Sensor Estimated Home 6-Minute Walk Distance and Cardiac Effort in Pulmonary Hypertension and Heart Failure

Area of Science:

• Cardiopulmonary exercise testing
• Biomedical engineering
• Remote patient monitoring

Background:

• Six-minute walk distance (6MWD) and Cardiac Effort (heartbeats per distance) are key functional metrics.
• Current assessment methods are often limited to clinical settings.
• Sensor technology offers potential for home-based, continuous monitoring.

Purpose of the Study:

• To evaluate the influence of walking course length on sensor-based 6MWD and Cardiac Effort measurements.
• To assess the feasibility and accuracy of home-based measurements compared to in-clinic tests.
• To examine changes in these metrics over time in patients with pulmonary hypertension and heart failure.

Main Methods:

• Prospective observational study with pulmonary hypertension, heart failure patients, and controls.
• Chest-based sensors recorded accelerometry and electrocardiographic data during clinic and home-based 6-minute walk tests (6MWT).
• Walk distance and Cardiac Effort were compared using direct observation, lap counts, and signal-derived methods, analyzed with t-tests, correlation, and Bland-Altman plots.

Main Results:

• Sixty-six participants (42 patients, 24 controls) were enrolled.
• Home-based walk distance correlated with shorter in-clinic courses, while Cardiac Effort measurements were consistent between home and clinic.
• Home-based Cardiac Effort effectively tracked changes over the eight-week study period.

Conclusions:

• Home-based functional testing using Cardiac Effort provides a reliable remote metric.
• This approach can potentially enhance the management of heart failure patients.
• Sensor-based remote monitoring offers a simple, effective tool for clinical practice.