Heitmann Kim Arne, Welde Boye, Løchen Maja-Lisa, Stylidis Michael, Schirmer Henrik, Morseth Bente
School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Centre for Research and Education, University Hospital of Northern Norway, Tromsø, Norway.
Front Cardiovasc Med. 2022 May 12;9:882077. doi: 10.3389/fcvm.2022.882077. eCollection 2022.
Current knowledge about the relationship between physical activity (PA) and cardiac remodeling is mainly derived from cross-sectional studies of athletes, and there is a knowledge gap of this association in the general adult and elderly population. Therefore, we aimed to explore the longitudinal association between cumulative PA and change in cardiac structure and function in a general adult and elderly population.
This longitudinal study includes 594 participants from the sixth (Tromsø6, 2007-08) and seventh (Tromsø7, 2015-16) survey of the Tromsø Study. Cardiac structure and function were assessed by echocardiography at two time points, and PA was self-reported by questionnaire at both time points. PA volume was expressed as cumulative PA (Low, Moderate, and Hard) and the association with left atrial (LA) and left ventricular (LV) structure and function was assessed using ANCOVA.
Overall, LA diameter index (LADi) increased significantly more in Hard compared to Moderate PA (+0.08 cm/m, 95% CI 0.01-0.15, = 0.020) from Tromsø6 to Tromsø7. When stratified by sex or age, higher levels of cumulative PA were associated with increased LADi in males and in participants <65 years only. Indexed LV mass (LVMi) increased significantly more in Moderate than in Low PA (+3.9 g/m, 95% CI 0.23-7.57, = 0.037). When stratified by sex or age, these changes in LVMi and indexed LV diameter (LVDi) were only significant in females. No significant associations were observed between cumulative PA and change in relative wall thickness, E/e' ratio, e' velocity, LV ejection fraction, and LADi/LVDi ratio.
Higher levels of cumulative PA were associated with increased LADi in males and participants <65 years, and with increased LVMi and LVDi in females. Despite cardiac chamber enlargement, the pump function of the heart did not change with higher levels of PA, and the atrioventricular ratio was unchanged. Our results indicate that cardiac chamber enlargement is a physiological response to PA.
目前关于体力活动（PA）与心脏重塑之间关系的知识主要来自对运动员的横断面研究，而在一般成年和老年人群中，这种关联存在知识空白。因此，我们旨在探讨一般成年和老年人群中累积PA与心脏结构和功能变化之间的纵向关联。
这项纵向研究纳入了来自特罗姆瑟研究第六次（特罗姆瑟6，2007 - 2008年）和第七次（特罗姆瑟7，2015 - 2016年）调查的594名参与者。在两个时间点通过超声心动图评估心脏结构和功能，两个时间点的PA均通过问卷自我报告。PA量表示为累积PA（低、中、高强度），并使用协方差分析评估其与左心房（LA）和左心室（LV）结构及功能的关联。
总体而言，从特罗姆瑟6到特罗姆瑟7，高强度PA组的左心房直径指数（LADi）相比中等强度PA组显著增加更多（+0.08 cm/m，95%CI 0.01 - 0.15，P = 0.020）。按性别或年龄分层时，仅在男性和65岁以下参与者中，较高水平的累积PA与LADi增加相关。中等强度PA组的左心室质量指数（LVMi）相比低强度PA组显著增加更多（+3.9 g/m，95%CI 0.23 - 7.57，P = 0.037）。按性别或年龄分层时，LVMi和左心室直径指数（LVDi）的这些变化仅在女性中显著。在累积PA与相对室壁厚度、E/e'比值、e'速度、左心室射血分数以及LADi/LVDi比值的变化之间未观察到显著关联。
较高水平的累积PA与男性和65岁以下参与者的LADi增加相关，与女性的LVMi和LVDi增加相关。尽管心腔扩大，但心脏的泵功能并未随较高水平的PA而改变，房室比也未改变。我们的结果表明心腔扩大是对PA的一种生理反应。
