Trial reportChest2026
Daily Physical Activity in Pulmonary Arterial Hypertension: Insights From a Multicenter Longitudinal Trial Using Accelerometry.
Trial report in Chest, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
13 authors.
Funding
Abstract
backgroundPulmonary arterial hypertension (PAH) is a progressive disease associated with high morbidity and mortality. Traditional assessments such as the 6-minute walk distance (6MWD) may not adequately capture daily physical activity or patient experience in real-world settings. RESEARCH QUESTION: Among patients with PAH, do accelerometer-derived measures of daily physical activity reflect disease severity, functional status, and outcomes over time? STUDY DESIGN AND
methodsPulmonary Hypertension and Anastrozole (PHANTOM), a multicenter randomized controlled trial of anastrozole in PAH, enrolled male patients and postmenopausal female patients with PAH at 7 centers in the United States. Patients completed 4 in-person study visits over 12 months. Participants wore hip-based accelerometers for 7 days at each visit. Mixed-effects models assessed associations between daily physical activity and demographic, clinical, echocardiographic, and environmental variables. 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). Cox models were used to examine associations between activity and time to clinical worsening.
resultsEighty-four participants were enrolled (mean age 61 years; 67% female). Device adherence was high across visits. 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. Lower daily activity was associated with worse HRQoL, worse baseline 6MWD, and worse baseline femoral/hip BMD. Lower baseline activity was associated with increased risk of clinical worsening (hazard ratio, 1.06 per hour/week less active; P < .01).
interpretationOur results suggest that accelerometer-derived physical activity reflects disease severity and is associated with HRQoL, BMD, and clinical worsening in PAH. These metrics may offer a dynamic, patient-centered complement to traditional assessments.
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