PMID- 30876658
OWN - NLM
STAT- MEDLINE
DCOM- 20200116
LR  - 20200516
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 123
IP  - 10
DP  - 2019 May 15
TI  - Physical Activity, Quality of Life, and Biomarkers in Atrial Fibrillation and 
      Heart Failure With Preserved Ejection Fraction (from the NEAT-HFpEF Trial).
PG  - 1660-1666
LID - S0002-9149(19)30230-9 [pii]
LID - 10.1016/j.amjcard.2019.02.025 [doi]
AB  - Although atrial fibrillation/atrial flutter (AF/AFL) and heart failure with 
      preserved ejection fraction (HFpEF) frequently coexist, the influence of AF/AFL 
      on physical activity, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and 
      quality of life in HFpEF is unclear and could have relevance to HFpEF trial 
      design. We evaluated the association between AF/AFL and volitional physical 
      activity, functional performance, NT-proBNP, and quality of life in patients with 
      HFpEF in the Nitrate's Effect on Activity Tolerance (NEAT)-HFpEF trial. Of 99 
      patients with accelerometer data, 35 (35%) had AF/AFL. There were no differences 
      between AF/AFL versus no AF/AFL in baseline average daily accelerometer units 
      (ADAUs; 9.06 +/- 0.54 vs 9.06 +/- 0.48, p = 0.75), hours active per day (9.7 +/- 2.3 vs 
      9.2 +/- 2.2, p = 0.86), or 6-minute walk distance (6MWD; 307 +/- 136m vs 321 +/- 110m, 
      p = 0.85). AF/AFL status was associated with higher baseline NT-proBNP (586 [25th 
      to 75th percentile: 291 to 1254] pg/ml vs 154 [25th to 75th percentile: 92 to 
      288] pg/ml, p <0.001) and Kansas City Cardiomyopathy Questionnaire scores (69 
      [25th to 75th percentile: 46 to 88] vs 48 [25th to 75th percentile: 37 to 70], p 
      = 0.01). Although treatment responses to isosorbide mononitrate measured by 
      change in ADAUs, hours active per day, or 6MWD did not vary by AF/AFL status 
      (interaction p >0.05 for all), AF/AFL patients had greater reductions in 
      NT-proBNP after isosorbide mononitrate than patients without AF/AFL (interaction 
      p <0.001), possibly due to regression to the mean. In conclusion, baseline 
      measures and treatment-related changes in volitional physical activity (ADAUs) 
      and functional performance (6MWD) did not differ by AF/AFL in NEAT-HFpEF, whereas 
      NT-proBNP did. In HFpEF-where AF/AFL prevalence is high-functional measures may 
      be superior to natriuretic peptides as trial endpoints.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Patel, Ravi B
AU  - Patel RB
AD  - Division of Cardiology, Department of Medicine, Northwestern University Feinberg 
      School of Medicine, Chicago, Illinois. Electronic address: 
      ravi.patel@northwestern.edu.
FAU - Vaduganathan, Muthiah
AU  - Vaduganathan M
AD  - Brigham and Women's Heart & Vascular Center, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Felker, G Michael
AU  - Felker GM
AD  - Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
FAU - Butler, Javed
AU  - Butler J
AD  - Department of Medicine, University of Mississippi Medical Center, Jackson, 
      Mississippi.
FAU - Redfield, Margaret M
AU  - Redfield MM
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
FAU - Shah, Sanjiv J
AU  - Shah SJ
AD  - Division of Cardiology, Department of Medicine, Northwestern University Feinberg 
      School of Medicine, Chicago, Illinois.
LA  - eng
GR  - UL1 TR002548/TR/NCATS NIH HHS/United States
GR  - U10 HL110342/HL/NHLBI NIH HHS/United States
GR  - U10 HL084904/HL/NHLBI NIH HHS/United States
GR  - U10 HL110312/HL/NHLBI NIH HHS/United States
GR  - T32 HL069771/HL/NHLBI NIH HHS/United States
GR  - U10 HL110262/HL/NHLBI NIH HHS/United States
GR  - U10 HL110337/HL/NHLBI NIH HHS/United States
GR  - U54 GM115428/GM/NIGMS NIH HHS/United States
GR  - U10 HL110309/HL/NHLBI NIH HHS/United States
GR  - U10 HL110336/HL/NHLBI NIH HHS/United States
GR  - U10 HL110338/HL/NHLBI NIH HHS/United States
GR  - U10 HL110302/HL/NHLBI NIH HHS/United States
GR  - U10 HL110297/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190223
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 0 (Protein Precursors)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - IA7306519N (Isosorbide Dinitrate)
RN  - LX1OH63030 (isosorbide-5-mononitrate)
SB  - IM
MH  - Accelerometry
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/complications/drug therapy/*physiopathology
MH  - Biomarkers/blood
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - *Exercise
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/blood/complications/*physiopathology
MH  - Humans
MH  - Isosorbide Dinitrate/analogs & derivatives/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Prognosis
MH  - Protein Precursors
MH  - *Quality of Life
MH  - Stroke Volume/*physiology
PMC - PMC6488421
MID - NIHMS1522530
EDAT- 2019/03/17 06:00
MHDA- 2020/01/17 06:00
PMCR- 2020/05/15
CRDT- 2019/03/17 06:00
PHST- 2018/12/27 00:00 [received]
PHST- 2019/02/07 00:00 [revised]
PHST- 2019/02/13 00:00 [accepted]
PHST- 2019/03/17 06:00 [pubmed]
PHST- 2020/01/17 06:00 [medline]
PHST- 2019/03/17 06:00 [entrez]
PHST- 2020/05/15 00:00 [pmc-release]
AID - S0002-9149(19)30230-9 [pii]
AID - 10.1016/j.amjcard.2019.02.025 [doi]
PST - ppublish
SO  - Am J Cardiol. 2019 May 15;123(10):1660-1666. doi: 10.1016/j.amjcard.2019.02.025. 
      Epub 2019 Feb 23.