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Association of cardiorespiratory fitness with left ventricular remodeling and diastolic function: the Cooper Center

Stephanie K Brinker1, Ambarish Pandey1, Colby R Ayers1

  • 1Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.

JACC. Heart Failure
|June 23, 2014
PubMed

Insights

Higher cardiorespiratory fitness in mid-life is linked to healthier heart structures, including larger left atrial volume and left ventricular diameter. This suggests exercise may reduce heart failure risk by improving cardiac remodeling and diastolic function.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Preventive Medicine

Background:

  • Cardiorespiratory fitness is inversely correlated with heart failure risk.
  • The precise mechanisms by which fitness impacts heart failure risk are not fully elucidated.
  • Understanding these mechanisms is crucial for developing effective preventive strategies.

Purpose of the Study:

  • To investigate the cross-sectional associations between cardiorespiratory fitness and echocardiographic measures of cardiac structure and function.
  • To identify specific cardiac adaptations related to varying levels of fitness.
  • To explore potential pathways through which fitness influences cardiovascular health.

Main Methods:

  • Analysis of 1,678 men and 1,247 women from the Cooper Center Longitudinal Study (1999-2011).
  • Fitness assessed using the Balke protocol (metabolic equivalents) and categorized into age-specific quartiles.
  • Multivariable linear regression used to examine associations between fitness and cardiac parameters (relative wall thickness, left ventricular end-diastolic diameter, left atrial volume, systolic function, E/e' ratio).

Main Results:

  • Higher mid-life fitness correlated with increased indexed left atrial volume and indexed left ventricular end-diastolic diameter in both men and women.
  • Increased fitness was associated with reduced relative wall thickness and E/e' ratio.
  • No significant association was found between low fitness and left ventricular systolic function.

Conclusions:

  • Low cardiorespiratory fitness is linked to concentric remodeling and diastolic dysfunction.
  • These findings suggest that regular exercise may mitigate heart failure risk by promoting favorable cardiac remodeling.
  • Improved diastolic function appears to be a key mechanism through which exercise confers cardiovascular benefits.
Abstract

Keywords:
diastolic dysfunctionechocardiographyexerciseheart failureremodeling

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