scholarly journals Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial

10.2196/20776 ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. e20776
Author(s):  
Josefine Dam Gade ◽  
Helle Spindler ◽  
Malene Hollingdal ◽  
Jens Refsgaard ◽  
Lars Dittmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Controlled Trial ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
Activity Data ◽  
Step Counter ◽  
Mortality And Morbidity ◽  
Nyha Classification ◽  
Walking Activity

Background Physical activity has been shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for patients with heart failure (HF). A step counter, measuring daily walking activity, might be a motivational factor for increased activity. Objective The aim of this study was to examine the association between walking activity and demographical and clinical data of patients with HF, and whether these associations could be used as predictors of walking activity. Methods A total of 65 patients with HF from the Future Patient Telerehabilitation (FPT) program were included in this study. The patients monitored their daily activity using a Fitbit step counter for 1 year. This monitoring allowed for continuous and safe data transmission of self-monitored activity data. Results A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher ejection fraction (EF). There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline (P=.01), between the increase in daily steps and EF at baseline (P<.001), and between the increase in daily steps and improvement in EF (P=.005). The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps. Conclusions This study demonstrated an association between demographic, clinical, and activity data for patients with HF that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity. Trial Registration ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918 International Registered Report Identifier (IRRID) RR2-10.2196/14517

scholarly journals Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Josefine Dam Gade ◽  
Helle Spindler ◽  
Malene Hollingdal ◽  
Jens Refsgaard ◽  
Lars Dittmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Controlled Trial ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
Activity Data ◽  
Step Counter ◽  
Mortality And Morbidity ◽  
Nyha Classification ◽  
Walking Activity

BACKGROUND Physical activity has been shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for patients with heart failure (HF). A step counter, measuring daily walking activity, might be a motivational factor for increased activity. OBJECTIVE The aim of this study was to examine the association between walking activity and demographical and clinical data of patients with HF, and whether these associations could be used as predictors of walking activity. METHODS A total of 65 patients with HF from the Future Patient Telerehabilitation (FPT) program were included in this study. The patients monitored their daily activity using a Fitbit step counter for 1 year. This monitoring allowed for continuous and safe data transmission of self-monitored activity data. RESULTS A higher walking activity was associated with younger age, lower New York Heart Association (NYHA) classification, and higher ejection fraction (EF). There was a statistically significant correlation between the number of daily steps and NYHA classification at baseline (<i>P</i>=.01), between the increase in daily steps and EF at baseline (<i>P</i>&lt;.001), and between the increase in daily steps and improvement in EF (<i>P</i>=.005). The patients’ demographic, clinical, and activity data could predict 81% of the variation in daily steps. CONCLUSIONS This study demonstrated an association between demographic, clinical, and activity data for patients with HF that could predict daily steps. A step counter can thus be a useful tool to help patients monitor their own physical activity. CLINICALTRIAL ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918 INTERNATIONAL REGISTERED REPORT RR2-10.2196/14517

scholarly journals Effect of ferric-carboxy maltose on oxygen kinetics and functional status in heart failure patients with iron deficiency

2020 ◽  
Vol 6 (5) ◽  
pp. FSO467
Author(s):  
Sandip Dhoot ◽  
Sanjay Mittal ◽  
Simar Pal Singh ◽  
Vishal Patel ◽  
Ravi R Kasliwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Iron Deficiency ◽  
Controlled Trial ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
Standard Of Care ◽  
Deficiency Anemia ◽  
Care Group ◽  
Test Distance

There is a very high prevalence of iron deficiency anemia in patients with systolic heart failure. The present study is a prospective, parallel, 1:1 randomized controlled trial of intravenous ferric-carboxy maltose compared with standard of care in patients with heart failure. A total of 70 patients who presented to us with symptomatic chronic heart failure were included and randomly assigned to either groups (35 per group). Post 12 weeks, there were improvements noticed in peak VO2, New York Heart Association functional classification, 6-min walk test distance covered and reduction in Minnesota Living with Heart Failure Questionnaire score in the ferric-carboxy maltose as compared with standard of care group. However, no improvement in ejection fraction was noticed.

