scholarly journals Use of Free-Living Step Count Monitoring for Heart Failure Functional Classification: Validation Study

JMIR Cardio ◽  
10.2196/12122 ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. e12122 ◽  
Author(s):  
Jonathan-F Baril ◽  
Simon Bromberg ◽  
Yasbanoo Moayedi ◽  
Babak Taati ◽  
Cedric Manlhiot ◽  
...  
Keyword(s):  
Heart Failure ◽  
Validation Study ◽  
Step Count ◽  
Functional Classification ◽  
Free Living

scholarly journals Use of Free-Living Step Count Monitoring for Heart Failure Functional Classification: Validation Study (Preprint)

2018 ◽  
Author(s):  
Jonathan-F. Baril ◽  
Simon Bromberg ◽  
Yasbanoo Moayedi ◽  
Babak Taati ◽  
Cedric Manlhiot ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Ejection Fraction ◽  
Functional Class ◽  
Step Count ◽  
Functional Classification ◽  
Free Living ◽  
Reduced Ejection Fraction ◽  
Nyha Functional Class ◽  
Daily Total

BACKGROUND The New York Heart Association (NYHA) functional classification system has poor inter-rater reproducibility. A previously published pilot study showed a statistically significant difference between the daily step counts of heart failure (with reduced ejection fraction) patients classified as NYHA functional class II and III as measured by wrist-worn activity monitors. However, the study’s small sample size severely limits scientific confidence in the generalizability of this finding to a larger heart failure (HF) population. OBJECTIVE This study aimed to validate the pilot study on a larger sample of patients with HF with reduced ejection fraction (HFrEF) and attempt to characterize the step count distribution to gain insight into a more objective method of assessing NYHA functional class. METHODS We repeated the analysis performed during the pilot study on an independently recorded dataset comprising a total of 50 patients with HFrEF (35 NYHA II and 15 NYHA III) patients. Participants were monitored for step count with a Fitbit Flex for a period of 2 weeks in a free-living environment. RESULTS Comparing group medians, patients exhibiting NYHA class III symptoms had significantly lower recorded 2-week mean daily total step count (3541 vs 5729 [steps], P=.04), lower 2-week maximum daily total step count (10,792 vs 5904 [steps], P=.03), lower 2-week recorded mean daily mean step count (4.0 vs 2.5 [steps/minute], P=.04,), and lower 2-week mean and 2-week maximum daily per minute step count maximums (88.1 vs 96.1 and 111.0 vs 123.0 [steps/minute]; P=.02 and .004, respectively). CONCLUSIONS Patients with NYHA II and III symptoms differed significantly by various aggregate measures of free-living step count including the (1) mean and (2) maximum daily total step count as well as by the (3) mean of daily mean step count and by the (4) mean and (5) maximum of the daily per minute step count maximum. These findings affirm that the degree of exercise intolerance of NYHA II and III patients as a group is quantifiable in a replicable manner. This is a novel and promising finding that suggests the existence of a possible, completely objective measure of assessing HF functional class, something which would be a great boon in the continuing quest to improve patient outcomes for this burdensome and costly disease.

scholarly journals Measuring Free-Living Physical Activity With Three Commercially Available Activity Monitors for Telemonitoring Purposes: Validation Study (Preprint)

2018 ◽  
Author(s):  
Martine JM Breteler ◽  
Joris H Janssen ◽  
Wilko Spiering ◽  
Cor J Kalkman ◽  
Wouter W van Solinge ◽  
...  
Keyword(s):  
Physical Activity ◽  
Validation Study ◽  
Cross Validation ◽  
Usability Evaluation ◽  
Step Count ◽  
Added Value ◽  
Reference Standard ◽  
Free Living ◽  
Activity Trackers ◽  
Leave One Out

