Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study

Kazuhiro P Izawa; Yusuke Kasahara; Satoshi Watanabe; Koichiro Oka; Peter H Brubaker; Keisuke Kida; Yoshihiro J Akashi

doi:10.1016/j.ahjo.2021.100051

Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study

Am Heart J Plus. 2021 Oct 7:10:100051. doi: 10.1016/j.ahjo.2021.100051. eCollection 2021 Oct.

Authors

Kazuhiro P Izawa¹, Yusuke Kasahara², Satoshi Watanabe³, Koichiro Oka⁴, Peter H Brubaker⁵, Keisuke Kida⁶, Yoshihiro J Akashi⁷

Affiliations

¹ Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan.
² Department of Rehabilitation Medicine, St. Marianna University Yokohama-city Seibu Hospital, Yokohama, Japan.
³ Department of Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan.
⁴ Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
⁵ Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
⁶ Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan.
⁷ Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.

Abstract

Background and aims: Physical activity (PA) levels are related to mortality and morbidity in patients with chronic heart failure (CHF). Health utility (HU), a very important cost-effectiveness analysis for health care and health status, is measured by several preference-based utility measures. This study aimed to evaluate the relation between PA and HU and the effect of disease severity on PA and HU in patients with CHF.

Methods: We enrolled 226 consecutive outpatients with CHF (mean age, 57.5 years; males, 79.6%) in this retrospective cross-sectional study. Patients were divided into three groups by NYHA class for classification of disease severity. Patient characteristics, average step count in steps/day, PA energy expenditure (PAEE) in kcal/day for 7 days as assessed by accelerometer, and HU assessed by Short Form-6D were compared between the groups.

Results: Average step count (r = 0.37, P < 0.01) and average PAEE (r = 0.36, P < 0.01) correlated positively with HU in all patients. Patients were classified into three groups by NYHA class: class I (n = 92), class II (n = 97), and class III (n = 37). Average step counts (7618.58, 6452.51, and 4225.63 steps/day, P < 0.001), average PAEE (244.65, 176.88, and 103.72 kcal/day, P < 0.001), and HU (0.68, 0.63, and 0.57, P < 0.001) respectively decreased with the increase in NYHA class (P < 0.001).

Conclusion: This study showed a significant relationship of daily PA and HU to disease severity in patients with CHF. Although causation cannot be determined from this study, these results suggest that PA and HU may provide important information related to the severity of disease in patients with CHF.

Keywords: Chronic heart failure; Disease severity; Health utility; Physical activity.