scholarly journals Lockdown, slow down: impact of the COVID-19 pandemic on physical activity—an observational study

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001600
Author(s):  
Joanne Kathryn Taylor ◽  
Haarith Ndiaye ◽  
Matthew Daniels ◽  
Fozia Ahmed
Keyword(s):  
Physical Activity ◽  
New York ◽  
Heart Association ◽  
Evaluation Study ◽  
Activity Data ◽  
Cardiac Devices ◽  
Significant Difference ◽  
New York Heart Association ◽  
Using Data ◽  
The Uk

AimsIn response to the COVID-19 pandemic, the UK was placed under strict lockdown measures on 23 March 2020. The aim of this study was to quantify the effects on physical activity (PA) levels using data from the prospective Triage-HF Plus Evaluation study.MethodsThis study represents a cohort of adult patients with implanted cardiac devices capable of measuring activity by embedded accelerometery via a remote monitoring platform. Activity data were available for the 4 weeks pre-implementation and post implementation of ‘stay at home’ lockdown measures in the form of ‘minutes active per day’ (min/day).ResultsData were analysed for 311 patients (77.2% men, mean age 68.8, frailty 55.9%. 92.2% established heart failure (HF) diagnosis, of these 51.2% New York Heart Association II), with comorbidities representative of a real-world cohort.Post-lockdown, a significant reduction in median PA equating to 20.8 active min/day was seen. The reduction was uniform with a slightly more pronounced drop in PA for women, but no statistically significant difference with respect to age, body mass index, frailty or device type. Activity dropped in the immediate 2-week period post-lockdown, but steadily returned thereafter. Median activity week 4 weeks post-lockdown remained significantly lower than 4 weeks pre-lockdown (p≤0.001).ConclusionsIn a population of predominantly HF patients with cardiac devices, activity reduced by approximately 20 min active per day in the immediate aftermath of strict COVID-19 lockdown measures.Trial registration numberNCT04177199.

Revisiting heart failure assessment based on objective measures in NYHA functional classes I and II

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317984
Author(s):  
Mariana Blacher ◽  
André Zimerman ◽  
Pedro H B Engster ◽  
Eduardo Grespan ◽  
Carisi A Polanczyk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Heart Association ◽  
Functional Class ◽  
Class I ◽  
Objective Measures ◽  
Functional Evaluation ◽  
Self Perception ◽  
Reduced Ejection Fraction ◽  
Nyha Classification

ObjectiveNew York Heart Association (NYHA) functional class plays a central role in heart failure (HF) assessment but might be unreliable in mild presentations. We compared objective measures of HF functional evaluation between patients classified as NYHA I and II in the Rede Brasileira de Estudos em Insuficiência Cardíaca (ReBIC)-1 Trial.MethodsThe ReBIC-1 Trial included outpatients with stable HF with reduced ejection fraction. All patients had simultaneous protocol-defined assessment of NYHA class, 6 min walk test (6MWT), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and patient’s self-perception of dyspnoea using a Visual Analogue Scale (VAS, range 0–100).ResultsOf 188 included patients with HF, 122 (65%) were classified as NYHA I and 66 (35%) as NYHA II at baseline. Although NYHA class I patients had lower dyspnoea VAS Scores (median 16 (IQR, 4–30) for class I vs 27.5 (11–49) for class II, p=0.001), overlap between classes was substantial (density overlap=60%). A similar profile was observed for NT-proBNP levels (620 pg/mL (248–1333) vs 778 (421–1737), p=0.015; overlap=78%) and for 6MWT distance (400 m (330–466) vs 351 m (286–408), p=0.028; overlap=64%). Among NYHA class I patients, 19%–34% had one marker of HF severity (VAS Score >30 points, 6MWT <300 m or NT-proBNP levels >1000 pg/mL) and 6%–10% had two of them. Temporal change in functional class was not accompanied by variation on dyspnoea VAS (p=0.14).ConclusionsMost patients classified as NYHA classes I and II had similar self-perception of their limitation, objective physical capabilities and levels of natriuretic peptides. These results suggest the NYHA classification poorly discriminates patients with mild HF.

