Cardiac MRI shows an association of lower cardiorespiratory fitness with decreased myocardial mass and higher cardiac stiffness in the general population - The Sedentary's Heart

Prog Cardiovasc Dis. 2021 Sep-Oct:68:25-35. doi: 10.1016/j.pcad.2021.09.003. Epub 2021 Sep 16.

Abstract

Background: The heart has the capacity to adapt to different demands. The pathophysiological mechanisms involved with sedentarism are not fundamentally the opposite of those related with physical activity and regular exercise. We investigated the impact of lower cardiorespiratory fitness (CRF) on heart's plasticity and function in a population-based setting.

Methods: We used data from 1165 participants (539 women; 46.3%) aged 21-81 years from two independent cohorts of the Study of Health in Pomerania (SHIP-2 and SHIP-TREND-0). We analyzed the cross-sectional associations of peak oxygen uptake (VO2peak), determined by symptom-limited cardiopulmonary exercise testing, with structural and functional left ventricular (LV) and left atrial (LA) parameters determined by magnetic resonance imaging (MRI) using multivariable- adjusted linear regression models.

Results: A 1 L/min lower VO2peak was associated with a 10.5 g (95% confidence interval: 8.00 to 12.9; p < 0.001) lower LV mass, a 14.8 mL (10.9 to 18.6; p < 0.001) lower LV end-diastolic volume, a 0.29 mm (0.19 to 0.40; p < 0.001) lower LV wall-thickness, a 8.85 mL/beat (6.53 to 11.2; p < 0.001) lower LV stroke volume, a 0.42 L/min (0.25 to 0.60; p < 0.001) lower LV cardiac output and a 7.51 mL (3.88 to 11.1; p < 0.001) lower LA end-diastolic volume. Moreover, there were no associations with a concentric or eccentric remodeling and LV and LA ejection fraction.

Conclusions: Lower CRF was associated with a smaller heart, LV wall-thickness and mass, LV and LA stroke volume and cardiac output. Conversely, there was no association with LA and LV ejection fraction. Our cross-sectional observations are consistent with cardiac adaptations reflecting reduced volume loading demands of a sedentary lifestyle - "the sedentary's heart".

Keywords: Fat-free mass; Left ventricular geometry and function; Left ventricular mass; Magnetic resonance imaging; Peak oxygen uptake; Physical activity; Remodeling; Sedentarism; VO(2peak).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiorespiratory Fitness*
  • Cross-Sectional Studies
  • Exercise
  • Female
  • Germany / epidemiology
  • Health Status
  • Heart Disease Risk Factors
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / epidemiology
  • Heart Diseases / pathology
  • Heart Diseases / physiopathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Oxygen Consumption
  • Predictive Value of Tests
  • Risk Assessment
  • Sedentary Behavior*
  • Sex Factors
  • Ventricular Function, Left*
  • Young Adult