The HEART Camp Exercise Intervention Improves Exercise Adherence, Physical Function, and Patient-Reported Outcomes in Adults With Preserved Ejection Fraction Heart Failure.
Heart failure
adherence
exercise
heart failure with preserved ejection fraction
heart failure with reduced ejection fraction
Journal
Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
10
05
2021
revised:
01
09
2021
accepted:
02
09
2021
pubmed:
18
9
2021
medline:
4
5
2022
entrez:
17
9
2021
Statut:
ppublish
Résumé
Despite exercise being one of few strategies to improve outcomes for individuals with heart failure with preserved ejection fraction (HFpEF), exercise clinical trials in HFpEF are plagued by poor interventional adherence. Over the last 2 decades, our research team has developed, tested, and refined Heart failure Exercise And Resistance Training (HEART) Camp, a multicomponent behavioral intervention to promote adherence to exercise in HF. We evaluated the effects of this intervention designed to promote adherence to exercise in HF focusing on subgroups of participants with HFpEF and heart failure with reduced ejection fraction (HFrEF). This randomized controlled trial included 204 adults with stable, chronic HF. Of those enrolled, 59 had HFpEF and 145 had HFrEF. We tested adherence to exercise (defined as ≥120 minutes of moderate-intensity [40%-80% of heart rate reserve] exercise per week validated with a heart rate monitor) at 6, 12, and 18 months. We also tested intervention effects on symptoms (Patient-Reported Outcomes Measurement Information System-29 and dyspnea-fatigue index), HF-related health status (Kansas City Cardiomyopathy Questionnaire), and physical function (6-minute walk test). Participants with HFpEF (n = 59) were a mean of 64.6 ± 9.3 years old, 54% male, and 46% non-White with a mean ejection fraction of 55 ± 6%. Participants with HFpEF in the HEART Camp intervention group had significantly greater adherence compared with enhanced usual care at both 12 (43% vs 14%, phi = 0.32, medium effect) and 18 months (56% vs 0%, phi = 0.67, large effect). HEART Camp significantly improved walking distance on the 6-minute walk test (η A multicomponent, behavioral intervention is associated with improvements in long-term adherence to exercise, physical function, and patient-reported outcomes in adults with HFpEF and anxiety in HFrEF. Our results provide a strong rationale for a large HFpEF clinical trial to validate these findings and examine interventional mechanisms and delivery modes that may further promote adherence and improve clinical outcomes in this population. URL: https://clinicaltrials.gov/. Unique identifier: NCT01658670.
Sections du résumé
BACKGROUND
Despite exercise being one of few strategies to improve outcomes for individuals with heart failure with preserved ejection fraction (HFpEF), exercise clinical trials in HFpEF are plagued by poor interventional adherence. Over the last 2 decades, our research team has developed, tested, and refined Heart failure Exercise And Resistance Training (HEART) Camp, a multicomponent behavioral intervention to promote adherence to exercise in HF. We evaluated the effects of this intervention designed to promote adherence to exercise in HF focusing on subgroups of participants with HFpEF and heart failure with reduced ejection fraction (HFrEF).
METHODS AND RESULTS
This randomized controlled trial included 204 adults with stable, chronic HF. Of those enrolled, 59 had HFpEF and 145 had HFrEF. We tested adherence to exercise (defined as ≥120 minutes of moderate-intensity [40%-80% of heart rate reserve] exercise per week validated with a heart rate monitor) at 6, 12, and 18 months. We also tested intervention effects on symptoms (Patient-Reported Outcomes Measurement Information System-29 and dyspnea-fatigue index), HF-related health status (Kansas City Cardiomyopathy Questionnaire), and physical function (6-minute walk test). Participants with HFpEF (n = 59) were a mean of 64.6 ± 9.3 years old, 54% male, and 46% non-White with a mean ejection fraction of 55 ± 6%. Participants with HFpEF in the HEART Camp intervention group had significantly greater adherence compared with enhanced usual care at both 12 (43% vs 14%, phi = 0.32, medium effect) and 18 months (56% vs 0%, phi = 0.67, large effect). HEART Camp significantly improved walking distance on the 6-minute walk test (η
CONCLUSIONS
A multicomponent, behavioral intervention is associated with improvements in long-term adherence to exercise, physical function, and patient-reported outcomes in adults with HFpEF and anxiety in HFrEF. Our results provide a strong rationale for a large HFpEF clinical trial to validate these findings and examine interventional mechanisms and delivery modes that may further promote adherence and improve clinical outcomes in this population.
