Daily Physical Activity Measured by Wearable Smartwatch for Patients Undergoing Transcatheter Aortic Valve Replacement : Insights From the SMART TAVR Study
BACKGROUND: This study aims to evaluate limited data about daily physical activity patterns, influential factors, and their association with 1-year mortality or rehospitalization after transcatheter aortic valve replacement (TAVR) through smartwatches.
METHODS: Consecutive severe aortic stenosis patients undergoing elective transfemoral TAVR in a Chinese tertiary hospital were enrolled from July 2021 to May 2022 and received a Huawei smartwatch at least 1 day before TAVR. The primary outcome was a composite of all-cause mortality or hospital readmission within 1 year. Linear mixed-effects models were applied to determine influential factors of daily step counts, and Cox proportional hazard regression models were to estimate the association between baseline step counts within 1 month since discharge and composite outcome from months 2 to 12. The dose-response association was assessed using restricted cubic spline curves.
RESULTS: A total of 222 participants and 59 469 valid monitoring person-day records were included (mean age, 72.7 years; 61% women). Step counts increased rapidly within the first 2 months (P<0.001), followed by a slower increase for those without composite outcomes (P=0.029) and a gradual decrease for those who developed composite outcomes (P<0.001). In multivariate linear mixed models, a 1-m increase in baseline 6-minute walk test and a 1-month delay after discharge were associated with 4 (95% CI, 1-7) and 170 (95% CI, 145-194) additional step counts, respectively. In restricted cubic spline analysis, the hazard ratio declined progressively until ≈5000 steps per day, after which they leveled. Below 5000 steps, the adjusted hazard ratio of composite outcome associated with each 1000-step count increase was 0.67 (0.50-0.89; P=0.007). However, above 5000 steps, step counts were not significantly associated with the composite outcome (P=0.645), with a hazard ratio of 1.12 (0.70-1.79).
CONCLUSIONS: Daily step counts rapidly increased within the first 2 months post-TAVR. Increased physical activity was associated with a lower risk of 1-year mortality or rehospitalization after TAVR for patients with daily step counts below 5000.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04454177.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Circulation. Cardiovascular quality and outcomes - 17(2024), 1 vom: 29. Jan., Seite e010066 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fan, Jiaqi [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic valve |
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| Anmerkungen: |
Date Completed 17.01.2024 Date Revised 29.03.2024 published: Print-Electronic ClinicalTrials.gov: NCT04454177 Citation Status MEDLINE |
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| doi: |
10.1161/CIRCOUTCOMES.123.010066 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365788864 |
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| 245 | 1 | 0 | |a Daily Physical Activity Measured by Wearable Smartwatch for Patients Undergoing Transcatheter Aortic Valve Replacement |b Insights From the SMART TAVR Study |
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| 500 | |a ClinicalTrials.gov: NCT04454177 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: This study aims to evaluate limited data about daily physical activity patterns, influential factors, and their association with 1-year mortality or rehospitalization after transcatheter aortic valve replacement (TAVR) through smartwatches | ||
| 520 | |a METHODS: Consecutive severe aortic stenosis patients undergoing elective transfemoral TAVR in a Chinese tertiary hospital were enrolled from July 2021 to May 2022 and received a Huawei smartwatch at least 1 day before TAVR. The primary outcome was a composite of all-cause mortality or hospital readmission within 1 year. Linear mixed-effects models were applied to determine influential factors of daily step counts, and Cox proportional hazard regression models were to estimate the association between baseline step counts within 1 month since discharge and composite outcome from months 2 to 12. The dose-response association was assessed using restricted cubic spline curves | ||
| 520 | |a RESULTS: A total of 222 participants and 59 469 valid monitoring person-day records were included (mean age, 72.7 years; 61% women). Step counts increased rapidly within the first 2 months (P<0.001), followed by a slower increase for those without composite outcomes (P=0.029) and a gradual decrease for those who developed composite outcomes (P<0.001). In multivariate linear mixed models, a 1-m increase in baseline 6-minute walk test and a 1-month delay after discharge were associated with 4 (95% CI, 1-7) and 170 (95% CI, 145-194) additional step counts, respectively. In restricted cubic spline analysis, the hazard ratio declined progressively until ≈5000 steps per day, after which they leveled. Below 5000 steps, the adjusted hazard ratio of composite outcome associated with each 1000-step count increase was 0.67 (0.50-0.89; P=0.007). However, above 5000 steps, step counts were not significantly associated with the composite outcome (P=0.645), with a hazard ratio of 1.12 (0.70-1.79) | ||
| 520 | |a CONCLUSIONS: Daily step counts rapidly increased within the first 2 months post-TAVR. Increased physical activity was associated with a lower risk of 1-year mortality or rehospitalization after TAVR for patients with daily step counts below 5000 | ||
| 520 | |a REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04454177 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aortic valve | |
| 650 | 4 | |a humans | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a quality of life | |
| 650 | 4 | |a transcatheter aortic valve replacement | |
| 700 | 1 | |a Liu, Qiong |e verfasserin |4 aut | |
| 700 | 1 | |a Dai, Hanyi |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Dao |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Yuchao |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Jianguo |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Lihan |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Po |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Jubo |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Xinping |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xianbao |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jian'an |e verfasserin |4 aut | |
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