添加治疗后，活动记录仪的汇总测量值（每日总步数或活动时间）并未显示增加。我们开发了一种新的治疗反应指标——峰值步数，以测量PAH患者的“运动能力”。利用ADAPT注册研究（NCT03045029）的数据，我们计算了峰值步数，并使用活动记录仪的汇总测量值，将其与6分钟步行距离（6MWD）和emPHasis - 10生活质量评分进行关联。在接受口服曲前列尼尔治疗后，我们观察到峰值步数显著增加，但每日总步数或活动时间没有变化。峰值步数与6MWD和emPHasis - 10评分密切相关。我们认为，与传统的活动记录仪参数相比，峰值步数是治疗反应更敏感的指标，传统参数可能受到较大行为因素的影响。
