SPC365

Physical activity and heart failure: a forgotten indicator

Session: Posters (Sessão 1 - Écran 4) - Insuficiência Cardíaca 1 - Vários 1
Speaker: M. Inês Barradas

Congress: CPC 2022
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.6 Chronic Heart Failure - Clinical
Session Type: Pósters Electrónicos
FP Number: ---
Authors: m. Inês Barradas; Fabiana Duarte; Luís Resendes de Oliveira; Cátia Serena; António Xavier Fontes; André Viveiros Monteiro; Carina Machado; Raquel Dourado; Emília Santos; Nuno Pelicano; Miguel Pacheco; Anabela Tavares; Dinis Martins

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri"><span style="color:#000000"><span style="color:black">Introduction: Low levels of&nbsp;physical activity may be associated with comorbidities, sedentary lifestyle or clinical worsening in heart failure (HF) patients. Cardiovascular implantable electronic devices (CIEDs) detect and analyse physical activity data that is often integrated in multifactorial algorithms for predicting HF decompensations, but its potential is probably underestimated.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri"><span style="color:#000000"><span style="color:black">Purpose: We hypothesized that low physical-activity levels, obtained from remote monitoring of CIEDs, help predict clinical outcomes in HF patients, independently from multifactorial algorithms.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri"><span style="color:#000000"><span style="color:black">Methods: We retrospectively evaluated consecutive patients with HF and CIEDs through clinical assessments and remote monitoring (two monitoring</span><span style="color:black"><span style="background-color:white"> systems were used).</span></span><span style="color:black"> Low activity was defined as &lt; 1 hour/day of physical activity and two groups of patients were defined: patients with low activity alerts (group 1) and patients without low activity alerts (group 2). Primary outcome was defined as death by all causes and secondary outcome as HF hospitalizations and sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) episodes.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri"><span style="color:#000000"><span style="color:black"><span style="background-color:white">Results: </span></span>From <span style="color:black">121 patients with RPM, physical activity data was obtained in 104 (85,9%)</span>. <span style="color:black">M</span><span style="color:black">ean age was 63,98 </span><span style="color:black">&plusmn; 12,44 years, </span><span style="color:black">70,2% were males and </span><span style="color:black">follow-up was 59,19 &plusmn; 38,491 months</span><span style="color:black">. </span><span style="color:black"><span style="background-color:white">Fifty-four (51,9%) had implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), </span></span><span style="color:black">46 </span><span style="color:black"><span style="background-color:white">(44,2%) transvenous implantable cardioverter defibrillator (ICD), and 4 (3,8%) CRT pacemaker (CRT-P).</span></span> The aetiology was idiopathic in 42,5% and ischemic in 40,2%. Mean left ventricular ejection fraction was 34,08 <span style="color:black">&plusmn; 11,40% and mean </span><span style="color:black">physical activity duration was 2,25 </span><span style="color:black">&plusmn; </span><span style="color:black">1,84 hours/day. Forty-eight (53,7%) patients had low activity alerts (group 1) and 56 (46,3%) had no low activity alerts (group 2). In group 1 mean period of low activity was </span><span style="color:black">52,978 &plusmn; 15,75 days/year. Patients from </span>group 1 <span style="color:black">were older (p=0,001), had more oncological disease (p=0,041) and peripheral artery disease (p=0,028). Three deaths occurred in total, all in group 1 (p=0,039) and HF hospitalizations were more frequent in group 1 (1,68 </span><span style="color:black">&plusmn; 2,59 vs 0,69 &plusmn; 1,32, p=0,005</span><span style="color:black">). Low activity burden was also associated with atrial fibrillation burden (r=0,473, p&lt;0,05) and number of episodes of VT or VF (r=0,267, p=0,007). A decrease of 50% or more in mean duration of physical activity, but above 1 hour/day, was associated with increase HF hospitalizations (1,83</span><span style="font-family:Symbol">&plusmn;</span> 2,13 vs 1,05<span style="font-family:Symbol">&plusmn;</span> 1,95<span style="color:black">, p=0,006).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri"><span style="color:#000000"><span style="color:black">Conclusion: Low physical activity data obtained from CIEDs was associated with HF hospitalizations, arrhythmic events and death by all causes, independently of multifactorial algorithms. A decrease in basal activity even above alert threshold, was associated with HF hospitalizations and may be an even earlier sign of HF decompensations.</span></span></span></span></p>