Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland.
Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, Durham, NC, 27705, USA.
BMC Cardiovasc Disord. 2019 Jul 30;19(1):180. doi: 10.1186/s12872-019-1164-6.
Cardiovascular (CV) diseases including heart failure are the leading causes of morbidity, with age being the primary risk factor. The combination of age-related organic functional impairment and reduced physical fitness can drastically impact an individual's healthspan. One's lifespan can potentially be prolonged by the preservation or improvement of physical fitness. However, it remains unclear as to which biomarkers are most suitable for distinguishing between healthy aging and the impaired organ function associated with heart failure. Therefore, a comprehensive assessment of the components of physical fitness and CV function will be performed to identify the most important factors contributing to aging in relation to both health and disease.
This cross-sectional investigation will consist of two parts: COmPLETE-Health (C-Health) and COmPLETE-Heart (C-Heart). C-Health will examine the aging trajectories of physical fitness components and CV properties in a healthy population sample aged between 20 and 100 years (n = 490). Separately, C-Heart will assess the same markers in patients at different stages of chronic heart failure (n = 80). The primary outcome to determine the difference between C-Health and C-Heart will be cardiorespiratory fitness as measured by cardiopulmonary exercise testing on a bicycle ergometer. Secondary outcomes will include walking speed, balance, isometric strength, peak power, and handgrip strength. Physical activity as a behavioural component will be assessed objectively via accelerometry. Further, CV assessments will include pulse wave velocity; retinal, arterial, and venous diameters; brachial and retinal arterial endothelial function; carotid intima-media thickness; and systolic and diastolic function. The health distances for C-Health and C-Heart will be calculated using the methodology based on statistical (Mahalanobis) distance applied to measurements of quantitative biomarkers.
This research seeks to identify physical fitness and CV biomarkers that best resemble underlying CV risk with age. Further, it will examine which physical fitness markers are impaired most in heart failure. The presented integrative approach could define new recommendations for diagnostic guidance in aging. Ultimately, this study is expected to offer a better understanding of which functional characteristics should be specifically targeted in primary and secondary prevention to achieve an optimal healthspan.
心血管（CV）疾病包括心力衰竭是发病率的主要原因，年龄是主要危险因素。与心力衰竭相关的器官功能障碍和身体活动能力下降的组合会严重影响个体的健康寿命。通过保持或提高身体活动能力，一个人的寿命可能会延长。然而，目前尚不清楚哪些生物标志物最适合区分健康衰老和与心力衰竭相关的器官功能障碍。因此，将对身体活动能力和 CV 功能的组成部分进行全面评估，以确定与健康和疾病相关的衰老的最重要因素。
本横断面研究将包括两部分：COmPLETE-Health（C-Health）和 COmPLETE-Heart（C-Heart）。C-Health 将检查 20 至 100 岁健康人群样本中身体活动能力组成部分和 CV 特性的衰老轨迹（n=490）。另外，C-Heart 将评估不同阶段慢性心力衰竭患者的相同标志物（n=80）。确定 C-Health 和 C-Heart 之间差异的主要结局将是通过自行车测力计心肺运动测试测量的心肺适能。次要结局将包括步行速度、平衡、等长力量、峰值功率和握力。通过加速度计对作为行为成分的身体活动进行客观评估。此外，CV 评估将包括脉搏波速度；视网膜、动脉和静脉直径；肱动脉和视网膜动脉内皮功能；颈动脉内膜中层厚度；和收缩和舒张功能。C-Health 和 C-Heart 的健康距离将使用基于应用于定量生物标志物测量的统计（马哈拉诺比斯）距离的方法计算。
本研究旨在确定最能反映与年龄相关的 CV 风险的身体活动能力和 CV 生物标志物。此外，它将检查心力衰竭中哪些身体活动能力标志物受损最严重。提出的综合方法可以为老化的诊断指导定义新的建议。最终，本研究有望更好地理解在初级和二级预防中应特别针对哪些功能特征，以实现最佳的健康寿命。