“I Can’t Go Far”: Perceptions and Experiences of Heart Failure Patients Regarding Physical Activity: A Qualitative Study Using Semistructured Face-to-Face Interviews

2021 ◽  
pp. 109019812110532
Author(s):  
Elodie Charuel ◽  
Martial Bernard ◽  
Hélène Vaillant Roussel ◽  
Benoit Cambon ◽  
Thibault Ménini ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
New York ◽  
General Practitioner ◽  
Qualitative Study ◽  
Heart Association ◽  
Enabling Factors ◽  
Face To Face ◽  
New York Heart Association

Background Participation in regular physical activity (RPA) is beneficial to the quality of life and life expectancy of patients with chronic heart failure (CHF). However, it is inadequate in many patients. Aims To determine the factors that influence the practice of RPA in patients with CHF managed in general practice. Method This was a qualitative study using semistructured, individual face-to-face interviews. Patients with CHF (New York Heart Association Stages 1–3) capable of participating in RPA were enrolled by their general practitioner. A longitudinal and transversal inductive thematic analysis was performed by two researchers. Results Five themes emerged from the 19 interviews that were conducted. Poor knowledge of the disease and the benefits of participating in RPA, as well as the lack of motivation or enjoyment, in particular due to the absence of previous participation, were considered significant obstacles. Fear associated with CHF or other comorbidities was also an obstacle. Attendance at a rehabilitation center, family and social circles, and having a pet all appeared to be beneficial. Family and friends were important for motivating the patient to participate in an activity but could also be an obstacle when they were overprotective. Conclusion This study helps highlight the difficulties for patients with CHF associated with participation in RPA. Despite the obstacles, there are enabling factors on which the general practitioner may rely to motivate their patients.

Abstract 216: Left Ventricular Enlargement and Heart Failure Events: Is Bigger Better?

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Farbod Raiszadeh ◽  
Neeraja Yedlapati ◽  
Ileana L Piña ◽  
Daniel M Spevack
Keyword(s):  
Heart Failure ◽  
New York ◽  
Cox Regression ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
Left Ventricular ◽  
Left Ventricular Volumes ◽  
End Diastolic Volume ◽  
New York Heart Association ◽  
The Individual

Background: Since stroke volume (SV) is a function of ejection fraction (EF) and end-diastolic volume (EDV) (SV = EF x EDV), we hypothesized that increased EDV may be advantageous in systolic heart failure (HF), allowing the left ventricle to supply increased cardiac output. Methods: Echocardiograms from 968 consecutive patients seen in our hospital’s HF clinic were reviewed. Left ventricular volumes were measured both at end systole and end diastole using the bi-plane Simpson’s method and were indexed to body surface area. EF was calculated using (EDV-ESV)/EDV. Dates of subsequent HF events (death or admission for HF exacerbation) were obtained from our database. Results: Systolic HF (EF < 50%) was found in 649 of the study subjects. Increased SV index was associated with increased EDV index. The strength of this association varied with EF, Figure. In a bivariate Cox regression model, lower SV index and higher EDV index were each independent predictors of HF events. Increase in EDV by 50 cc was associated with a 20% increase in HF events, p<0.001. Decrease in SVI by 5 cc was associated with 5% increase in HF events, p<0.001. These associations were limited to those with systolic HF. The associations between both EDVI and SVI and HF events were not confounded by patient age, sex and New York Heart Association Class. Conclusion: Increased EDV index was independently associated with increased HF events, indicating that LV enlargement in HF is not favorable. These findings underscore the individual contributions of the components of EF (SV and EDV) in predicting HF outcomes.

scholarly journals Impact of CardioMEMS device placement on lifestyle modifications: a “pseudo-placebo” effect beyond the expected?

