{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T22:21:44Z","timestamp":1775600504258,"version":"3.50.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>This study aims to evaluate limited data about daily physical activity patterns, influential factors, and their association with 1-year mortality or rehospitalization after transcatheter aortic valve replacement (TAVR) through smartwatches.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Consecutive severe aortic stenosis patients undergoing elective transfemoral TAVR in a Chinese tertiary hospital were enrolled from July 2021 to May 2022 and received a Huawei smartwatch at least 1 day before TAVR. The primary outcome was a composite of all-cause mortality or hospital readmission within 1 year. Linear mixed-effects models were applied to determine influential factors of daily step counts, and Cox proportional hazard regression models were to estimate the association between baseline step counts within 1 month since discharge and composite outcome from months 2 to 12. The dose-response association was assessed using restricted cubic spline curves.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 222 participants and 59\u2005469 valid monitoring person-day records were included (mean age, 72.7 years; 61% women). Step counts increased rapidly within the first 2 months (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), followed by a slower increase for those without composite outcomes (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.029) and a gradual decrease for those who developed composite outcomes (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). In multivariate linear mixed models, a 1-m increase in baseline 6-minute walk test and a 1-month delay after discharge were associated with 4 (95% CI, 1\u20137) and 170 (95% CI, 145\u2013194) additional step counts, respectively. In restricted cubic spline analysis, the hazard ratio declined progressively until \u22485000 steps per day, after which they leveled. Below 5000 steps, the adjusted hazard ratio of composite outcome associated with each 1000-step count increase was 0.67 (0.50\u20130.89;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.007). However, above 5000 steps, step counts were not significantly associated with the composite outcome (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.645), with a hazard ratio of 1.12 (0.70\u20131.79).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Daily step counts rapidly increased within the first 2 months post-TAVR. Increased physical activity was associated with a lower risk of 1-year mortality or rehospitalization after TAVR for patients with daily step counts below 5000.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04454177.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.123.010066","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T10:00:35Z","timestamp":1702461635000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Daily Physical Activity Measured by Wearable Smartwatch for Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the SMART TAVR Study"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct04454177","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1909-9026","authenticated-orcid":true,"given":"Jiaqi","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (J.F.)."},{"name":"State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."},{"name":"State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.)."},{"name":"Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China (Q.L., J.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7782-891X","authenticated-orcid":true,"given":"Hanyi","family":"Dai","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine, Hangzhou, China (H.D., D.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-9490","authenticated-orcid":true,"given":"Dao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine, Hangzhou, China (H.D., D.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8206-6323","authenticated-orcid":true,"given":"Yuchao","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianguo","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Electrocardiogram (J.X.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jubo","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinping","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."},{"name":"State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing (C.L.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianbao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian\u2019an","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China."},{"name":"State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.)."},{"name":"Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China (Q.L., J.W.)."},{"name":"Research Center for Life Science and Human Health, Binjiang Institute of Zhejiang University, Hangzhou, China (J.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.03.075"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.08.016"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.5302"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.2039"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.04.018"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV8I4A68"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.02.049"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12908"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023219"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02012-w"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2021.07.001"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/s23063347"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjdh\/ztab007"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2018.03.016"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.026349"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13670-015-0152-7"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.09.050"},{"key":"e_1_3_3_19_2","unstructured":"U.S. Department of Health and Human Services. 2018 Physical activity guidelines advisory committee scientific report. https:\/\/health.gov\/sites\/default\/files\/2019-09\/PAG_Advisory_Committee_Report.pdf"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00302-9"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0899"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001569"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000778"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.123.010066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T21:14:57Z","timestamp":1748553297000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.123.010066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.123.010066"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.123.010066","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}