Objective Vigorous physical activity (PA) in highly trained athletes has been associated with heightened left ventricular (LV) trabeculation extent. It has therefore been hypothesised that LV trabeculation extent may participate in exercise-induced physiological cardiac remodelling. Our cross-sectional observational study aimed to ascertain whether there is a ‘dose–response’ relationship between PA and LV trabeculation extent and whether this could be identified at opposite PA extremes.
Methods In a cohort of 1030 individuals from the community-based UK Biobank study (male/female ratio: 0.84, mean age: 61 years), PA was measured via total metabolic equivalent of task (MET) min/week and 7-day average acceleration, and trabeculation extent via maximal non-compaction/compaction ratio (NC/C) in long-axis images of cardiovascular magnetic resonance studies. The relationship between PA and NC/C was assessed by multivariate regression (adjusting for potential confounders) as well as between demographic, anthropometric and LV phenotypic parameters and NC/C.
Results There was no significant linear relationship between PA and NC/C (full adjustment, total MET-min/week: ß=−0.0008, 95% CI −0.039 to –0.037, p=0.97; 7-day average acceleration: ß=−0.047, 95% CI −0.110 to –0.115, p=0.13, per IQR increment in PA), or between extreme PA quintiles (full adjustment, total MET-min/week: ß=−0.026, 95% CI −0.146 to –0.094, p=0.67; 7-day average acceleration: ß=−0.129, 95% CI −0.299 to –0.040, p=0.49), across all adjustment levels. A negative relationship was identified between left ventricular ejection fraction and NC/C, significantly modified by PA (ß difference=−0.006, p=0.03).
Conclusions In a community-based general population cohort, there was no relationship at, or between, extremes, between PA and NC/C, suggesting that at typical general population PA levels, trabeculation extent is not influenced by PA changes.
- cardiac magnetic resonance (cmr) imaging
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Contributors SPW and NA designed the study and performed statistical analysis, with data acquired by NA and SEP and trabeculation measurements performed by SPW. SPW wrote the first draft of the manuscript, with critical review from NA and SEP. All authors contributed to data interpretation and draft revision until approval of the final version.
Funding SEP acknowledges the British Heart Foundation (BHF) for funding the manual analysis to create a cardiovascular MRI reference standard for the UK Biobank imaging resource in 5000 CMR scans (PG/14/89/31194). SEP acknowledges support from the National Institute for Health Research (NIHR) Barts Biomedical Research Centre and from the ‘SmartHeart’ Engineering and Physical Sciences Research Council programme grant (EP/P001009/1). This project was enabled through access to the Medical Research Council eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (grant number MR/L016311/1). NA is supported by a Wellcome Trust Research Training Fellowship (203553/Z/Z). KF is supported by The Medical College of Saint Bartholomew’s Hospital Trust, an independent registered charity that promotes and advances medical and dental education and research at Barts and The London School of Medicine and Dentistry. The UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also received funding from the Welsh Assembly Government and the British Heart Foundation.
Competing interests SEP provides consultancy to Circle Cardiovascular Imaging Inc, Calgary, Canada. Other authors have no conflicts of interest to declare.
Ethics approval The UK Biobank’s scientific protocol and operational measures were approved by the Northwest Research Ethics Committee in the UK.
Provenance and peer review Not commissioned; externally peer reviewed.
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