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Change in Physical Activity and Cardiac Structure over 10 Years

The Multi-Ethnic Study of Atherosclerosis

FLORIDO, ROBERTA1,2; ZHAO, DI1,3; NDUMELE, CHIADI E.1,2,3; BLUEMKE, DAVID A.4; HECKBERT, SUSAN R.5; ALLISON, MATTHEW A.6; AMBALE-VENKATESH, BHARATH7; LIU, CHIA-YING2; LIMA, JOAO2; MICHOS, ERIN D.1,2,3

Medicine & Science in Sports & Exercise: October 2019 - Volume 51 - Issue 10 - p 2033–2040
doi: 10.1249/MSS.0000000000002027
EPIDEMIOLOGY
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Introduction Physical activity (PA) is inversely associated with risk of heart failure and cardiovascular disease (CVD), whereas increased left ventricular (LV) mass and mass to volume (m:v) ratio are unfavorable CVD risk factors. We assessed whether changes in leisure time PA were associated with longitudinal changes in cardiac structure in a community-based population.

Methods We included 2779 Multi-Ethnic Study of Atherosclerosis participants, free of baseline CVD, who had available data on PA and cardiac magnetic resonance imaging at examinations 1 (2000–2002) and 5 (2010–2012). Physical activity was measured by a Typical Week PA Survey and converted to MET-minutes per week of moderate+vigorous activity. We used linear mixed effect models to estimate the associations of baseline and change in PA with baseline and change in cardiac structure, adjusting for CVD risk factors and body size.

Results At baseline, the mean age was 59 yr, 53% were women, and 58% of nonwhite race/ethnicity. During average 10-yr follow-up, and after accounting for baseline PA levels, the highest quintiles of PA increase were significantly associated with increases in LV mass (2.3 g; 95% confidence interval [CI], 0.4–4.2), LV end-diastolic volume (4.7 mL; 95% CI, 2.4–7.0), and stroke volume (3.3 mL; 95% CI, 1.6–5.1), but lower M:V ratio (−2.9; 95% CI, −5.0 to −0.8) compared with the lowest quintiles. Increasing exercise PA was associated with increases in LV diameter and reductions in M:V ratio, whereas occupational PA was associated with increases in m:v ratio. Increasing PA over 10 yr was also associated with greater risk of eccentric dilated LV hypertrophy at examination 5.

Conclusions After accounting for baseline PA, greater positive changes in leisure-time PA levels were associated with a more eccentric-type of LV remodeling pattern over 10 yr. The clinical implications of such findings remain to be determined.

1Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD

2Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD

3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

4Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison WI

5Department of Epidemiology, University of Washington, Seattle, WA

6Department of Family Medicine and Public Health, University of California, San Diego, CA

7Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD

Address for correspondence: Roberta Florido, M.D., M.H.S., 600 North Wolfe St, Carnegie 565B Baltimore, MD 21287; E-mail: rflorid1@jhmi.edu.

Submitted for publication October 2018.

Accepted for publication March 2019.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.acsm-msse.org).

Online date: May 4, 2019

© 2019 American College of Sports Medicine