OBJECTIVES:Patient-reported outcomes such as quality of life are gaining importance in the assessment of patients suffering from inflammatory bowel disease (IBD). The association of objectively measured physical activity and quality of life in patients with IBD has not been studied in depth. To investigate the association of disease-specific quality of life and physical activity as well as clinical and biochemical disease activity in patients with IBD.METHODS:A total of 91 patients with IBD were stratified into 4 groups (Crohn's disease and ulcerative colitis, in remission and with moderate-severe activity, respectively) and evaluated in terms of disease-specific quality of life (Inflammatory Bowel Disease Questionnaire [IBDQ]), physical activity (accelerometry), body composition (bioelectrical impedance analysis), as well as clinical (Harvey-Bradshaw Index and Simple Clinical Colitis Activity Index) and biochemical (C-reactive protein and fecal calprotectin) parameters of disease activity.RESULTS:In patients with moderate-severe disease activity, the IBDQ was significantly lower as compared to patients in remission (Mann-Whitney U test and Kruskal-Wallis test, P < 0.001). The physical activity level was higher in remission than in active disease (Mann-Whitney U test, P < 0.05). The IBDQ was significantly correlated with the duration of strenuous physical activity per day (P = 0.029178, r = 0.235), skeletal muscle mass (P = 0.033829, r = 0.229), and biomarkers of inflammation (C-reactive protein: P < 0.005, r = −0.335 and fecal calprotectin: P < 0.005, r = −0.385).DISCUSSION:In this prospective, cross-sectional study, disease-specific quality of life was significantly associated with accelerometrically determined physical activity and disease activity in patients with IBD. This may be related to a reciprocal impact of these factors (DRKS00011370).

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Background Heart failure (HF) is a leading cause of mortality in adults with congenital heart disease (ACHD). ACHD is characterized by predominant right heart disease. In non-congenital heart disease inflammation and its mediators such as monocytes/macrophages play an important pathophysiological role in HF. We aimed to evaluate the role of circulating monocyte subsets in ACHD-HF. Methods This cross-sectional study includes 209 ACHD outpatients (mean age: 35.3±11.0 years; NYHA class I/II/III-IV 58.3%/19.6%/13%; male: 59.8%) and 21 healthy controls (age: 29.8±12.6 years; male: 47.6%). Patients with clinical signs of infection, inflammatory diseases or malignancies were excluded. Multivariate analysis was used to relate blood monocyte subsets to NYHA class and echocardiographically derived parameters of right and left ventricular function. Results Compared to control, ACHD had significantly higher circulating levels of pro-inflammatory HLA-DR+CD14++CD16+ intermediate monocytes (24.0±3.3 vs. 43.6±1.7 cells/μL; p<0.001). NT-proBNP was independently associated with reduced left (p<0.0001) and right (p<0.001) ventricular function, diastolic dysfunction (p=0.04) and vena cava diameter (p=0.02). Independent predictors of NYHA class were intermediate monocytes (p=0.022), plasma noradrenaline (p=0.002), albumin (p=0.001) and NT-proBNP (p<0.001). Elevated right ventricular systolic pressure (>35 mmHg) was independently associated with both, higher intermediate monocyte counts (OR 1.36; 95% CI: 1.13–1.62; p=0.001) and low oxygen saturation (OR 0.8; 95% CI: 0.7–0.92; p=0.001), even after multivariable adjustment for age, sex and NYHA class. Conclusions Right ventricular pressure and oxygen saturation are linked to elevated intermediate monocytes, suggesting an important link between inflammation and HF in ACHD. Circulating blood intermediate monocytes represent a promising biomarker in ACHD. Acknowledgement/Funding German Heart Foundation (Deutsche Herzstiftung e.V.)

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