Abstract 14: Poor Physical Activity is Associated with Subclinical Myocardial Injury in Obese Adults
Background: Obesity is associated with myocardial injury and subsequent heart failure (HF). Higher physical activity (PA) is associated with reduced risk of HF among individuals with obesity, but the mechanisms for this protective association remain poorly understood.
Hypothesis: We hypothesized that low levels of PA would be independently associated with a higher prevalence of subclinical myocardial injury among obese individuals, as assessed by a high-sensitivity assay for cardiac troponin T (hs-cTnT).
Methods: We evaluated 9,845 ARIC participants without cardiovascular disease at Visit 4 (1996-99) and with body-mass index (BMI) >18.5 kg/m2. PA was assessed at Visit 3 (1993-95) using a modified Baecke questionnaire. The sports indices were converted into minutes per week of moderate or vigorous exercise, and categorized as per AHA guidelines as: recommended (≥150 min/wk of moderate + vigorous intensity or ≥75 min/wk of vigorous intensity); intermediate (1-149 min/wk of moderate + vigorous intensity or 1-74 min/wk of vigorous intensity); or poor (0 min/wk of moderate or vigorous exercise). BMI was also assessed at Visit 3. The primary outcome was elevated hs-cTnT (>14 ng/L) measured at Visit 4. We constructed multivariable logistic regression models to assess the association of PA and obesity with elevated hs-cTnT.
Results: After multivariable regression, relative to recommended PA, poor PA was associated with elevated hs-cTnT (OR 1.33, 95% CI: 1.09-1.61). In analyses stratified by obesity status, lower PA levels were associated with subclinical myocardial injury among non-obese and obese participants (p for trend <0.02 in both groups). Among obese participants, those with recommended PA levels had the lowest likelihood of myocardial injury (Table).
Conclusion: Low PA was associated with prevalent subclinical chronic myocardial injury as manifested by elevated hs-cTnT. This may help explain the possible protection conferred by PA against the development of HF in obese individuals.
Author Disclosures: R. Florido: None. C.E. Ndumele: None. Y. Pang: None. K. Matsushita: None. J.A. Schrack: None. M. Lazo: None. V. Nambi: H. Other; Modest; Has filed a provisional patent (patent #61721475) entitled “Biomarkers to Improve Prediction of Heart Failure Risk”. R.S. Blumenthal: None. A.R. Folsom: None. J. Coresh: None. C.M. Ballantyne: H. Other; Modest; Has filed a provisional patent (patent #61721475) entitled “Biomarkers to Improve Prediction of Heart Failure Risk”. E. Selvin: None.
- © 2015 by American Heart Association, Inc.