Physical activity and its clinical correlates in chronic thromboembolic pulmonary hypertension

Limited data are available on physical activity (PhA) levels in chronic thromboembolic pulmonary hypertension (CTEPH) patients, as well as on the clinical utility of PhA measurements using questionnaires and accelerometers. We aimed to study PhA levels of CTEPH patients and their clinical correlates, and to compare PhA levels measured by the International Physical Activity Questionnaire (IPAQ) with measures from accelerometers. This is a cross-sectional study (n = 50). PhA levels were measured using accelerometers and questionnaires (IPAQ). Clinical parameters evaluated were walked distance on the 6-min-walking test (6MWT), pulmonary vascular resistance, N-terminal brain natriuretic peptide and quality of life (HRQoL) (Cambridge Pulmonary Hypertension Outcome Review questionnaire). Time spent in sedentary behavior was lower in self-reported measurement (279 +/- 165 min/day) compared with accelerometry (446 +/- 117 min/day, p < 0.000). Accelerometer-derived data showed that CTEPH patients spent 60% of the recorded time in sedentary behaviors and 2% in moderate-to-vigorous PhA (MVPA). Correlation analysis showed that MVPA was significantly correlated with 6MWT (p = 0.023) and symptom domain of HRQoL (p = 0.044). Self-reported MVPA was significantly higher than the one registered by the accelerometer (411 +/- 569 vs. 131 +/- 108 min/week, p = 0.027). Bland-Altman analysis indicated poor agreement between the two methods. Our results showed that CTEPH patients spend most of their days in sedentary behaviors and only a small amount of time in MVPA. Only MVPA was associated with HRQoL and CTEPH severity. In addition, we showed a poor agreement between self-reported and accelerometer-derived PhA in CTEPH patients, with the former overestimating the overall PhA.