Physical activity in pediatric pulmonary arterial hypertension measured by accelerometry a candidate clinical endpoint

Willemijn M.H. Zijlstra*, Mark Jan Ploegstra, Theresia Vissia-Kazemier, Marcus T.R. Roofthooft, Gideon Du Marchie Sarvaas, Beatrijs Bartelds, Annette Rackowitz, Freek Van Den Heuvel, Hans L. Hillege, Guy Plasqui, Rolf M.F. Berger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

34 Citations (Scopus)



The development of evidence-based treatment guidelines for pediatric pulmonary arterial hypertension (PAH) is hampered by lack of pediatric clinical trials. Trial design is hampered by lack of a feasible clinical endpoint in this population. Objectives: To evaluate the use of accelerometry for measuring physical activity (PA) in pediatric PAH and to investigate its correlation with clinical disease severity markers. Methods: We included children from the Dutch National Network for Pediatric Pulmonary Hypertension. Control patients were recruited from the outpatient cardiology clinic of the Beatrix Children's Hospital. Children were asked to wear the accelerometer for 7 days. Vector magnitude counts per minute (VMCPM) and time per day spent in different PA intensity levels were defined as accelerometer outcomes. Measurements and Main Results: VM CPM was lower in children withPAH(n = 29) than in controls (n = 60; 647 vs. 921; P< 0.001). Children with PAH spent less time in moderate and vigorous PA(13 vs. 29 min/d and 2 vs. 13 min/d, respectively; P<0.001). Time spent in moderate and vigorous PA correlated inversely with World Health Organization functional class. Time spent in moderate PA correlated positively with 6-minute-walk distance. In post hoc analyses, VM CPM and time spent in moderate/vigorous combined and vigorous PA were associated with outcome (P≤0.044). Conclusions: PA is markedly decreased in children with PAH. Accelerometer output correlated with clinical disease severity markers and may predict outcome.We showed an exciting potential of PA as a meaningful endpoint for clinical trials in pediatric PAH, although its clinical utility and prognostic value need to be further validated.

Original languageEnglish
Pages (from-to)220-227
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number2
Publication statusPublished - 15 Jul 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 by the American Thoracic Society.


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