Abstract 17891: Impact of Physical Activity and Sedentary Time on Heart Failure Outcomes

Abstract

Introduction: The impact of physical inactivity and sedentary time on heart failure (HF) outcomes in patients not participating in exercise program is unclear. Hypothesis: Physical inactivity and sedentary time are associated with worse HF outcomes. Methods: We analyzed data from the multicenter, HF Adherence and Retention Trial (HART) which enrolled 902 NYHA - II/III HF patients with preserved or reduced ejection fraction, followed for 36 months. Based on the mean weekly purposeful physical activity duration, patients were classified into inactive (0 min/wk), partially active (1-90 min/wk), and active (>90min/wk) groups. Patients were also classified according to average daily sedentary television (TV) time into <2 hrs/d, 2-4 hrs/d, and >4 hrs/d groups. Study groups were propensity score matched according to 33 baseline covariates in 1:1:1 ratio. The primary outcome was all-cause death. Secondary outcomes were cardiac death and HF hospitalization. Results: There were 196 inactive, 341 partially active and 365 active patients, of whom 492 (164 in each group) were successfully propensity matched. Physical inactivity was associated with higher risk of death and cardiac death than any level of physical activity, Fig 1. There was no significant difference in HF hospitalization. Furthermore, 465 subjects were propensity matched into three sedentary TV time groups (155 in each group). Sedentary TV time >4 hrs/d was independently and incrementally associated with all-cause death (Δ χ 2 = 6.05; P=0.049), beyond physical activity time, Fig 1. There was no significant difference in mortality between <2 and 2-4 hrs/d sedentary TV time groups, after adjusting to physical activity time, Fig 2. Conclusions: In symptomatic chronic HF patients, physical inactivity is associated with higher all-cause and cardiac mortality. Modest purposeful physical activity was associated with survival benefit. Extended sedentary time was associated incremental increased mortality.