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Physical activity and physiological cardiac remodelling in a community setting: the Multi-Ethnic Study of Atherosclerosis (MESA)
  1. E B Turkbey1,
  2. N W Jorgensen2,
  3. W C Johnson2,
  4. A G Bertoni3,
  5. J F Polak4,
  6. A V Diez Roux5,
  7. R P Tracy6,
  8. J A C Lima7,
  9. D A Bluemke1
  1. 1
    Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
  2. 2
    Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
  3. 3
    Department of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
  4. 4
    Department of Radiology, Tufts Medical Center, Boston, Massachusetts, USA
  5. 5
    Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  6. 6
    Departments of Pathology and Biochemistry, University of Vermont, Colchester, Vermont, USA
  7. 7
    Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr D A Bluemke, Radiology and Imaging Sciences (RAD&IS); 9000 Rockville Pike, Bldg 10/Rm 1C355, National Institutes of Health/Clinical Center, Bethesda, MD 20892, USA; bluemked{at}


Objective: To evaluate the association of physical activity with left ventricular structure and function in the general population in a community setting.

Design: Cross-sectional study.

Setting: The Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of subclinical atherosclerosis.

Participants: A multiethnic sample of 4992 participants (aged 45–84 years; 52% female) free of clinically apparent cardiovascular disease.

Interventions: Physical activity induces beneficial physiological cardiac remodelling in a cross-sectional study of non-athlete individuals.

Main Outcome Measures: Left ventricular mass, volumes and function were assessed by cardiac magnetic resonance imaging. Physical activity, defined as intentional exercise and total moderate and vigorous physical activity, was assessed by a standard semiquantitative questionnaire.

Results: Left ventricular mass and end-diastolic volume were positively associated with physical activity (eg, 1.4 g/m2 (women) and 3.1 g/m2 (men) greater left ventricular mass in the highest category of intentional exercise compared with individuals reporting no intentional exercise; p = 0.05 and p<0.001, respectively). Relationships were non-linear, with stronger positive associations at lower levels of physical activity (test for non-linearity; p = 0.02 and p = 0.03, respectively). Cardiac output and ejection fraction were unchanged with increased physical activity levels. Resting heart rate was lower in women and men with higher physical activity levels (eg, −2.6 beats/minute lower resting heart rate in the highest category of intentional exercise compared with individuals reporting no intentional exercise; p<0.001).

Conclusions: In a community-based population free of clinically apparent cardiovascular disease, higher physical activity levels were associated with proportionally greater left ventricular mass and end-diastolic volume and lower resting heart rate.

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  • Funding This research was supported by contracts N01-HC-95159 to N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute.

  • Competing interests None.

  • Ethics approval The institutional review boards at all participating centres approved the study.

  • Patient consent Obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.