First Cardiology Clinic, School of Medicine, University of Athens, Greece.
Hellenic J Cardiol. 2014 Nov-Dec;55(6):448-56.
Regular physical activity has been associated with less severity of an acute coronary syndrome (ACS), lower in-hospital mortality rates, and an improved short term prognosis. This study evaluated the relationship between physical activity status and the development of left ventricular systolic dysfunction (LVSD) according to inflammation and sex in elderly patients who had had an ACS.
We analyzed prospectively collected data from 355 male (age 74 ± 6 years) and 137 female (76 ± 6 years) patients who were hospitalized with an ACS. LVSD was evaluated by echocardiography on the 5th day of hospitalization and physical activity status was assessed by a self-reported questionnaire. Inflammatory response was evaluated by measuring C-reactive protein levels. Logistic regression models were applied to evaluate the effect of physical activity status on the development of LVSD and inflammatory response at entry.
Physical inactivity had a higher prevalence in women who developed LVSD than in the female patients with preserved systolic function (46% vs. 20%, p=0.02). There was a significant positive association between physical activity levels and ejection fraction in women (p=0.06), but not in men (p=0.30). Multiadjusted logistic regression showed that women who were physically active had 76% lower odds (95%CI: 1-94%) of developing LVSD compared to their sedentary counterparts. Furthermore, physical activity was inversely associated with C-reactive protein levels in both sexes (p=0.08).
Long-term involvement in a physically active lifestyle seems to confer further cardio-protection by reducing the inflammatory response and preserving left ventricular systolic function in elderly female, but not male patients with an ACS.
有规律的身体活动与急性冠状动脉综合征（ACS）严重程度降低、住院死亡率降低以及短期预后改善有关。本研究评估了身体活动状况与炎症和性别对老年 ACS 患者左心室收缩功能障碍（LVSD）发展的关系。
我们分析了 355 名男性（年龄 74±6 岁）和 137 名女性（年龄 76±6 岁）因 ACS 住院的前瞻性收集的数据。通过入院第 5 天行超声心动图评估 LVSD，通过自我报告问卷评估身体活动状况。通过测量 C 反应蛋白水平评估炎症反应。应用逻辑回归模型评估身体活动状况对入院时 LVSD 和炎症反应发展的影响。
与收缩功能正常的女性患者相比，发生 LVSD 的女性患者体力活动不足的比例更高（46% vs. 20%，p=0.02）。身体活动水平与女性射血分数呈显著正相关（p=0.06），但与男性无关（p=0.30）。多因素逻辑回归显示，与久坐不动的女性相比，身体活跃的女性发生 LVSD 的几率降低了 76%（95%CI：1-94%）。此外，身体活动与两性的 C 反应蛋白水平呈负相关（p=0.08）。
长期参与积极的生活方式可能会通过降低炎症反应并保护老年 ACS 女性患者的左心室收缩功能，从而提供进一步的心脏保护，但对男性患者没有这种作用。
