Original Investigation
Association Between Left Ventricular Noncompaction and Vigorous Physical Activity

https://doi.org/10.1016/j.jacc.2020.08.030Get rights and content
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Abstract

Background

Left ventricular (LV) hypertrabeculation fulfilling noncompaction cardiomyopathy criteria has been detected in athletes. However, the association between LV noncompaction (LVNC) phenotype and vigorous physical activity (VPA) in the general population is disputed.

Objectives

The aim of this study was to assess the relationship between LVNC phenotype on cardiac magnetic resonance (CMR) imaging and accelerometer-measured physical activity (PA) in a cohort of middle-aged nonathlete participants in the PESA (Progression of Early Subclinical Atherosclerosis) study.

Methods

In PESA participants (n = 4,184 subjects free of cardiovascular disease), PA was measured by waist-secured accelerometers. CMR was performed in 705 subjects (mean age 48 ± 4 years, 16% women). VPA was recorded as total minutes per week. The study population was divided into 6 groups: no VPA and 5 sex-specific quintiles of VPA rate (Q1 to Q5). The Petersen criterion for LVNC was evaluated in all subjects undergoing CMR. For participants meeting this criterion (noncompacted-to-compacted ratio ≥2.3), 3 more restrictive LVNC criteria were also evaluated (Jacquier, Grothoff, and Stacey).

Results

LVNC phenotype prevalence according to the Petersen criterion was significantly higher among participants in the highest VPA quintile (Q5 = 30.5%) than in participants with no VPA (14.2%). The Jacquier and Grothoff criteria were also more frequently fulfilled in participants in the highest VPA quintile (Jacquier Q5 = 27.4% vs. no VPA = 12.8% and Grothoff Q5 = 15.8% vs. no VPA = 7.1%). The prevalence of the systolic Stacey LVNC criterion was low (3.6%) and did not differ significantly between no VPA and Q5.

Conclusions

In a community-based study, VPA was associated with a higher prevalence of CMR-detected LVNC phenotype according to diverse established criteria. The association between VPA and LVNC phenotype was independent of LV volumes. According to these data, vigorous recreational PA should be considered as a possible but not uncommon determinant of LV hypertrabeculation in asymptomatic subjects.

Key Words

exercise
LVNC
magnetic resonance imaging
MRI
noncompaction

Abbreviations and Acronyms

CI
confidence interval
CMR
cardiac magnetic resonance
IQR
interquartile range
LAX
long-axis
LV
left ventricular
LVEF
left ventricular ejection fraction
LVNC
left ventricular noncompaction
NC/C
noncompacted-to-compacted
PA
physical activity
RV
right ventricular
VPA
vigorous physical activity

Cited by (0)

The PESA study is cofunded by Centro Nacional de Investigaciones Cardiovasculares and Banco Santander. The study also receives funding from Instituto de Salud Carlos III (PI15/02019 and PI16/02110), the European Regional Development Fund (“A Way to Make Europe”), and Comunidad de Madrid (S2017/BMD-3867 RENIM-CM). Centro Nacional de Investigaciones Cardiovasculares is supported by Ministerio de Ciencia e Innovación and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (SEV-2015-0505). Dr. Sanchez-González is an employee of Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Barry J. Maron, MD, served as the Guest Associate Editor for this paper. P.K. Shah, MD, served as the Guest Editor-in-Chief for this paper.

The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.

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© 2020 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.