Sedentary behavior is associated with physical activity, functional capacity, and a history of stroke in patients with heart failure. A cross-sectional study

Abstract Aims: Sedentary behavior (SB) has emerged as an important risk factor for poor health. Evidence showed that patients with heart failure (HF) exhibit high levels of SB, and that high SB increases mortality among such patients. We aimed to identify factors associated with SB in HF patients. Methods: A cross-sectional study was carried out with adults with HF and categorized under New York Heart Association (NYHA) functional class I-III. Sociodemographic, clinical, and health information were gathered. Evaluation of SB (by sitting time) and moderate-to-vigorous physical activity (MVPA) was performed by self-reported measures. Functional capacity was assessed using the Duke Activity Status Index. Simple and multivariate linear regression analyses were performed to identify the most suitable predictive model. Results: The sample (n = 80) comprised predominantly of patients in functional class I, men, and with an average age of 50.8 years. Time spent on SB totaled to 7.69 ± 2.35 h/day. Weekly volume of MVPA, functional capacity, and previous stroke were predictors of higher SB. Using simple linear regression analysis, the variables body mass index, quality of life, NYHA functional class, total comorbidities, dyslipidemia, MVPA in the leisure domain, and the use of diuretics, statins, and sildenafil were shown to have a statistically significant association with SB. Conclusion: In patients with HF, a longer time spent in SB was associated with low volumes of MVPA, low functional capacity, and history of stroke. More studies are needed to corroborate these findings.

摘要 研究目标：久坐行为（Sedentary Behavior，SB）已成为损害健康的重要危险因素。现有研究证实，心力衰竭（Heart Failure，HF）患者的久坐行为水平较高，且高水平久坐行为会升高该类患者的死亡率。本研究旨在明确心力衰竭患者久坐行为的相关影响因素。
方法：本研究针对符合纽约心脏协会（New York Heart Association，NYHA）心功能分级I~III级的成年心力衰竭患者开展横断面研究。收集受试者的社会人口学特征、临床及健康相关信息。采用自我报告法评估久坐行为（以每日久坐时长为衡量指标）及中等至高强度体力活动（Moderate-to-Vigorous Physical Activity，MVPA）。通过杜克活动状态指数（Duke Activity Status Index）评估受试者的活动功能能力。采用简单线性回归与多元线性回归分析筛选最优预测模型。
结果：本研究共纳入80例受试者，受试者以心功能I级患者、男性为主，平均年龄为50.8岁。受试者日均久坐总时长为7.69±2.35小时。每周中等至高强度体力活动总量、活动功能能力及既往卒中史为高水平久坐行为的预测因素。经简单线性回归分析显示，体重指数、生活质量、NYHA心功能分级、共病总数、血脂异常、休闲领域中等至高强度体力活动，以及利尿剂、他汀类药物、西地那非的使用情况均与久坐行为存在统计学意义上的显著关联。
结论：心力衰竭患者的久坐时长越长，其每周中等至高强度体力活动总量越低、活动功能能力越差，且合并卒中病史。未来需开展更多研究以验证本研究结果。