Too Little of a Good Thing Strong Associations Between Cardiac Size and Fitness Among Women

被引：18

作者：

Foulkes, Stephen J. ^{[1
,2
]}

Howden, Erin J. ^{[1
,2
]}

Dillon, Hayley T. ^{[1
,3
]}

Janssens, Kristel ^{[1
,2
]}

Beaudry, Rhys ^{[4
]}

Mitchell, Amy M. ^{[1
]}

Lindqvist, Anniina ^{[1
]}

Wallace, Imogen ^{[1
]}

Wright, Leah ^{[1
,2
]}

Costello, Benedict T. ^{[1
,5
]}

Claessen, Guido ^{[1
,6
,7
]}

Haykowsky, Mark J. ^{[1
,8
]}

La Gerche, Andre ^{[1
,2
,5
,9
]}

机构：

[1] Baker Heart & Diabet Inst, Melbourne, Vic, Australia

[2] Univ Melbourne, Baker Dept Cardiometab Hlth, Parkville, Vic, Australia

[3] Deakin Univ, Inst Phys Act & Nutr, Sch Exercise & Nutr Sci, Geelong, Vic, Australia

[4] Univ Alberta, Coll Hlth Sci, Fac Med & Dent, Edmonton, AB, Canada

[5] St Vincents Hosp Melbourne, Cardiol Dept, Melbourne, Vic, Australia

[6] Katholieke Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium

[7] Univ Hosp Leuven, Leuven, Belgium

[8] Univ Alberta, Coll Hlth Sci, Fac Nursing, Edmonton, AB, Canada

[9] Baker Heart & Diabet Inst, 75 Commercial Rd, Melbourne, Vic 3004, Australia

来源：

JACC-CARDIOVASCULAR IMAGING | 2023年 / 16卷 / 06期

基金：

英国医学研究理事会; 芬兰科学院;

关键词：

cardiac magnetic resonance; cardiopulmonary exercise testing; cardiorespiratory fitness; cardiovascular aging; echocardiography; functional disability; HFpEF; PRESERVED EJECTION FRACTION; HEART-FAILURE; CARDIORESPIRATORY FITNESS; EXERCISE; QUANTIFICATION; STIFFNESS; SOCIETY; UPDATE; IMPACT; ADULTS;

D O I：

10.1016/j.jcmg.2022.12.009

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Cardiorespiratory fitness (CRF) is associated with functional impairment and cardiac events, particularly heart failure (HF). However, the factors predisposing women to low CRF and HF remain unclear. OBJECTIVES This study sought to evaluate the association between CRF and measures of ventricular size and function and to examine the potential mechanism linking these factors. METHODS A total of 185 healthy women aged >30 years (51 +/- 9 years) underwent assessment of CRF (peak volume of oxygen uptake [VO(2)peak]) and biventricular volumes at rest and during exercise by using cardiac magnetic resonance (CMR). The relationships among VO(2)peak, cardiac volumes, and echocardiographic measures of systolic and diastolic function were assessed using linear regression. The effect of cardiac size on cardiac reserve (change in cardiac function during exercise) was assessed by comparing quartiles of resting left ventricular end-diastolic volume (LVEDV). RESULTS VO(2)peak was strongly associated with resting measures of LVEDV and right ventricular end-diastolic volume (R-2 = 0.58-0.63; P < 0.0001), but weakly associated with measures of resting left ventricular (LV) systolic and diastolic function (R-2 = 0.01-0.06; P < 0.05). Increasing LVEDV quartiles were positively associated with cardiac reserve, with the smallest quartile showing the smallest reduction in LV end-systolic volume (quartile [Q]1: -4 mL vs Q4: -12 mL), smallest augmentation in LV stroke volume (Q1: +11 mL vs Q4: +20 mL) and cardiac output (Q1: +6.6 L/min vs Q4: +10.3 L/min) during exercise (interaction P < 0.001 for all). CONCLUSIONS A small ventricle is strongly associated with low CRF because of the combined effect of a smaller resting stroke volume and an attenuated capacity to increase with exercise. The prognostic implications of low CRF in midlife highlight the need for further longitudinal studies to determine whether women with small ventricles are predisposed to functional impairment, exertional intolerance, and HF later in life. (c) 2023 by the American College of Cardiology Foundation.

引用

页码：768 / 778

页数：11