Differences in Exercise Capacity of Heart Failure and Chronic Obstructive Pulmonary Disease Patients Undergoing Exercise Rehabilitation

Ganesh Raam Kumarasamy1, Hélène De Cannière2, Julie Deckers1, Daimy Roebroek3, Julie Vranken1, Peter Karsmakers4, David Ruttens5, Pieter Vandervoort6
1Hasselt University, 2Mobile Health Unit, Hasselt University, 3Future Health Department, Ziekenhuis Oost-Limburg, 4Declaratieve Talen en Artificiele Intelligentie - Advanced Integrated Sensing (DTAI-ADVISE) – KU Leuven, 5Department of Pulmonary Medicine, Ziekenhuis Oost-Limburg, 6Department of Cardiology, Ziekenhuis Oost-Limburg

Abstract

Aim

Prevalence of chronic cardiorespiratory diseases such as heart failure (HF) and chronic obstructive pulmonary disease (COPD) has increased due to population aging and lifestyle changes, increasing the load on healthcare systems. It is important to monitor the disease status outside the hospital to detect early worsening and reduce (re-)hospitalizations. To objectively track disease progression of HF and COPD, we hypothesize that changes in disease status can be captured by measuring changes in exercise capacity of patients. These can be compared with changes in physiological signals to create a score that reflects disease status.

Methods

60 patients (n_HF=35, n_COPD=25) undergoing an exercise rehabilitation program were included in this observational study. Patients underwent rehabilitation 2x/week for 3 months. During this period, they also performed a six-minute walk test (6MWT) every 3 weeks (5 in total) to measure changes in exercise capacity using six-minute walking distance (6MWD). Patients also wore a chest patch that measured single-lead ECG and accelerometer signals. Demographic parameters were analyzed using t-test and the different 6MWDs were analyzed using a mixed-model ANOVA.

Results

Age and BMI did not differ significantly (p_AGE=0.44, p_BMI=0.15) between HF and COPD groups. 6MWD was higher in patients with HF than in COPD (p<0.01) for all 6MWTs. Difference in 6MWD between the five 6MWTs was significant (p<0.01). Post-hoc analysis showed that all pairs of 6MWTs except (6MWT_3, 6MWT_4) and (6MWT_4, 6MWT_5) were different. The interaction between the disease and 6MWT was significant (F(4, 152)=4.038, p=0.004) for all 6MWTs.

Discussion

Changes in functional capacity measured using 6MWTs showed a difference between the HF and COPD groups over time. Further analysis of ECG and accelerometer data during the 6MWT sessions will provide insight into actual disease progression (i.e., functional improvement). This will facilitate the development of an objective score that enables remote monitoring of these diseases.