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Actigraphy-Quantified Physical Activity Measurements in Patients with Symptomatic LMNA-Related Dilated Cardiomyopathy
Pablo Garcia-Pavia1, Xuemei Cai2, Junrui Di2
1Hospital Universitario Puerta de Hierro Majadahonda, CIBERCV, IDIPHISA, and Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
Introduction:
Actigraphy-quantified physical activity (PA) allows for continuous measurements of PA that are reflective of real-world day-to-day functioning and morbidity in persons living with cardiomyopathy. This analysis reports the results of actigraphy monitoring and relates these to other clinical outcome assessments in the phase 3, multinational REALM-dilated cardiomyopathy (DCM) (NCT03439514) clinical trial in LMNA-related DCM.
Methods:
Between 2020 and 2022, REALM-DCM randomized 37 patients with actigraphy worn on the nondominant wrist continuously to monitor daily PA. Of those, 35 participants had analyzable data for this analysis.
Results:
The median duration of actigraphy monitoring for all participants was 293 days across 120 patient visits. Over 85% of the visits met a predefined threshold of wear-time compliance of 10 h of awake wear time for at least 4 days within the 2-week monitoring period prior to and after clinic visits. Kansas City Cardiomyopathy Questionnaire (KCCQ) physical limitation scores were positively associated with several actigraphy-quantified PA metrics, including moderate-to-vigorous physical activity (MVPA), moderate activity, non-sedentary behavior, total step counts, total activity counts (all 3 axes and their vector magnitude). Six-minute walk time distance was positively associated with time spent in MVPA and moderate activity, and total step counts. Patient Global Impression (PGI) Symptom Heart Failure Severity was negatively associated with non-sedentary behavior, total activity counts (vector magnitude, X- and Y-axes), and light activity. Actigraphy endpoints also distinguished between NYHA class II and class III patients. Actigraphy endpoints did not correlate with the KCCQ total score.
Conclusion:
This is the largest and most longitudinal dataset of LMNA-DCM patients collected and reported to date using wearable sensors to gain understanding of PA patterns in these patients. These data help understand the potential use of actigraphy monitoring and wearable technologies in genetic cardiomyopathy and heart failure clinical trials.
