Lifestyle Walking Intervention for Patients With Heart Failure With Reduced Ejection Fraction: The WATCHFUL Trial

作者：Tomáš Větrovský, Michal Širanec, Tereza Frybova, Iulian Gant, Iveta Svobodová, Aleš Linhart, Jiří Pařenica, Marie Miklíková, Lenka Šujáková, David Pospíšil, Radek Pelouch, Daniela Odrazkova, Petr Pařízek, Jan Přeček, Martin Hutyra, Miloš Táborský, Jiří Veselý, Martin Gřiva, Miroslav Semerad, Václav Bunc, Karolína Hrabcová, Adéla Vojkůvková, Michal Svoboda, Jan Bělohlávek, on behalf of the WATCHFUL Investigators · 发表于：Circulation · 年份：2023 · DOI：10.1161/circulationaha.123.067395 · 被引用次数：46 · 研究领域：Cardiovascular and exercise physiology、Heart Failure Treatment and Management、Cardiovascular Function and Risk Factors

BACKGROUND: Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS: The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the di...