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Physical activity, change in biomarkers of myocardial stress and injury, and subsequent heart failure risk in older adults.

TitlePhysical activity, change in biomarkers of myocardial stress and injury, and subsequent heart failure risk in older adults.
Publication TypeJournal Article
Year of Publication2012
AuthorsdeFilippi, CR, de Lemos, JA, Tkaczuk, AT, Christenson, RH, Carnethon, MR, Siscovick, DS, Gottdiener, JS, Seliger, SL
JournalJ Am Coll Cardiol
Volume60
Issue24
Pagination2539-47
Date Published2012 Dec 18
ISSN1558-3597
KeywordsAged, Biomarkers, Female, Heart Failure, Humans, Male, Motor Activity, Natriuretic Peptide, Brain, Peptide Fragments, Risk Assessment, Troponin
Abstract<p><b>OBJECTIVES: </b>The aim of this study was to evaluate the association between physical activity and changes in levels of highly sensitive troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the subsequent risk of the development of heart failure (HF) in community-dwelling older adults.</p><p><b>BACKGROUND: </b>Higher baseline levels of cTnT and NT-proBNP and increases over time correlate with the risk of HF in older adults. Factors modifying these levels have not been identified.</p><p><b>METHODS: </b>NT-proBNP and cTnT were measured at baseline and 2 to 3 years later in adults 65 years of age and older free of HF participating in the Cardiovascular Health Study. Self-reported physical activity and walking pace were combined into a composite score. An increase was prespecified for NT-proBNP as a >25% increment from baseline to ≥190 pg/ml and for cTnT as a >50% increment from baseline in participants with detectable levels (≥3 pg/ml).</p><p><b>RESULTS: </b>A total of 2,933 participants free of HF had NT-proBNP and cTnT measured at both time points. The probability of an increase in biomarker concentrations between baseline and follow-up visits was inversely related to the physical activity score. Compared with participants with the lowest score, those with the highest score had an odds ratio of 0.50 (95% confidence interval: 0.33 to 0.77) for an increase in NT-proBNP and an odds ratio of 0.30 (95% confidence interval: 0.16 to 0.55) for an increase in cTnT, after adjusting for comorbidities and baseline levels. A higher activity score associated with a lower long-term incidence of HF. Moreover, at each level of activity, an increase in either biomarker still identified those at higher risk.</p><p><b>CONCLUSIONS: </b>These findings suggest that moderate physical activity has protective effects on early heart failure phenotypes, preventing cardiac injury and neurohormonal activation.</p>
DOI10.1016/j.jacc.2012.08.1006
Alternate JournalJ. Am. Coll. Cardiol.
PubMed ID23158528
PubMed Central IDPMC3591516
Grant ListR01 AG015928 / AG / NIA NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
N01 HC015103 / HC / NHLBI NIH HHS / United States
R56 AG020098 / AG / NIA NIH HHS / United States
N01HC55222 / HL / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
R01 HL080295 / HL / NHLBI NIH HHS / United States
R01 AG020098 / AG / NIA NIH HHS / United States
N01HC75150 / HL / NHLBI NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States
R01 AG023629 / AG / NIA NIH HHS / United States
R01 AG027058 / AG / NIA NIH HHS / United States
N01 HC045133 / HC / NHLBI NIH HHS / United States
N01 HC035129 / HC / NHLBI NIH HHS / United States
R56 AG023629 / AG / NIA NIH HHS / United States