Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, PR China; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, PR China.
Faculty of Medicine & St Vincent Clinical School, UNSW Sydney, NSW, Australia.
Nutr Metab Cardiovasc Dis. 2021 Jan 4;31(1):247-253. doi: 10.1016/j.numecd.2020.08.022. Epub 2020 Aug 23.
Physical activity (PA) could modify the risk of atrial fibrillation (AF) in the general population and mortality in heart failure patients with preserved ejection fraction (HFpEF). HFpEF patients are frequently concomitant with AF, but whether PA could modify the risk of AF in HFpEF patients remains undiscovered.
We performed a post hoc analysis of the TOPCAT trial. Patients without AF at baseline and with data on PA (n = 652) were included. The association between PA and risk of AF occurrence was explored using the Cox proportional hazard model. During a median follow-up of 2.84 years, 9.4% of the studied patients (n = 60) had an occurrence of AF. When PA was analyzed as a continuous variable, every ten-fold increase of PA was associated with a 42.8% risk reduction of AF occurrence (hazard ratio [HR] 0.572, 95% CI 0.357-0.916, p = 0.020). When HFpEF patients were divided into three tertile groups according to PA levels, patients in the second tertile (HR 0.507, 95% CI 0.272-0.946, p = 0.033) and the third tertile (HR 0.487, 95% CI 0.261-0.908, p = 0.024) had significantly lower risks of AF occurrence when compared to those in the first tertile.
Our current results suggest that a higher PA level associates with a lower risk of AF in HFpEF patients.
URL: https://clinicaltrials.gov. Unique identifier: NCT00094302.
体力活动（PA）可能会改变普通人群中心律失常（AF）的风险和射血分数保留的心力衰竭（HFpEF）患者的死亡率。HFpEF 患者常并发 AF，但 PA 是否会改变 HFpEF 患者的 AF 风险仍未可知。
我们对 TOPCAT 试验进行了事后分析。纳入了基线时无 AF 且有 PA 数据的患者（n=652）。使用 Cox 比例风险模型探讨 PA 与 AF 发生风险之间的关系。在中位随访 2.84 年期间，研究患者中有 9.4%（n=60）发生了 AF。当 PA 作为连续变量进行分析时，PA 每增加十倍，AF 发生的风险降低 42.8%（风险比[HR]0.572，95%CI 0.357-0.916，p=0.020）。当根据 PA 水平将 HFpEF 患者分为三组时，第二组（HR 0.507，95%CI 0.272-0.946，p=0.033）和第三组（HR 0.487，95%CI 0.261-0.908，p=0.024）患者的 AF 发生风险显著低于第一组。
我们目前的结果表明，HFpEF 患者中 PA 水平较高与 AF 风险较低相关。