2018 ◽  
Vol 46 (8) ◽  
pp. 3195-3199 ◽  
Author(s):  
Mahmoud Assaad ◽  
Robby Singh ◽  
Sinan Sarsam ◽  
Abbie Bowen ◽  
Marcel Zughaib
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Placebo Effect ◽  
The United States ◽  
Medication Regimen ◽  
Lifestyle Modifications ◽  
Mortality And Morbidity ◽  
Device Placement ◽  
Cardiac Medication

Introduction Congestive heart failure is a leading cause of cardiovascular mortality and morbidity in the United States and places a significant economic burden on the health care system. The CHAMPION trial showed significant reductions in heart failure hospitalizations and length of stay as well as improvements in quality of life among patients who underwent implantation of the CardioMEMS device (CardioMEMS Inc., Atlanta, GA, USA). While the benefits of the device have been well demonstrated, we explored the “pseudo-placebo” effect of device placement on patients’ lifestyle modifications. Methods Thirty patients with the CardioMEMS device were contacted for a follow-up survey that included questions about lifestyle modifications, symptomatic and dietary improvement, increased physical activity, and changes in their cardiac medication regimen. Results Dyspnea improved in 57% of patients, 70% of patients improved their diet, and 43% increased their physical activity. Only 7% of patients found it difficult to transmit the data. Discussion The CHAMPION trial showed numerous benefits for patients who underwent CardioMEMS device placement. In our study, we found that device placement also resulted in a “pseudo-placebo” effect with most patients making positive lifestyle modifications.

Abstract 16124: Implantable Cardioverter Defibrillators in Patients With Hereditary Transthyretin Cardiac Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sreeram Yalamanchili ◽  
Matthew T Brown ◽  
Evan A Blank ◽  
Melissa A Lyle ◽  
Kunal N Bhatt
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Cardiac Amyloidosis ◽  
Clinical Decision Making ◽  
Systolic Heart Failure ◽  
Heart Association ◽  
High Rate ◽  
Implantable Cardioverter Defibrillators ◽  
Antitachycardia Pacing ◽  
Icd Implantation

Introduction: Implantable cardioverter defibrillator (ICD) implantation in patients with cardiac amyloidosis is controversial, with no clear guidelines for clinical decision-making.. The role of ICD implantation in hereditary Transthyretin Amyloid Cardiomyopathy (hATTR-CM) is unclear. We sought to establish the burden of ventricular arrhythmias and the outcomes of ICD implantation in a single center cohort of hATTR-CM patients. Methods: A total of 69 patients with a confirmed diagnosis of hATTR-CM from genetic testing, and technetium pyrophosphate (PYP) scanning, or endomyocardial biopsy underwent retrospective chart review for demographic, clinical, and arrhythmia data. Results: Seventy-four percent of the cohort was male, with a mean age at diagnosis of 68 (SD=18 years). Sixty-five patients (94.2%) patients were African-American; all of whom carried the Valine 122 Isoleucine mutation. Most had systolic heart failure (New York Heart Association Staging II [18, 26%] and III [40, 58.8%]); 37 (54%) patients had an LVEF ≤ 35%. Thirty-six (52.2%) patients had documented episodes of non-sustained ventricular tachycardia (NSVT), three (4.3%) with ventricular tachycardia (VT), and one (1.5%) with ventricular fibrillation (VF). A total of 15 (21.7%) patients had ICDs placed for prevention of sudden cardiac death in the setting of low LVEF (EF <35%). All recorded VT/VF episodes occurred in three patients with ICDs. Of these patients, one experienced two episodes of VT each successfully abated by antitachycardia pacing (ATP), another experienced a single episode of VT abated by ATP, while the final experienced VF with successful 36J shock as well as two episodes of VT each successfully treated with 36J shocks. No inappropriate ICD shocks were delivered, however, there were two instances of ATP for inappropriately detected atrial arrhythmias. Conclusions: In a cohort of patients with hATTR-CM, we observed a high incidence of NSVT, yet only 41% of patients with severe systolic heart failure had ICDs implanted. A high rate of successful defibrillation and no inappropriate ICD shocks were noted, suggesting that ICDs should be strongly considered, and may be underutilized, in patients with systolic heart failure and/or arrhythmias in the setting of hATTR-CM.

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