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Sato T, Ono M, Kawamura K, Naganuma W, Shishito N, Morishita S, Sasamoto Y, Kohzuki M. Impact of moderate to vigorous intensity physical activity on change in renal function in patients after acute myocardial infarction. Heart Vessels 2024; 39:393-403. [PMID: 38189923 DOI: 10.1007/s00380-023-02354-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
Acute myocardial infarction (AMI) is associated with a decline in renal function. This study aimed to investigate the impact of engaging in moderate to vigorous intensity physical activity (MVPA) for more than 30 min per day on changes in renal function during the first 3 months after AMI onset. A prospective, observational study was conducted, enrolling 87 patients (75 men; average age, 65.2 ± 12.5 years) who had experienced AMI. The cystatin C-based estimated glomerular filtration rate (eGFRcys) was collected at and 3 months after discharge. Daily MVPA was measured using triaxial accelerometers at a threshold of 3.0 Metabolic equivalent of the task for 3 months. Generalized estimating equations (GEE) were applied to evaluate the longitudinal association between the number of days per week of MVPA for 30 min or more and within-patient changes in eGFRcys. The patients were categorized into three groups based on their MVPA engagement days: 0 days (n = 20), 1-2 days (n = 14), and 3-7 days (n = 53) groups. After adjusting for potential confounding variables, GEE analysis revealed that the eGFRcys slope over 3 months was significantly higher in the 3-7 days group than in 0 days group (B = 2.9, (95% confidence interval: 1.5-4.2), p < 0.001). Similar results were obtained when MVPA time thresholds were set to 40 and 60 min. These findings suggest a significant positive effect of engaging in MVPA for 30 min or more for 3-7 days per week in the improvement of renal function after AMI onset.
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Affiliation(s)
- Toshimi Sato
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, 10-6, Sakaemachi, Fukushima, 960-8516, Japan.
| | - Masahiro Ono
- Department of Cardiology, Southern Tohoku General Hospital, Koriyama, Japan
| | - Keiichi Kawamura
- Department of Cardiology, Southern Tohoku General Hospital, Koriyama, Japan
| | - Wakako Naganuma
- Department of Cardiology, Southern Tohoku General Hospital, Koriyama, Japan
| | - Namiko Shishito
- Department of Cardiology, Southern Tohoku General Hospital, Koriyama, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, 10-6, Sakaemachi, Fukushima, 960-8516, Japan
| | - Yuichiro Sasamoto
- Department of Rehabilitation, Ohta General Hospital Foundation, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - Masahiro Kohzuki
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
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Bayshtok G, Tiosano S, Furer A. Use of Wearable Devices for Peak Oxygen Consumption Measurement in Clinical Cardiology: Case Report and Literature Review. Interact J Med Res 2023; 12:e45504. [PMID: 37581915 PMCID: PMC10466150 DOI: 10.2196/45504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/16/2023] [Accepted: 05/11/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Oxygen consumption is an important index to evaluate in cardiac patients, particularly those with heart failure, and is measured in the setting of advanced cardiopulmonary exercise testing. However, technological advances now allow for the estimation of this parameter in many consumer and medical-grade wearable devices, making it available for the medical provider at the initial evaluation of patients. We report a case of an apparently healthy male aged 40 years who presented for evaluation due to an Apple Watch (Apple Inc) notification of low cardiac fitness. This alert triggered a thorough workup, revealing a diagnosis of familial nonischemic cardiomyopathy with severely reduced left ventricular systolic function. While the use of wearable devices for the measurement of oxygen consumption and related parameters is promising, further studies are needed for validation. OBJECTIVE The aim of this report is to investigate the potential utility of wearable devices as a screening and risk stratification tool for cardiac fitness for the general population and those with increased cardiovascular risk, particularly through the measurement of peak oxygen consumption (VO2). We discuss the possible advantages of measuring oxygen consumption using wearables and propose its integration into routine patient evaluation and follow-up processes. With the current evidence and limitations, we encourage researchers and clinicians to explore bringing wearable devices into clinical practice. METHODS The case was identified at Sheba Medical Center, and the patient's cardiac fitness was monitored through an Apple Watch Series 6. The patient underwent a comprehensive cardiac