Daily Physical Activity in Pulmonary Arterial Hypertension: Insights From a Multicenter Longitudinal Trial Using Accelerometry.

Traditional assessments such as the 6-minute walk distance (6MWD) may not adequately capture daily physical activity or patient experience in real-world settings.

传统的评估方法，如6分钟步行距离（6MWD），可能无法充分捕捉到现实世界中患者的日常身体活动或体验。

research_question

Among patients with PAH, do accelerometer-derived measures of daily physical activity reflect disease severity, functional status, and outcomes over time?

在肺动脉高压（PAH）患者中，加速度计衍生的日常身体活动测量是否反映了疾病的严重程度、功能状态和随时间变化的结果？

study_design_and_methods

Pulmonary Hypertension and Anastrozole (PHANTOM), a multicenter randomized controlled trialof anastrozole in PAH, enrolled male patients and postmenopausal female patients with PAH at 7 centers in the United States.

肺动脉高压和阿那曲唑（PHANTOM）是一项在美国7个中心进行的多中心随机对照试验，研究了阿那曲唑在PAH中的应用，招募了男性患者和绝经后女性PAH患者。

Patients completed 4 in-person study visits over 12 months.

患者在12个月内完成了4次面对面的研究访问。

Participants wore hip-based accelerometers for 7 days at each visit.

在每次访问中，参与者佩戴了髋部加速度计7天。

Mixed-effects models assessed associations between daily physical activity and demographic, clinical, echocardiographic, and environmental variables.

混合效应模型评估了日常身体活动与人口统计学、临床、超声心动图和环境变量之间的关联。

Clinical outcomes included: 6MWD; health-related quality of life (HRQoL), assessed by using the emPHasis-10 questionnaire and the 36-item Short Form Health Survey; bone mineral density (BMD); and time to clinical worsening (hospitalization, treatment escalation, or death).

临床结果包括：6分钟步行距离（6MWD）；通过使用emPHasis-10问卷和36项简短形式健康调查评估的健康相关生活质量（HRQoL）；骨密度（BMD）；以及临床恶化的时间（住院、治疗升级或死亡）。

Cox models were used to examine associations between activity and time to clinical worsening.

使用Cox模型来检查活动与临床恶化时间之间的关联。

Results

Eighty-four participants were enrolled (mean age 61 years; 67% female).

共有84名参与者被纳入研究（平均年龄61岁；女性占67%）。

Device adherence was high across visits.

在各次随访中，设备依从性都很高。

Activity declined over time and was lower in patients with World Health Organization functional class III, worse right ventricular function, and connective tissue disease-associated PAH.

随着时间的推移，活动量有所下降，并且在世界卫生组织功能分类III级、右心室功能较差以及结缔组织疾病相关肺动脉高压的患者中活动量更低。

Lower daily activity was associated with worse HRQoL, worse baseline 6MWD, and worse baseline femoral/hip BMD.

较低的日均活动量与较差的健康相关生活质量（HRQoL）、较差的基线6分钟步行距离（6MWD）以及较差的基线股骨/髋部骨密度（BMD）相关。

Lower baseline activity was associated with increased risk of clinical worsening (hazard ratio, 1.06 per hour/week less active; P < .01).

较低的基线活动量与临床恶化风险增加相关（风险比，每减少1小时/周活动量，风险增加1.06；P < .01）。

interpretation

Our results suggest that accelerometer-derived physical activity reflects disease severity and is associated with HRQoL, BMD, and clinical worsening in PAH.

我们的结果表明，加速度计测量的体力活动反映了疾病的严重程度，并与PAH患者的健康相关生活质量、骨密度以及临床恶化相关。

These metrics may offer a dynamic, patient-centered complement to traditional assessments.

这些指标可能为传统的评估方法提供了一个动态的、以患者为中心的补充。