Chung Ho-Gi, Yang Pil-Sung, Jang Eunsun, Kim Juntae, Kim Min, Kim Daehoon, Yu Hee Tae, Kim Tae-Hoon, Uhm Jae-Sun, Sung Jung-Hoon, Pak Hui-Nam, Lee Moon-Hyoung, Joung Boyoung
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Heart Rhythm. 2025 Jul;22(7):e155-e164. doi: 10.1016/j.hrthm.2025.01.005. Epub 2025 Jan 9.
There is limited information on protective factors related to atrioventricular (AV) block.
This study examines the association between accelerometer-derived moderate-to-vigorous physical activity (MVPA) and AV block in healthy elderly individuals.
A total of 23,590 UK Biobank participants ≥60 years of age involved in a wrist-worn accelerometer study with no history of hypertension, diabetes mellitus, dyslipidemia, and coronary heart disease were analyzed. The associations of MVPA with primary (second- or third-degree AV block) and secondary outcome (third-degree AV block, pacemaker implantation) were evaluated by Cox regression analysis. The associations of MVPA with electrocardiogram parameters were evaluated by linear regression analysis.
The mean age was 63.8 ± 2.8 years, and 57.4% were women. During the median follow-up period of 6.1 years, 115 primary outcome events occurred. Compared with quintile 1 (< 89 min/week), those in quintile 4 (280-449 min/week) had a 63% lower incidence of primary outcome (hazard ratio [HR] 0.37, 95% confidence interval [CI] 0.19-0.73, P = .004); however, the result was attenuated in quintile 5. This pattern was consistently observed in the relationship between MVPA and third-degree AV block (quintile 4 vs quintile 1: HR 0.29, 95% CI 0.11-0.74, P = .010) and pacemaker implantation. MVPA per 150 minutes per week increase was independently negatively associated with normalized PQ interval (msec) (β: -2.13, 95% CI 0-3.03 to ‒1.24, P < .001).
In the healthy elderly population, MVPA was associated with a lower risk of second- or third-degree AV block, which correlates with the reduction of normalized PQ interval. However, excessive MVPA attenuated the results.
关于与房室传导阻滞相关的保护因素的信息有限。
本研究探讨在健康老年人中，加速度计测量的中等到剧烈身体活动（MVPA）与房室传导阻滞之间的关联。
对英国生物银行中23590名年龄≥60岁、参与佩戴腕式加速度计研究且无高血压、糖尿病、血脂异常和冠心病病史的参与者进行分析。通过Cox回归分析评估MVPA与主要结局（二度或三度房室传导阻滞）和次要结局（三度房室传导阻滞、起搏器植入）之间的关联。通过线性回归分析评估MVPA与心电图参数之间的关联。
平均年龄为63.8±2.8岁，女性占57.4%。在6.1年的中位随访期内，发生了115例主要结局事件。与第一五分位数组（<89分钟/周）相比，第四五分位数组（280 - 449分钟/周）的主要结局发生率降低了63%（风险比[HR]0.37，95%置信区间[CI]0.19 - 0.73，P = 0.004）；然而，在第五五分位数组中该结果有所减弱。在MVPA与三度房室传导阻滞（第四五分位数组与第一五分位数组：HR 0.29，95%CI 0.11 - 0.74，P = 0.010）以及起搏器植入之间的关系中也一致观察到这种模式。每周MVPA每增加150分钟与标准化PQ间期（毫秒）独立呈负相关（β：-2.13，95%CI -3.03至-1.24，P < 0.001）。
在健康老年人群中，MVPA与二度或三度房室传导阻滞风险较低相关，这与标准化PQ间期缩短有关。然而，过度的MVPA会使结果减弱。
