Data collected via wearables may complement in-clinic assessments to monitor subclinical heart failure (HF). Evaluate the association of sensor-based digital walking measures with HF stage and characterize their correlation with in-clinic measures of physical performance, cardiac function and participant reported outcomes (PROs) in individuals with early HF. The analyzable cohort included participants from the Project Baseline Health Study (PBHS) with HF stage 0, A, or B, or adaptive remodeling phenotype (without risk factors but with mild echocardiographic change, termed RF-/ECHO+) (based on available first-visit in-clinic test and echocardiogram results) and with sufficient sensor data. We computed daily values per participant for 18 digital walking measures, comparing HF subgroups vs stage 0 using multinomial logistic regression and characterizing associations with in-clinic measures and PROs with Spearman's correlation coefficients, adjusting all analyses for confounders. In the analyzable cohort (N=1265; 50.6% of the PBHS cohort), one standard deviation decreases in 17/18 walking measures were associated with greater likelihood for stage-B HF (multivariable-adjusted odds ratios [ORs] vs stage 0 ranging from 1.18-2.10), or A (ORs vs stage 0, 1.07-1.45), and lower likelihood for RF-/ECHO+ (ORs vs stage 0, 0.80-0.93). Peak 30-minute pace demonstrated the strongest associations with stage B (OR vs stage 0=2.10; 95% CI:1.74-2.53) and A (OR vs stage 0=1.43; 95% CI:1.23-1.66). Decreases in 13/18 measures were associated with greater likelihood for stage-B HF vs stage A. Strength of correlation with physical performance tests, echocardiographic cardiac-remodeling and dysfunction indices and PROs was greatest in stage B, then A, and lowest for 0. Digital measures of walking captured by wearable sensors could complement clinic-based testing to identify and monitor pre-symptomatic HF.

中文翻译：

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现实世界的步行行为与早期心力衰竭有关：项目基线健康研究

通过可穿戴设备收集的数据可以补充临床评估，以监测亚临床心力衰竭（HF）。评估基于传感器的数字步行测量与心力衰竭阶段的关联，并描述其与早期心力衰竭患者的身体表现、心脏功能和参与者报告结果 (PRO) 的临床测量的相关性。可分析的队列包括来自项目基线健康研究 (PBHS) 的 HF 0、A 或 B 期或适应性重塑表型（无危险因素，但有轻度超声心动图变化，称为 RF-/ECHO+）的参与者（基于可用的第一-访问临床测试和超声心动图结果）并拥有足够的传感器数据。我们计算了每个参与者 18 项数字步行测量的每日值，使用多项 Logistic 回归比较 HF 亚组与 0 阶段，并用 Spearman 相关系数描述与临床测量和 PRO 的关联，调整所有混杂因素分析。在可分析队列中（N=1265；PBHS 队列的 50.6%），17/18 步行测量中的一个标准差下降与 B 期心力衰竭的可能性更大相关（多变量调整比值比 [OR] 与 0 期范围从 1.18-2.10），或 A（OR 与阶段 0，1.07-1.45），以及 RF-/ECHO+ 的可能性较低（OR 与阶段 0，0.80-0.93）。 30 分钟峰值配速与 B 阶段（OR 与 0 阶段=2.10；95% CI：1.74-2.53）和 A 阶段（OR 与 0 阶段=1.43；95% CI：1.23-1.66）的关联性最强。与 A 期相比，13/18 测量值的下降与 B 期 HF 的可能性更大相关。与身体机能测试、超声心动图心脏重塑和功能障碍指数以及 PRO 的相关性强度在 B 期最大，然后是 A，0 期最低。可穿戴传感器捕获的步行数字测量可以补充基于临床的测试，以识别和监测症状前的心力衰竭。