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Wearable Device Measured Step Counts and HF Outcomes
Quick Takes
- Step counts measured via a smartwatch are associated with health status, including reported physical limitations among patients with HF.
- Floors climbed measured through a smartwatch are associated with HF symptoms and health status.
Study Questions:
Is smartwatch-collected physical activity associated with patient-centered outcomes among patients with heart failure (HF)?
Methods:
Data from the CHIEF-HF trial (Canagliflozin: Impact on Health Status, Quality of Life, and Functional Status in Heart Failure) were used for the present analysis. HF patients who had a compatible smartphone were included in this study. Participants were given a Fitbit Versa 2, and all completed serial Kansas City Cardiomyopathy Questionnaires (KCCQs) through a smartphone application. For the present analysis, daily step count and floors climbed were examined with total symptom (TS) and physical limitation (PL) scores from the KCCQ at baseline, 2 weeks, and 12 weeks.
Results:
A total of 476 participants were randomized; after withdrawing or missing data, 425 remained for the analysis. The mean age was 63.5 ± 13.2 years; 44.5% were female, 83.3% were White, and 27.5% had type 2 diabetes mellitus. HF with reduced ejection fraction (EF) was present in 174 (40.9%) participants, and 251 (59.1%) had HF with preserved EF. Baseline daily step count increased across categories of KCCQ-TS scores (2,437.6 ± 1,419.5 steps/day for scores 0-24 vs. 4,870.9 ± 3,171.3 steps/day for scores 75-100; p < 0.001) with similar results for KCCQ-PL scores. This relationship remained significant for KCCQ-TS and KCCQ-PL scores after multivariable adjustment. Changes in daily step count were significantly associated with nonlinear changes in KCCQ-TS (p = 0.004) and KCCQ-PL (p = 0.003) scores. Floors climbed were associated with baseline KCCQ scores alone.
Conclusions:
The authors concluded that daily step count was nonlinearly associated with health status at baseline and over time in patients with HF. These results may inform the interpretation of wearable device data in clinical and research contexts.
Perspective:
Physical activity is an important metric associated with mortality and morbidity outcomes and quality of life. Such measures can identify patients for interventions that improve physical function and possibly slow down the development of frailty. This study adds to current evidence reading step counts associated with cardiovascular conditions such as HF.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Exercise
Keywords: Canagliflozin, Cardiomyopathies, Diabetes Mellitus, Type 2, Exercise, Frailty, Heart Failure, Morbidity, Patient Reported Outcome Measures, Primary Prevention, Quality of Life, Smartphone, Stroke Volume, Wearable Electronic Devices
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