BACKGROUND Remote monitoring of physical activity in patients with chronic conditions could be useful to offer care professionals real-time assessment of their patient’s daily activity pattern to adjust appropriate treatment. However, the validity of commercially available activity trackers that can be used for telemonitoring purposes is limited. OBJECTIVE The purpose of this study was to test usability and determine the validity of 3 consumer-level activity trackers as a measure of free-living activity. METHODS A usability evaluation (study 1) and validation study (study 2) were conducted. In study 1, 10 individuals wore one activity tracker for a period of 30 days and filled in a questionnaire on ease of use and wearability. In study 2, we validated three selected activity trackers (Apple Watch, Misfit Shine, and iHealth Edge) and a fourth pedometer (Yamax Digiwalker) against the reference standard (Actigraph GT3X) in 30 healthy participants for 72 hours. Outcome measures were 95% limits of agreement (LoA) and bias (Bland-Altman analysis). Furthermore, median absolute differences (MAD) were calculated. Correction for bias was estimated and validated using leave-one-out cross validation. RESULTS Usability evaluation of study 1 showed that iHealth Edge and Apple Watch were more comfortable to wear as compared with the Misfit Flash. Therefore, the Misfit Flash was replaced by Misfit Shine in study 2. During study 2, the total number of steps of the reference standard was 21,527 (interquartile range, IQR 17,475-24,809). Bias and LoA for number of steps from the Apple Watch and iHealth Edge were 968 (IQR −5478 to 7414) and 2021 (IQR −4994 to 9036) steps. For Misfit Shine and Yamax Digiwalker, bias was −1874 and 2004, both with wide LoA of (13,869 to 10,121) and (−10,932 to 14,940) steps, respectively. The Apple Watch noted the smallest MAD of 7.7% with the Actigraph, whereas the Yamax Digiwalker noted the highest MAD (20.3%). After leave-one-out cross validation, accuracy estimates of MAD of the iHealth Edge and Misfit Shine were within acceptable limits with 10.7% and 11.3%, respectively. CONCLUSIONS Overall, the Apple Watch and iHealth Edge were positively evaluated after wearing. Validity varied widely between devices, with the Apple Watch being the most accurate and Yamax Digiwalker the least accurate for step count in free-living conditions. The iHealth Edge underestimates number of steps but can be considered reliable for activity monitoring after correction for bias. Misfit Shine overestimated number of steps and cannot be considered suitable for step count because of the low agreement. Future studies should focus on the added value of remotely monitoring activity patterns over time in chronic patients.

scholarly journals Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nduka C. Okwose ◽  
Leah Avery ◽  
Nicola O’Brien ◽  
Sophie Cassidy ◽  
Sarah J. Charman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Pilot Study ◽  
Chronic Heart Failure ◽  
Physical Activity Intervention ◽  
Step Count ◽  
Home Based ◽  
At Home

Abstract Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m2, P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.

Invariance of Wearing Location of Omron-BI Pedometers: A Validation Study

2010 ◽  
Vol 7 (6) ◽  
pp. 706-717 ◽  
Author(s):  
Weimo Zhu ◽  
Miyoung Lee
Keyword(s):  
Validation Study ◽  
Absolute Error ◽  
Activity Monitor ◽  
Error Rates ◽  
Living Conditions ◽  
The Body ◽  
Validity And Reliability ◽  
Free Living ◽  
Climbing Stairs ◽  
Free Living Conditions

Background:The purpose of this study was to investigate the validity and reliability evidences of the Omron BI pedometer, which could count steps taken even when worn at different locations on the body.Methods:Forty (20 males and 20 females) adults were recruited to walk wearing 5 sets, 1 set at a time, of 10 BI pedometers during testing, 1 each at 10 different locations. For comparison, they also wore 2 Yamax Digi-Walker SW-200 pedometers and a Dynastream AMP 331 activity monitor. The subjects walked in 3 free-living conditions: a fat sidewalk, stairs, and mixed conditions.Results:Except for a slight decrease in accuracy in the pant pocket locations, Omron BI pedometers counted steps accurately across other locations when subjects walked on the fat sidewalk, and the performance was consistent across devices and trials. When the subjects climbed up stairs, however, the absolute error % of the pant pocket locations increased significantly (P < .05) and similar or higher error rates were found in the AMP 331 and SW-200s.Conclusions:The Omron BI pedometer can accurately count steps when worn at various locations on the body in free-living conditions except for front pant pocket locations, especially when climbing stairs.

Abstract P507: Interplay Between Diet and Gut Microbiota, and Circulating Levels of Trimethylamine N-oxide: Findings From the Men’s Lifestyle Validation Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jun Li ◽  
Yanping Li ◽  
Kerry Ivey ◽  
Dong Wang ◽  
Jeremy Wilkinson ◽  
...  
Keyword(s):  
Validation Study ◽  
Microbial Metabolism ◽  
Red Meat ◽  
Cardiometabolic Health ◽  
Metagenomic Sequencing ◽  
Free Living ◽  
Meat Intake ◽  
Fecal Samples ◽  
Red Meat Intake ◽  
Cardiometabolic Traits

