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Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial).

Publication ,  Journal Article
Patel, RB; Vaduganathan, M; Felker, GM; Butler, J; Redfield, MM; Shah, SJ
Published in: Am J Cardiol
May 15, 2019

Although atrial fibrillation/atrial flutter (AF/AFL) and heart failure with preserved ejection fraction (HFpEF) frequently coexist, the influence of AF/AFL on physical activity, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and quality of life in HFpEF is unclear and could have relevance to HFpEF trial design. We evaluated the association between AF/AFL and volitional physical activity, functional performance, NT-proBNP, and quality of life in patients with HFpEF in the Nitrate's Effect on Activity Tolerance (NEAT)-HFpEF trial. Of 99 patients with accelerometer data, 35 (35%) had AF/AFL. There were no differences between AF/AFL versus no AF/AFL in baseline average daily accelerometer units (ADAUs; 9.06 ± 0.54 vs 9.06 ± 0.48, p = 0.75), hours active per day (9.7 ± 2.3 vs 9.2 ± 2.2, p = 0.86), or 6-minute walk distance (6MWD; 307 ± 136m vs 321 ± 110m, p = 0.85). AF/AFL status was associated with higher baseline NT-proBNP (586 [25th to 75th percentile: 291 to 1254] pg/ml vs 154 [25th to 75th percentile: 92 to 288] pg/ml, p <0.001) and Kansas City Cardiomyopathy Questionnaire scores (69 [25th to 75th percentile: 46 to 88] vs 48 [25th to 75th percentile: 37 to 70], p = 0.01). Although treatment responses to isosorbide mononitrate measured by change in ADAUs, hours active per day, or 6MWD did not vary by AF/AFL status (interaction p >0.05 for all), AF/AFL patients had greater reductions in NT-proBNP after isosorbide mononitrate than patients without AF/AFL (interaction p <0.001), possibly due to regression to the mean. In conclusion, baseline measures and treatment-related changes in volitional physical activity (ADAUs) and functional performance (6MWD) did not differ by AF/AFL in NEAT-HFpEF, whereas NT-proBNP did. In HFpEF-where AF/AFL prevalence is high-functional measures may be superior to natriuretic peptides as trial endpoints.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

May 15, 2019

Volume

123

Issue

10

Start / End Page

1660 / 1666

Location

United States

Related Subject Headings

  • Stroke Volume
  • Quality of Life
  • Protein Precursors
  • Prognosis
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male
  • Isosorbide Dinitrate
  • Humans
 

Citation

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Patel, R. B., Vaduganathan, M., Felker, G. M., Butler, J., Redfield, M. M., & Shah, S. J. (2019). Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial). Am J Cardiol, 123(10), 1660–1666. https://doi.org/10.1016/j.amjcard.2019.02.025
Patel, Ravi B., Muthiah Vaduganathan, G Michael Felker, Javed Butler, Margaret M. Redfield, and Sanjiv J. Shah. “Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial).Am J Cardiol 123, no. 10 (May 15, 2019): 1660–66. https://doi.org/10.1016/j.amjcard.2019.02.025.
Patel RB, Vaduganathan M, Felker GM, Butler J, Redfield MM, Shah SJ. Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial). Am J Cardiol. 2019 May 15;123(10):1660–6.
Patel, Ravi B., et al. “Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial).Am J Cardiol, vol. 123, no. 10, May 2019, pp. 1660–66. Pubmed, doi:10.1016/j.amjcard.2019.02.025.
Patel RB, Vaduganathan M, Felker GM, Butler J, Redfield MM, Shah SJ. Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial). Am J Cardiol. 2019 May 15;123(10):1660–1666.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

May 15, 2019

Volume

123

Issue

10

Start / End Page

1660 / 1666

Location

United States

Related Subject Headings

  • Stroke Volume
  • Quality of Life
  • Protein Precursors
  • Prognosis
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male
  • Isosorbide Dinitrate
  • Humans