Device-Measured Physical Activity Versus Six-Minute Walk Test as a Predictor of Reverse Remodeling and Outcome After Cardiac Resynchronization Therapy for Heart Failure

Implanted devices can provide objective assessment of physical activity over prolonged periods. The purpose of this study was to investigate the prognostic value of device-measured physical activity data compared with a six-minute walk test (6MWT) in predicting clinical response to cardiac resynchro...

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Bibliographic Details
Published in:The American journal of cardiology 2014-05, Vol.113 (9), p.1523-1528
Main Authors: Vegh, Eszter Maria, MD, Kandala, Jagdesh, MD, MPH, Orencole, Mary, ANP, Upadhyay, Gaurav A., MD, Sharma, Ajay, MD, Miller, Alexandra, BA, Merkely, Bela, MD, PhD, DSc, Parks, Kimberly A., DO, Singh, Jagmeet P., MD, DPhil
Format: Article
Language:English
Subjects:
Aged
Cardiac Resynchronization Therapy
Cardiovascular
Echocardiography
Female
Forecasting - methods
Heart failure
Heart Failure - physiopathology
Heart Failure - therapy
Hospitalization
Humans
Male
Medical equipment
Mortality
Motor Activity
Multivariate analysis
Studies
Transplants & implants
Treatment Outcome
Variables
Ventricular Function, Left
Ventricular Remodeling
Walking
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Summary:Implanted devices can provide objective assessment of physical activity over prolonged periods. The purpose of this study was to investigate the prognostic value of device-measured physical activity data compared with a six-minute walk test (6MWT) in predicting clinical response to cardiac resynchronization therapy (CRT). This was a single-center study in which patients who underwent CRT for standard indications were evaluated. Daily physical activity and 6MWT were evaluated postimplant at 1, 3, and 6 months. The primary end point was a composite of heart failure hospitalization, transplant, left ventricular (LV) assist device, and all-cause death at 3 years. Echocardiographic response, defined as a ≥10% improvement in LV ejection fraction (LVEF), at 6 months was the secondary end point. About 164 patients were included: average age was 67.3 ± 12.9 years, 77% were men, baseline LVEF was 25% ± 7%. Kaplan-Meier curves showed superior freedom from the composite end point in the highest tertile of both 6MWT and physical activity compared with the lowest tertile (41 vs 23 cases, respectively, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2014.01.430