Physical activity and left ventricular trabeculation in the UK Biobank community-based cohort study

Objective Vigorous physical activity (PA) in highly trained athletes has been associated with heightened left ventricular (LV) trabeculation extent. It has therefore been hypothesised that LV trabeculation extent may participate in exercise-induced physiological cardiac remodelling. Our cross-sectional observational study aimed to ascertain whether there is a ‘dose–response’ relationship between PA and LV trabeculation extent and whether this could be identified at opposite PA extremes. Methods In a cohort of 1030 individuals from the community-based UK Biobank study (male/female ratio: 0.84, mean age: 61 years), PA was measured via total metabolic equivalent of task (MET) min/week and 7-day average acceleration, and trabeculation extent via maximal non-compaction/compaction ratio (NC/C) in long-axis images of cardiovascular magnetic resonance studies. The relationship between PA and NC/C was assessed by multivariate regression (adjusting for potential confounders) as well as between demographic, anthropometric and LV phenotypic parameters and NC/C. Results There was no significant linear relationship between PA and NC/C (full adjustment, total MET-min/week: ß=−0.0008, 95% CI −0.039 to –0.037, p=0.97; 7-day average acceleration: ß=−0.047, 95% CI −0.110 to –0.115, p=0.13, per IQR increment in PA), or between extreme PA quintiles (full adjustment, total MET-min/week: ß=−0.026, 95% CI −0.146 to –0.094, p=0.67; 7-day average acceleration: ß=−0.129, 95% CI −0.299 to –0.040, p=0.49), across all adjustment levels. A negative relationship was identified between left ventricular ejection fraction and NC/C, significantly modified by PA (ß difference=−0.006, p=0.03). Conclusions In a community-based general population cohort, there was no relationship at, or between, extremes, between PA and NC/C, suggesting that at typical general population PA levels, trabeculation extent is not influenced by PA changes.

[1]  D. O’Regan,et al.  Fractal analysis of left ventricular trabeculations is associated with impaired myocardial deformation in healthy Chinese , 2017, Journal of Cardiovascular Magnetic Resonance.

[2]  Nils Y. Hammerla,et al.  Large Scale Population Assessment of Physical Activity Using Wrist Worn Accelerometers: The UK Biobank Study , 2017, PloS one.

[3]  Lena Osterhagen,et al.  Multiple Imputation For Nonresponse In Surveys , 2016 .

[4]  D. Bluemke,et al.  The relationship of left ventricular trabeculation to ventricular function and structure over a 9.5-year follow-up: the MESA study. , 2014, Journal of the American College of Cardiology.

[5]  E. Arbustini,et al.  Left ventricular noncompaction: a distinct cardiomyopathy or a trait shared by different cardiac diseases? , 2014, Journal of the American College of Cardiology.

[6]  Joss Langford,et al.  Autocalibration of accelerometer data for free-living physical activity assessment using local gravity and temperature: an evaluation on four continents , 2014, Journal of applied physiology.

[7]  B. Thilaganathan,et al.  Reversible De Novo Left Ventricular Trabeculations in Pregnant Women: Implications for the Diagnosis of Left Ventricular Noncompaction in Low-Risk Populations , 2014, Circulation.

[8]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[9]  P. Matthews,et al.  Imaging in population science: cardiovascular magnetic resonance in 100,000 participants of UK Biobank - rationale, challenges and approaches , 2013, Journal of Cardiovascular Magnetic Resonance.

[10]  Vivek Muthurangu,et al.  Quantification of left ventricular trabeculae using fractal analysis , 2013, Journal of Cardiovascular Magnetic Resonance.

[11]  Matt Reed,et al.  Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes? , 2013, Heart.

[12]  Rolf Jenni,et al.  Left ventricular non-compaction revisited: a distinct phenotype with genetic heterogeneity? , 2011, European heart journal.

[13]  D A Bluemke,et al.  Physical activity and physiological cardiac remodelling in a community setting: the Multi-Ethnic Study of Atherosclerosis (MESA) , 2009, Heart.

[14]  Eloisa Arbustini,et al.  Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. , 2007, European heart journal.

[15]  Barry J Maron,et al.  Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interd , 2006, Circulation.

[16]  A. Moss,et al.  Contemporary Definitions and Classification of the Cardiomyopathies , 2006 .

[17]  Stefan Neubauer,et al.  Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. , 2005, Journal of the American College of Cardiology.

[18]  B. Ainsworth,et al.  Guidelines for data processing analysis of the International Physical Activity Questionnaire (IPAQ) - Short and long forms , 2005 .

[19]  B. Ainsworth,et al.  International physical activity questionnaire: 12-country reliability and validity. , 2003, Medicine and science in sports and exercise.

[20]  B Maisch,et al.  Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. , 1996, Circulation.

[21]  D. Rubin Multiple imputation for nonresponse in surveys , 1989 .