workup following his presentation. Subsequently, we searched the literature for articles relating to the clinical utility of peak VO2 monitoring and available wearable devices. RESULTS The Apple Watch data provided by the patient demonstrated reduced peak VO2, a surrogate index for cardiac fitness, which improved after treatment initiation. A cardiological workup confirmed familial nonischemic cardiomyopathy with severely reduced left ventricular systolic function. A review of the literature revealed the potential clinical benefit of peak VO2 monitoring in both cardiac and noncardiac scenarios. Additionally, several devices on the market were identified that could allow for accurate oxygen consumption measurement; however, future studies and approval by the Food and Drug Administration (FDA) are still necessary. CONCLUSIONS This case report highlights the potential utility of peak VO2 measurements by wearable devices for early identification and screening of cardiac fitness for the general population and those at increased risk of cardiovascular disease. The integration of wearable devices into routine patient evaluation may allow for earlier presentation in the diagnostic workflow. Cardiac fitness can be serially measured using the wearable device, allowing for close monitoring of functional capacity parameters. Devices need to be used with caution, and further studies are warranted.
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Affiliation(s)
- Gabriella Bayshtok
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Arrow Program for Medical Research Education, Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
| | - Shmuel Tiosano
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Arrow Program for Medical Research Education, Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - Ariel Furer
- Leviev Heart Center, Sheba Medical Center, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Soulard J, Carlin T, Knitza J, Vuillerme N. Wearables for Measuring the Physical Activity and Sedentary Behavior of Patients With Axial Spondyloarthritis: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e34734. [PMID: 35994315 PMCID: PMC9446133 DOI: 10.2196/34734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/02/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease associated with chronic back pain and restricted mobility and physical function. Increasing physical activity is a viable strategy for improving the health and quality of life of patients with axSpA. Thus, quantifying physical activity and sedentary behavior in this population is relevant to clinical outcomes and disease management. However, to the best of our knowledge, no systematic review to date has identified and synthesized the available evidence on the use of wearable devices to objectively measure the physical activity or sedentary behavior of patients with axSpA.
Objective
This study aimed to review the literature on the use of wearable activity trackers as outcome measures for physical activity and sedentary behavior in patients with axSpA.
Methods
PubMed, PEDro, and Cochrane electronic databases were searched in July 2021 for relevant original articles, with no limits on publication dates. Studies were included if they were original articles, targeted adults with a diagnosis of axSpA, and reported wearable device–measured physical activity or sedentary behavior among patients with axSpA. Data regarding the study’s characteristics, the sample description, the methods used for measuring physical activity and sedentary behavior (eg, wearable devices, assessment methods, and outcomes), and the main results of the physical activity and sedentary behavior assessments were extracted.
Results
A total of 31 studies were initially identified; 13 (13/31, 42%) met the inclusion criteria, including 819 patients with axSpA. All the studies used accelerometer-based wearable devices to assess physical activity. Of the 13 studies, 4 (4/31, 31%) studies also reported outcomes related to sedentary behavior. Wearable devices were secured on the wrists (3/13 studies, 23%), lower back (3/13, 23%), right hip (3/13, 23%), waist (2/13, 15%), anterior thigh (1/13, 8%), or right arm (1/13, 8%). The methods for reporting physical activity and sedentary behavior were heterogeneous. Approximately 77% (10/13) of studies had a monitoring period of 1 week, including weekend days.
Conclusions
To date, few studies have used wearable devices to quantify the physical activity and sedentary behavior of patients with axSpA. The methodologies and results were heterogeneous, and none of these studies assessed the psychometric properties of these wearables in this specific population. Further investigation in this direction is needed before using wearable device–measured physical activity and sedentary behavior as outcome measures in intervention studies in patients with axSpA.
