Elsevier

American Heart Journal

Volume 179, September 2016, Pages 151-156
American Heart Journal

Clinical Investigation
Impact of moderate physical activity on the longitudinal trajectory of a cardiac specific biomarker of injury: Results from a randomized pilot study of exercise intervention

https://doi.org/10.1016/j.ahj.2016.07.001Get rights and content

Background

In animal models, physical activity (PA) prevents cardiac myocyte cell death. Data for PA mitigating myocyte injury in humans are limited to observational studies. Using a randomized controlled trial design, we sought to determine if introducing moderate PA to previously sedentary older adults could reduce the trajectory of myocardial injury as measured by the high-sensitive cardiac troponin T (hs-cTnT) assay.

Methods

Participants (age ≥70 years) were assigned to a 1-year intervention of moderate PA or health education control. High-sensitive cTnT was measured at baseline and 1 year in the 307 of 424 subjects who had available stored serum. Changes in hs-cTnT within 1 year were compared between PA and control groups, as were differences in the proportion of subjects with a significant rise in hs-cTnT (prospectively defined as a>50% increase at follow-up from baseline). Moderate to vigorous PA in kcal/wk was estimated with the CHAMPS questionnaire.

Results

Baseline hs-cTnT levels and PA kcal/wk were similar for both groups. Activity kcal/wk increased in the PA, but not in the control group at 1 year. The median increase in hs-cTnT level from baseline was >3 times larger in the control (0.73 ng/L, interquartile range −0.64 to 2.59) vs the PA group (0.19ng/L, interquartile range −1.10 to 1.93) (P=.02). The proportion with a>50% increase in hs-cTnT was larger in the control group than in the PA group (9.3% vs 5.1%), but this difference was not statistically significant (P=.16).

Conclusions

Initiation of moderate PA in sedentary older adults may favorably modify subclinical myocardial injury.

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)

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