Clinical InvestigationImpact of moderate physical activity on the longitudinal trajectory of a cardiac specific biomarker of injury: Results from a randomized pilot study of exercise intervention
Section snippets
Study population
This substudy used participants enrolled in the LIFE-P study, which randomized 424 sedentary community-dwelling adults (age 70-89years) at high risk for mobility disability.Eligible participants reported performing <20min per week of moderate physical activity, had functional limitations as defined by a Short Physical Performance Battery (SPPB) score of <10 (of 12 points maximum), and could complete a 400-m walk in ≤15minutes without sitting or using assistive devices. Subjects were randomized
Baseline characteristics
The LIFE-P results have been previously reported.13 There were no significant differences between participants who did and did not have serum available at both time points (Supplementary Table I). Three hundred seven subjects with hs-cTnT measured at baseline and 1 year without interim cardiovascular events were analyzed. One hundred fifty-six were randomized to the physical activity arm and 151 to the successful aging arm. The 2 treatment groups were generally similar with respect to baseline
Discussion
In previously sedentary older adults capable of walking 400 m, initiation of moderate physical activity significantly reduced the progression of biochemical evidence of myocardial injury compared with individuals who remained sedentary. Although the differences in hs-cTnT changes between groups were modest, this finding is significant in that it was found in a pilot feasibility trial of physical activity that the analysis of the change in the biomarker was limited by 3 factors including the
Conclusions
Introduction of a moderate intensity leisure physical activity program results in smaller increases in hs-cTnT over 1 year of follow-up compared with a sedentary control group. This provides evidence that physical activity mitigates myocyte cell injury.A larger randomized trial of a physical activity intervention in sedentary older adults with longer-term follow-up will be required to determine if adopting a physically active lifestyle associated with a smaller rise in cTnT levels also
References (16)
- et al.
Physical activity, change in biomarkers of myocardial stress and injury, and subsequent heart failure risk in older adults
J Am Coll Cardiol
(2012) - et al.
Changes in physical fitness and changes in mortality
Lancet
(1998) - et al.
Changes in physical activity, mortality, and incidence of coronary heart disease in older men
Lancet
(1998) - et al.
The Lifestyle Interventions and Independence for Elders (LIFE) pilot study: design and methods
Contemp Clin Trials
(2005) - et al.
Heart Disease and Stroke Statistics—2014 update: a report from the American Heart Association
Circulation
(2014) - et al.
2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines
Circulation
(2013) - et al.
Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults
JAMA
(2010) - et al.
Exercise training stimulates ischemia-induced neovascularization via phosphatidylinositol 3-kinase/Akt-dependent hypoxia-induced factor-1α reactivation in mice of advanced age
Circulation
(2010)
Cited by (24)
Patterns of Cardiac Troponin I Concentrations as Risk Predictors of Cardiovascular Disease and Death: The Trøndelag Health Study
2023, American Journal of MedicineLongitudinal Changes in Cardiac Troponin and Risk of Heart Failure Among Black Adults
2023, Journal of Cardiac FailureCitation Excerpt :Additionally, longitudinal changes in hs-cTnI may serve as a surrogate for effectiveness of preventive interventions. For example, lifestyle interventions focused on physical activity are associated with more favorable profiles of change in hs-cTn over follow-up.34,35 Furthermore, in the present study we observed that individuals with higher SBP on follow-up had more marked increase in hs-cTnI levels on follow-up.
Physical Activity, Subclinical Myocardial Injury, and Risk of Heart Failure Subtypes in Black Adults
2021, JACC: Heart FailureGastric bypass surgery is associated with reduced subclinical myocardial injury and greater activation of the cardiac natriuretic peptide system than lifestyle intervention
2020, Clinical BiochemistryCitation Excerpt :The current data demonstrate that GBS was associated with a roughly similar reduction in cTnT and cTnI, while ILI was associated with a comparable increase in both markers, suggesting a weight dependent response pattern for both markers. Improved physical fitness and statin therapy has been linked to an attenuation or reduction in the age-related expected increase in cardiac troponins [33,37–40]. ILI comprising both measures to reduce weight [9] and to increase physical fitness, would therefore be expected to reduce cardiac troponin concentrations.
Analytical performance of cardiac troponin assays – Current status and future needs
2020, Clinica Chimica ActaCitation Excerpt :Seminal papers have demonstrated the strong predictive power of stable low-grade increased cardiac troponin concentrations [14–16] and the condition was recently acknowledged as clinically important and termed chronic myocardial injury [3]. The observation that chest pain patients with chronic injury show similar long-term prognosis as those diagnosed with acute MI [17] has led to increased interest in and search for treatment possibilities in this population [18–20]. Strategies to define the necessary analytical performance for laboratory tests have recently been updated [21].