{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T16:10:19Z","timestamp":1778343019808,"version":"3.51.4"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Wearable smartwatches enable objective quantification of physical activity. This study evaluated the association of extravalvular cardiac damage in aortic stenosis with smartwatch\u2010recorded physical activity before and after transcatheter aortic valve implantation (TAVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with severe symptomatic aortic stenosis were dichotomized into cardiac damage stages 0 to 2 (left\u2010heart dysfunction) and stages 3 to 4 (pulmonary\/right\u2010heart dysfunction) by echocardiography. All patients received a Fitbit smartwatch for 7\u2009days of continuous monitoring before transcatheter aortic valve implantation and at 6\u2010month follow\u2010up. Regression models determined significant predictors of total daily step count and moderate to vigorous physical activity (MVPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Within the study cohort (stages 0\u20132: 43 [50.6%]; stages 3\u20134: 42 [49.4%]), all patients showed significant improvement in physical activity from baseline to follow\u2010up (all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Patients in stages 3 to 4 had significantly lower total daily step count and MVPA at baseline and follow\u2010up, as well as a smaller improvement in MVPA (all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05). Relative to stages 0 to 2, stages 3 to 4 were significantly associated with lower step count and MVPA at baseline (step count: \u03b2=\u22121453.8 [95% CI, \u22122351.3 to \u2212554.2],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002; MVPA: \u03b2=\u221212.9 [95% CI, \u221224.3 to \u22121.5],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.027) and follow\u2010up (step count: \u03b2=\u22121438.1 [95% CI, \u22122453.9 to \u2212422.3],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006; MVPA: \u03b2=\u221227.4 [95% CI, \u221247.7 to \u22127.1],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.009), as well as less improvement in MVPA (\u03b2=\u221214.5 [95% CI, \u221228.4 to \u22120.48],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.043) after transcatheter aortic valve implantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The extent of cardiac damage before transcatheter aortic valve implantation has an important impact on physical activity, both at baseline and following intervention. Future studies should examine whether smartwatch\u2010measured activity predicts death across cardiac damage stages and whether cardiac rehabilitation improves outcomes in aortic stenosis with advanced remodeling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047277","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:10:18Z","timestamp":1775556618000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Extravalvular Remodeling on Wearable Smartwatch\u2010Recorded Physical Activity in Patients Undergoing Transcatheter Aortic Valve Implantation for Severe Symptomatic Aortic Stenosis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1464-3109","authenticated-orcid":false,"given":"Vitaliy","family":"Androshchuk","sequence":"first","affiliation":[{"name":"King\u2019s College London","place":["London, 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