Characteristics of Daily Walking Bouts as Valid and Reliable Indicators of Exercise Capacity in Pulmonary Arterial Hypertension: Insights From the Randomized Controlled Study With Selexipag (TRACE).

IF 2.2 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Pulmonary Circulation Pub Date : 2025-05-26 eCollection Date: 2025-04-01 DOI:10.1002/pul2.70097
Rana Zia Ur Rehman, Federico Parisi, Noman Ashraf, Meenakshi Chatterjee, Robert P Frantz, Anna R Hemnes, Nikolay V Manyakov, Oscar M Carrasco-Zevallos, Tarik Yardibi, Mona Selej, Tommaso Mansi, Preston Dunnmon, Dzmitry A Kaliukhovich
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引用次数: 0

Abstract

There is a need for objective, continuous and remote assessment of exercise capacity in patients with pulmonary arterial hypertension (PAH). Using data from the TRACE study, in which 108 adult patients with PAH were continuously monitored with a wrist-worn accelerometer, we evaluated whether actigraphy can facilitate continuous monitoring of exercise capacity. Distributions of step rate, distance and duration of patient's walking bouts were estimated at baseline, Week 16 and Week 24 using 2-week periods of actigraphy data. Twenty-one metrics per walking bout characteristic were described (mean, standard deviation, 19 percentiles [5th-95th]). The relationships between these metrics and the 6-min walk distance (6MWD), Borg dyspnea index (BDI), and the PAH Symptoms and Impact questionnaire (PAH-SYMPACT) Physical Impact domain score were assessed at the three timepoints. Test-retest reliability, and discriminant and known-group validity of each metric were also evaluated. All metrics of step rate and bout distance were significantly correlated with 6MWD (Pearson's correlation coefficients: 0.34-0.67; p < 0.005) and the PAH-SYMPACT Physical Impact domain score (Pearson's correlation coefficients: -0.51 to -0.32; p < 0.05) at all timepoints. Negative correlations were also observed with the BDI and the actigraphy-derived metrics, with the majority reaching significance. Strong test-retest reliability was demonstrated (intra-class correlation coefficient ≥ 0.70). The metrics differentiated well between patients with varying disease severity levels. In conclusion, actigraphy-derived metrics of patients' walking bouts correlate significantly with 6MWD, BDI and physical impacts of PAH, indicating the utility of actigraphy in facilitating continuous monitoring of exercise capacity in adult patients with PAH.

Trial registration: ClinicalTrials.gov: NCT03078907; URL: clinicaltrials.gov.

每日步行量作为肺动脉高压患者运动能力有效可靠指标的特征:来自Selexipag (TRACE)随机对照研究的见解
有必要对肺动脉高压(PAH)患者的运动能力进行客观、持续和远程评估。在TRACE研究中,108名成年PAH患者通过腕带加速度计进行持续监测,我们利用该研究的数据评估了活动描记术是否有助于持续监测运动能力。在基线、第16周和第24周使用2周的活动记录仪数据估计患者步行次数的步速、距离和持续时间的分布。每个行走行走特征描述了21个指标(平均值,标准差,19个百分位数[5 -95])。在三个时间点评估这些指标与6分钟步行距离(6MWD)、Borg呼吸困难指数(BDI)以及PAH症状和影响问卷(PAH- sympact)物理影响域评分之间的关系。测试-重测信度,并评估每个指标的判别效度和已知组效度。步频和步距的所有指标均与6MWD显著相关(Pearson相关系数:0.34-0.67;p试验注册:ClinicalTrials.gov: NCT03078907;URL: clinicaltrials.gov。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pulmonary Circulation
Pulmonary Circulation Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.20
自引率
11.50%
发文量
153
审稿时长
15 weeks
期刊介绍: Pulmonary Circulation''s main goal is to encourage basic, translational, and clinical research by investigators, physician-scientists, and clinicans, in the hope of increasing survival rates for pulmonary hypertension and other pulmonary vascular diseases worldwide, and developing new therapeutic approaches for the diseases. Freely available online, Pulmonary Circulation allows diverse knowledge of research, techniques, and case studies to reach a wide readership of specialists in order to improve patient care and treatment outcomes.
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