Comparison of questionnaire and accelerometer-based assessments of physical activity in patients with heart failure with preserved ejection fraction: clinical and prognostic implications

Figures & data

Table 1. Patients characteristics.

	All (n = 22)	Women (n = 16)	Men (n = 6)
Body composition
Weight	71 ± 16	65 ± 10	86 ± 21*
BMI (kg/m^2)	31 ± 5.2	30 ± 5.4	32 ± 5.3
Fat mass (%)	36 ± 6.6	37 ± 5	32 ± 8
Free fat mass (kg)	45 ± 10	41 ± 5	58 ± 10*
Waist circumference (cm)	100 ± 13	97 ± 11	108 ± 16
Risk factors, n (%)
Obesity	12 (55%)	8 (50%)	4 (67%)
Former smoker	3 (14%)	0 (0%)	3 (50%)*
Hypertension	20 (91%)	14 (88%)	6 (100%)
Dyslipidemia	15 (68%)	10 (63%)	5 (83%)
Type 2 diabetes	2 (9%)	1 (6%)	1 (17%)
Pre-diabetic	8 (36%)	5 (31%)	3 (50%)
AF	11 (50%)	8 (50%)	3 (50%)
AF (paroxysmal)	4 (18%)	3 (19%)	1 (17%)
COPD	2 (9%)	0 (0%)	2 (33%)*
Clinical signs
Resting heart rate (bpm)	73 ± 17	72 ± 16	74 ± 20
SBP (mmHg)	135 ± 18	134 ± 18	138 ± 21
DBP (mmHg)	70 ± 14	69 ± 16	72 ± 7
BNP (pg/mL)	272 ± 180	273 ± 176	273 ± 206
NYHA class II (%)	17 (77%)	12 (75%)	5 (83%)
NYHA class III (%)	4 (18%)	4 (25%)	0 (0%)
Medication, n (%)
ACE-i/ARB	16 (73%)	11 (69%)	5 (83%)
β-Blockers	18 (82%)	13 (81%)	5 (84%)
Loop diuretics	16 (73%)	10 (63%)	6 (100%)
Statins	14 (64%)	10 (63%)	4 (67%)
Digoxin	3 (14%)	3 (19%)	0 (0%)
MRAs	2 (9%)	1 (6%)	1 (17%)
Cardiac function
LVEF (%)	59 ± 6	60 ± 6	57 ± 6
E/e′	12 ± 3	12.9 ± 3.1	11 ± 2.6
E/A	1 ± 0.5	1.02 ± 0.5	0.97 ± 0.5
LVMI (g/m^2)	222 ± 96	193 ± 51	277 ± 138
LAVI (mL/m^2)	43 ± 12	44 ± 13	38.7 ± 7
Physical fitness
6MWT (m)	313 ± 91	312 ± 92	315 ± 95
VO2 (mL/min/kg)	11.2 ± 2.3	11 ± 2.3	11.7 ± 2.4
Quality of life questioner
MLHFQ total (points)	24 ± 24	29 ± 26	11 ± 10

BMI: body mass index; AF: atrial fibrillation; COPD: chronic obstructive pulmonary disease; SPB: systolic blood pressure; DBP: diastolic blood pressure; BNP: brain natriuretic peptide; NYHA: New York Heart Association; ACEi/ARB: angiotensin-converting enzyme inhibitor and an angiotensin receptor blocker; MRAs: mineralocorticoid receptor antagonists; LVEF: left ventricle ejection fraction; E/e′: ratio of early mitral transmitral flow velocity with early diastolic velocity of the mitral valve annulus; E/A: mitral ratio of peak early to late diastolic filling velocity; LVMI: left ventricle mass index; LAVI: left atrium volume index; 6MWT: six-minute walk distance test; VO₂: relative oxygen uptake; MLHFQ: Minnesota Living With Heart Failure Questionnaire.

*p<.05.

Table 2. Descriptive PA levels from IPAQ and accelerometer variables.

	All	Women	Men	≤76 y	>76 y
	(n = 22)	(n = 16)	(n = 6)	(n = 11)	(n = 11)
IPAQ-S Questionnaire
IPAQ total activity (MET.min·d^1)	152 ± 183	149 ± 204	159 ± 123	232 ± 71	72 ± 114*
IPAQ sitting (min·d^−1)	253 ± 156	226 ± 141	323 ± 184	280 ± 138	224 ± 173
IPAQ MVPA (min·d^−1)	44 ± 56	43 ± 62	46 ± 35	66 ± 64	21 ± 34
Accelerometer
Total wear (min.d^−1)	790 ± 65	808 ± 46	741 ± 86*	803 ± 60	775 ± 68
Total activity (counts.min^−1)	550 ± 239	574 ± 214	489 ± 313	641 ± 271	459 ± 170
Sedentary time (min.d^−1)	392 ± 104	370 ± 98	450 ± 103	386 ± 123	396 ± 85
Light activity (min.d^−1)	379 ± 128	423 ± 111	260 ± 91*	383 ± 134	374 ± 127
MVPA (min.d^−1)	19.3 ± 26	15 ± 21	31 ± 37	34 ± 31	5 ± 3*
MVPA 10 min-bouts (n)	0.07 ± 0.14	0.02 ± 0.07	0.1 ± 0.2	0.13 ± 0.18	0 ± 0*
MVPA 10 min-bouts (min.d^−1)	1.1 ± 2.4	0.2 ± 0.8	3.4 ± 7*	2.2 ± 3	0 ± 0*

IPAQ: international PA questionnaire; MVPA: moderate to vigorous PA.

Data are mean ± SD.

*p<.05.

Table 3. Self-report physical activity and differences to objective.

	Self-reported (mean ± SD)	Mean difference (95% LOA)	r (p)	SEE
Sedentary time	253 ± 156	–138.9 (–427.8; 150)*	0.368 (0.111)	96.7
MVPA	44 ± 56	24.4 (–88.9; 137.8)	0.261 (0.266)	26.7
MVPA 10-min-bouts	44 ± 56	42.6 (–65.2; 150.5)*	0.236 (0.317)	2.4

MVPA: moderate-to-vigorous physical activity; mean difference: self-reported – objective measured parameter (min.d^–1); LOA: limits of agreement (mean difference ± 1.96SD); r: Pearson’s correlations between self-reported and measured parameters (validation coefficient); SEE: standard error of the estimate expressed in min.d^–1.

*p<.05 for comparison between self-reported and measured parameters.

Figure 1. The Bland–Altman plot of the mean bias and 95% limits of agreement for time spent in (A) sedentary time, (B) MVPA and (C) 10-min-bouts-MVPA. Full line indicates mean difference (systematic error); dashed lines indicate the 95% limits of agreement (mean ± 1.96 SD). SD: standard deviation. MVPA: moderate-to-vigorous physical activity.

Table 4. Partial correlations between accelerometer-derived data and prognosis values.

	VO2	6MWT	QoL	BNP	E/e′
Total activity (CPM)	0.509*	0.271	−0.371	−0.097	−0.068
Sedentary time	−0.323	−0.012	−0.128	−0.025	0.203
Light activity	0.367	0.225	−0.211	0.318	0.183
MVPA	0.512*	0.652*	−0.490*	−0.068	−0.133
MVPA 10 min-bouts	0.459*	0.427	−0.559*	0.022	−0.016

CPM: counts per minute; MVPA: moderate-to-vigorous-PA; VO₂: oxygen uptake; 6MWT: six-minute walk distance test; QoL: quality of life; BNP: brain natriuretic peptide; E/e′: ratio of early mitral transmitral flow velocity with early diastolic velocity of the mitral valve annulus.

*p<.05.