Assessment of Instantaneous Heart Rate and Accelerometry Changes During 6-Minute Walk Tests in Pulmonary Hypertension Using a Multi-modality Patch

The 6-minute walk test (6MWT) is widely used in the assessment in patients with pulmonary arterial hypertension (PAH) to measure disease progression or demonstrate improvement after adding additional treatments.Incorporating continuous heart rate monitoring during 6MWT, Cardiac Effort, has provided more granular information on physiologic stress during 6MWT.With the increased availability for patients to use remote monitoring, we developed an experimental setup and analytical tools to help patients conduct a 6MWT from home by incorporating a wearable device to measure changes in heart rate variables and acceleration.We enrolled 50 subjects and computed a list of ECG and accelerometry measurements at rest, during the 6MWT, and after the test that could be measured easily in the home setting.We studied the reproducibility and absolute values of these measurements across multiple cohorts of PAH (stable and requiring therapy) and healthy subjects.The measurements were reproducible in healthy and stable PAH subjects.In the future, we envision the integration of these variables in a self-administered home 6MWT or other functional assessment to improve remote monitoring in PAH.This will further support patient care and healthcare professionals by detecting changes in clinical status early, especially as more therapies become available and are administered in the home setting.