Cardiorespiratory Fitness, Handgrip Strength, And Movement Behaviors In Heart Failure: Insights From UK Biobank

Previous research reported that adults with heart failure (HF) have high sedentary time (ST), low sleep, and low physical activity (PA), which are associated with cardiorespiratory fitness (CRF) and muscular strength. However, little is known about the compositional associations between movement behaviors and fitness outcomes in HF. PURPOSE: To examine the CRF and handgrip strength (HS) predictions of time reallocations between daily movement behaviors in adults with HF via compositional data analysis. METHODS: A secondary analysis of the UK Biobank was performed in a subsample of adults with pre-existing HF, diagnosed via inpatient hospital records. Measures included accelerometer-derived 24 h activity (ST, light-intensity PA [LPA], moderate-to vigorous-intensity PA [MVPA], and sleep), CRF (predicted peak METs from a cycle ergometer), HS assessed with a dynamometer, and covariates (demographic and anthropometric). Compositional isotemporal substitution modeling was used to predict CRF and HS for the mean movement behavior composition, and for new compositions where 10 minutes of time was statistically reallocated from one behavior to another while holding the remaining behaviors constant and adjusting for covariates. RESULTS: There was a statistically significant association between the overall movement composition and CRF (P = 0.001), but not HS. Replacing 10 minutes of ST, sleep, or LPA with 10 minutes of MVPA predicted greater CRF (Δ peak METs = 0.077, 0.075, and 0.077, respectively). There were asymmetrical CRF predictions from time reallocation: transferring time to MVPA from ST, sleep, or LPA resulted in the estimated increases to CRF that were lower in magnitude than the unfavorable effects of time reallocation from MVPA to ST, sleep, or LPA. Reallocating 10 minutes to ST from MVPA resulted in the greatest change in CRF (Δ predicted peak METs = -0.215). Although not statistically significant, reallocating 10 min to MVPA from any other behavior resulted in positive changes in predicted HS, while substituting MVPA for sleep, ST, or LPA resulted in unfavorable changes in predicted HS (-0.460, -0.454, and -0.460, respectively). CONCLUSIONS: Findings reinforce the importance of healthy movement behavior for adults with HF. Further research on reallocating time from ST to LPA and MVPA is warranted.