The Relationship Between Objectively Measured Step Count, Clinical Characteristics, and Quality of Life Among Depressed Patients Recently Hospitalized With Systolic Heart Failure

Objective Physical activity (PA) can improve symptoms of both depression and heart failure (HF), but objective activity data among recently hospitalized HF patients with co-morbid depression is lacking. We examined PA and the relationship between daily step counts and mood, health-related quality of life (HRQoL), and heart health among patients enrolled in a clinical trial treating HF and co-morbid depression. Methods We screened hospitalized patients with systolic HF (left ventricular ejection fraction [LVEF] ≤45%) and New York Heart Association (NYHA) class II-IV symptoms for depression using the 2-item Patient Health Questionnaire (PHQ-2) and telephoned screen-positive patients to administer the PHQ-9 two-weeks post-discharge. If the patient scored PHQ-9 ≥ 10 and agreed to continue in our study, we administered our baseline assessment and mailed them an armband accelerometer. We instructed patients to wear the armbands for 7 days before returning them and classified their data as "usable" if they wore it ≥10 hours per day on ≥4 separate days. Results We mailed accelerometers to 531 depressed HF patients and 222 (42%) returned them with usable data. Their median age was 64 years, 54% were women, 23% were non-White, and they walked a median of 1,170 steps daily. Higher median daily step counts were associated with lower NYHA class and better physical- and heart failure-specific HRQoL, but not mood symptoms, mental HRQoL, or LVEF. Conclusions Patients with HF and co-morbid depression are generally sedentary following hospital discharge. While mood symptoms and LVEF were unrelated to objective physical activity, patients with higher step counts self-reported better HRQoL.Trial registrationClinicalTrials.gov identifier NCT02044211.