Abstract
AIMS: To evaluate free-living Total and Physical Activity Energy Expenditures (TEE/PAEE) and to assess the validity of the Daily Activity Questionnaire in Heart Failure (DAQIHF) in chronic heart failure (CHF) patients against the doubly labelled water (DLW) and motion sensors methods. METHODS AND RESULTS: Twenty-nine women/men (12/17) with CHF performed an incremental symptom-limited peak V̇O(2) test. Free-living TEE and PAEE were estimated with the DAQIHF (TEEquest), motion sensor (Armband® TEEActi) and measured over 2 weeks using DLW (TEEDLW). Resting metabolic rate (RMR) and body composition were assessed with different methods, and peak V̇O(2) with quality of life were correlated to TEE. Bland-Altman and Student's t-test analyses were used to compare methods. Statistical significance was set for P < 0.05. Mean TEE did not significantly differ between TEEDLW and TEEquest (+352.4 kJ.24h(-1); +5.3%; P & NS) for the whole group, nor between women or men, NYHA class, or cardiomyopathy: dilated cardiomyopathy/ischaemic cardiomyopathy. Bland-Altman plots revealed no systematic bias for TEE between methods. In a subgroup of women, TEEquest was significantly higher than TEEacti (P < 0.05). RMR estimated from bioelectric impedance overestimated measured RMR (16.4%, P & 0.0028). Patients spent 9.4% of their TEE in activities ≥3 metabolic equivalents. Measured peak V̇O(2) and estimated from the questionnaire were similar (14.1 ± 4.7 vs. 14.8 ± 3.4 mL.min(-1).kg(-1); P < 0.0001) and were correlated to both TEEDLW and TEEquest (R & 0.85 and 0.82, respectively, both P < 0.0001). CONCLUSION: Free-living TEE and peak V̇O(2) can be estimated from the DAQIHF in patients with CHF across all activity domains allowing a complete description/assessment of daily physical activity intensities associated with powerful prognostic risk factors.