CLINICAL TRIAL REGISTRATION
URL: https://clinicaltrials.gov/. Unique identifier: NCT01658670.
Identifiants
pubmed: 34534664
pii: S1071-9164(21)00363-8
doi: 10.1016/j.cardfail.2021.09.003
pmc: PMC8920955
mid: NIHMS1740656
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT01658670']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
431-442Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL112979
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115458
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Références
Eur J Prev Cardiol. 2015 May;22(5):582-93
pubmed: 24627449
Am Heart J. 2012 Jan;163(1):88-94.e3
pubmed: 22172441
Am Heart J. 2017 Mar;185:130-139
pubmed: 28267466
J Clin Epidemiol. 2016 May;73:89-102
pubmed: 26952842
Am Heart J. 2007 Feb;153(2):201-11
pubmed: 17239677
Am Heart J. 2001 Oct;142(4):698-703
pubmed: 11579362
Circulation. 2007 Jul 31;116(5):572-84
pubmed: 17638929
Cardiol Res Pract. 2010 Sep 30;2011:
pubmed: 20953365
Arch Phys Med Rehabil. 2017 Mar;98(3):600-603
pubmed: 27693420
J Card Fail. 2018 Oct;24(10):654-660
pubmed: 30010027
Qual Life Res. 2008 Mar;17(2):291-8
pubmed: 18165909
JAMA. 2016 Jan 5;315(1):36-46
pubmed: 26746456
Circ Heart Fail. 2015 Nov;8(6):1044-51
pubmed: 26578668
J Appl Physiol (1985). 2015 Sep 15;119(6):753-8
pubmed: 25190739
J Am Geriatr Soc. 2017 Aug;65(8):1698-1704
pubmed: 28338229
J Am Coll Cardiol. 2012 Nov 6;60(19):1899-905
pubmed: 23062530
J Clin Epidemiol. 2016 May;73:112-8
pubmed: 26970039
JACC Heart Fail. 2021 Oct;9(10):747-757
pubmed: 34246602
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
pubmed: 12091180
Congest Heart Fail. 2012 Nov-Dec;18(6):295-301
pubmed: 22536983
J Am Coll Cardiol. 2017 Aug 8;70(6):776-803
pubmed: 28461007
Circ Heart Fail. 2010 Nov;3(6):659-67
pubmed: 20852060
J Cardiopulm Rehabil Prev. 2020 Nov;40(6):427-433
pubmed: 32604218
Res Nurs Health. 2019 Aug;42(4):306-316
pubmed: 31045275
J Card Fail. 2021 Mar 1;:
pubmed: 33663906
J Clin Epidemiol. 2010 Nov;63(11):1179-94
pubmed: 20685078
Eur Heart J. 2008 Aug;29(15):1858-66
pubmed: 18515805
Heart Lung. 2010 Nov-Dec;39(6 Suppl):S1-13
pubmed: 20598373
Eur J Cardiovasc Nurs. 2020 Jan;19(1):64-73
pubmed: 31373222
J Am Coll Cardiol. 2011 Oct 18;58(17):1780-91
pubmed: 21996391
Phys Sportsmed. 2010 Apr;38(1):28-36
pubmed: 20424399
JACC Heart Fail. 2019 Jul;7(7):537-546
pubmed: 31078475
Circ Heart Fail. 2013 Nov;6(6):1139-46
pubmed: 24130003
BMC Cardiovasc Disord. 2014 Nov 29;14:172
pubmed: 25433674
JACC Heart Fail. 2021 Jul;9(7):471-481
pubmed: 33992563
JAMA. 2009 Apr 8;301(14):1439-50
pubmed: 19351941
J Am Coll Cardiol. 2012 Jul 10;60(2):120-8
pubmed: 22766338
Circ Cardiovasc Qual Outcomes. 2020 Jan;13(1):e005902
pubmed: 31931615
J Am Coll Cardiol. 2020 Nov 24;76(21):2527-2564
pubmed: 33153861
N Engl J Med. 2021 Jul 15;385(3):203-216
pubmed: 33999544
JAMA. 2021 Feb 9;325(6):542-551
pubmed: 33560320
Circ Heart Fail. 2015 Jan;8(1):209-20
pubmed: 25605639