Trial Registration
PROSPERO CRD42020182398; https://tinyurl.com/ec22jzkt
International Registered Report Identifier (IRRID)
RR2-10.2196/23359
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Affiliation(s)
- Julie Soulard
- Université Grenoble Alpes, AGEIS, La Tronche, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
- Grenoble Alpes University Hospital, Grenoble, France
| | - Thomas Carlin
- Université Grenoble Alpes, AGEIS, La Tronche, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
| | - Johannes Knitza
- Université Grenoble Alpes, AGEIS, La Tronche, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University, Erlangen-Nürnberg, and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Nicolas Vuillerme
- Université Grenoble Alpes, AGEIS, La Tronche, France
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
- Institut Universitaire de France, Paris, France
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Frodi DM, Manea V, Diederichsen SZ, Svendsen JH, Wac K, Andersen TO. Using Consumer-Wearable Activity Trackers for Risk Prediction of Life-Threatening Heart Arrhythmia in Patients with an Implantable Cardioverter-Defibrillator: An Exploratory Observational Study. J Pers Med 2022; 12:jpm12060942. [PMID: 35743727 PMCID: PMC9225164 DOI: 10.3390/jpm12060942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/29/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022] Open
Abstract
Ventricular arrhythmia (VA) is a leading cause of sudden death and health deterioration. Recent advances in predictive analytics and wearable technology for behavior assessment show promise but require further investigation. Yet, previous studies have only assessed other health outcomes and monitored patients for short durations (7−14 days). This study explores how behaviors reported by a consumer wearable can assist VA risk prediction. An exploratory observational study was conducted with participants who had an implantable cardioverter-defibrillator (ICD) and wore a Fitbit Alta HR consumer wearable. Fitbit reported behavioral markers for physical activity (light, fair, vigorous), sleep, and heart rate. A case-crossover analysis using conditional logistic regression assessed the effects of time-adjusted behaviors over 1−8 weeks on VA incidence. Twenty-seven patients (25 males, median age 59 years) were included. Among the participants, ICDs recorded 262 VA events during 8093 days monitored by Fitbit (median follow-up period 960 days). Longer light to fair activity durations and a higher heart rate increased the odds of a VA event (p < 0.001). In contrast, lengthier fair to vigorous activity and sleep durations decreased the odds of a VA event (p < 0.001). Future studies using consumer wearables in a larger population should prioritize these outcomes to further assess VA risk.
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Affiliation(s)
- Diana My Frodi
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
| | - Vlad Manea
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Vital Beats ApS, 1434 Copenhagen, Denmark
| | - Søren Zöga Diederichsen
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
| | - Jesper Hastrup Svendsen
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Katarzyna Wac
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Quality of Life Technologies Lab, Center for Informatics, University of Geneva, 1227 Carouge, Switzerland
| | - Tariq Osman Andersen
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Vital Beats ApS, 1434 Copenhagen, Denmark
- Correspondence: or ; Tel.: +45-26-14-91-69
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Wearable Devices for Physical Monitoring of Heart: A Review. BIOSENSORS 2022; 12:bios12050292. [PMID: 35624593 PMCID: PMC9138373 DOI: 10.3390/bios12050292] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/19/2022]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death globally. An effective strategy to mitigate the burden of CVDs has been to monitor patients’ biomedical variables during daily activities with wearable technology. Nowadays, technological advance has contributed to wearables technology by reducing the size of the devices, improving the accuracy of sensing biomedical variables to be devices with relatively low energy consumption that can manage security and privacy of the patient’s medical information, have adaptability to any data storage system, and have reasonable costs with regard to the traditional scheme where the patient must go to a hospital for an electrocardiogram, thus contributing a serious option in diagnosis and treatment of CVDs. In this work, we review commercial and noncommercial wearable devices used to monitor CVD biomedical variables. Our main findings revealed that commercial wearables usually include smart wristbands, patches, and smartwatches, and they generally monitor variables such as heart rate, blood oxygen saturation, and electrocardiogram data. Noncommercial wearables focus on monitoring electrocardiogram and photoplethysmography data, and they mostly include accelerometers and smartwatches for detecting atrial fibrillation and heart failure. However, using wearable devices without healthy personal habits will cause disappointing results in the patient’s health.
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