Background: Trimethylamine N-oxide (TMAO) is proposed as a possible culprit linking red meat intake and poor cardiovascular health. The relationship between diet, microbial metabolism, circulating TMAO levels, and cardiometabolic health in free-living individuals, is yet to be elucidated. Hypothesis: Specific microbial taxa may modulate associations of choline/L-carnitine and red meat intake with plasma TMAO levels and cardiometabolic traits. Method: We collected 2 pairs of fecal samples (n=925) and, simultaneously, 2 blood samples (n=473), 6 months apart, from 307 healthy men in the Men’s Lifestyle Validation Study in 2012. We performed Shotgun metagenomic sequencing using fecal samples and identified microbial taxonomic features using MetaPhlAn2. We measured hemoglobin A1c (HBA1c), and plasma levels of TMAO, lipids, and other cardiometabolic risk markers. Diet was assessed repeatedly using validated food-frequency questionnaires and dietary records. Results: Multivariable random-effect linear regressions identified 10 bacterial species that were significantly associated with TMAO levels ( FDR <0.05; Figure A ), and these species significantly modified the associations of dietary choline/L-carnitine and/or red meat intake with TMAO levels ( P interaction <0.05). In particular, Alistipes s hahii and Clostridium c itroniae significantly strengthened the association between red meat intake and TMAO levels, whereas Eubacterium b iforme attenuated this association ( P interaction <0.05). Consistently, the associations of higher red meat intake with higher HBA1c and lower high-density lipoprotein cholesterol levels were more pronounced in the presence of A. s hahii and C. c itroniae or in the absence of E. b ifome ( Figure B ). Conclusions: We identified microbial taxa that modify the associations of red meat intake with circulating TMAO levels and cardiometabolic traits, in free-living men, suggesting an interplay between diet and microbial metabolism in producing TMAO and affecting cardiometabolic health.

P2610Increase in comfortable walking speed during hospitalization predicts the readmission due to decompensated heart failure in heart failure patients with preserved ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Tabata ◽  
M Kato ◽  
N Hamazaki ◽  
T Masuda
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Walking Speed ◽  
Decompensated Heart Failure ◽  
Preserved Ejection Fraction ◽  
Functional Classification ◽  
Multivariate Logistic Regression ◽  
Heart Failure Patients

Abstract Background Heart failure patients with preserved ejection fraction (HFpEF) have reduced exercise capacity and poor prognosis as well as those with reduced ejection fraction (HFrEF). Both cardiac function and exercise capacity have been known as prognostic factors for patients with HFrEF. However, few reports documented the relations of comfortable walking speed (CWS) during hospitalization to exercise capacity and prognosis. is used as a clinical measure to assess their exercise capacity and prognosis. However, few reports documented the correlations of CWS with exercise capacity and prognosis in patients with HFpEF. Purpose This study aimed to investigate whether CWS at hospital discharge and the increase in CWS during hospitalization predicted the readmission due to decompensated heart failure in patients with HFpEF and HFrEF. Methods Patients who were hospitalized due to heart failure with New York Heart Association (NYHA) Functional Classification III or IV were prospectively followed up for 3 years after hospital discharge. Consequently, 264 patients, 173 males and 92 females, aged 73.2±6.8 years were studied. Patients were divided into 3 groups based on their ejection fraction (EF): HFpEF group (EF≥50%; n=98), HFrEF group (EF<40%; n=138) and heart failure with mid-range ejection fraction (HFmrEF) group (40%≤EF≤49%; n=28). We assessed clinical characteristics including age, gender, height, NYHA functional classification, etiology of CHF, plasma brain natriuretic peptide and left ventricular ejection fraction (LVEF) on admission, and measured CWS several days after admission and at discharge. We determined significant factors affecting the readmission and their cut-off values using univariate and multivariate logistic regression analyses and the area under the receiver operating characteristics curves in the three groups. Results Forty patients (40.8%), 54 (39.1%) and 6 (21.4%) were readmitted in the HFpEF, HFrEF and HFmrEF groups, respectively, within 3 years after the discharge. Univariate logistic regression analysis detected the age, LVEF, CWS at discharge and the CWS increase during hospitalization as significant limiting factors for readmission in the HFpEF and HFrEF groups (P<0.05, respectively). The multivariate logistic regression analysis detected the CWS increase during hospitalization as significant limiting factor for readmission in the HFpEF and HFrEF groups (P<0.001 and P<0.05, respectively). The odds ratios of readmission were 1.86 (P<0.01) and 1.44 (P<0.001) with each 5-meter decrease of CWS increase during hospitalization and predictive cut-off values of the CWS increase were 7.5 and 8.5 meters/min in the HFpEF and HFrEF groups, respectively. Conclusion This study demonstrated that the CWS increase during hospitalization was a strong predictor for readmission due to decompensated heart failure in patients not only with HFrEF but also with HFpEF and each predictive the cut-off value was 7.5 and 8.5 meters/min.

scholarly journals Proposal for a Functional Classification System of Heart Failure in Patients With End-Stage Renal Disease

2014 ◽  
Vol 63 (13) ◽  
pp. 1246-1252 ◽  
Author(s):  
Lakhmir S. Chawla ◽  
Charles A. Herzog ◽  
Maria Rosa Costanzo ◽  
James Tumlin ◽  
John A. Kellum ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Classification System ◽  
Functional Classification ◽  
Stage Renal Disease ◽  
End Stage
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