Relation of Physical Activity and Incident Atrial Fibrillation (from the Multi-Ethnic Study of Atherosclerosis)

Introduction: Prior studies have raised the question of whether an association exists between physical activity (PA) and atrial fibrillation (AF), with mixed results. We sought to use the Multi-Ethnic Study of Atherosclerosis (MESA) database to examine the association between PA and AF in a diverse population without clinically recognized prevalent cardiovascular disease (CVD). Hypothesis: Increased exercise will have a protective influence on AF incidence. Methods: MESA participants (N=5793) with a completed baseline PA survey and complete covariate data were included. Incident AF events were determined based on hospital discharge ICD-9 codes and Medicare inpatient claims. Total intentional exercise (TIE), defined as a sum of walking for exercise, dance/sport, and conditioning, was used as our independent variable of interest. The MESA population was stratified based on whether they reported participation in any vigorous physical activity (VPA), which was defined as “heavy effort” expended in household chores, lawn/yard/garden/farm work, conditioning activities, and occupational/volunteering work. Cox models, adjusted for demographics and CVD risk factors, were used to determine hazard ratios (HR) for incident AF based on total intentional exercise (TIE) for the subgroups. We performed similar analyses using TIE as a categorical variable stratified into tertiles. Results: During a mean follow-up of 7.7±1.9 years, 199 AF cases occurred. In the overall MESA population, TIE alone was not associated with incident AF. However, within the group that reported any VPA (N=1866), there was a statistically significant protective influence of increasing TIE on incident AF (HR=0.658, p=0.014). Additionally, among the same group, the top tertile of TIE was associated with a significantly lower risk of incident AF compared with the group with no TIE (HR=0.48, p=0.048). Conclusions: TIE was associated with a lower risk of incident AF among those that participated in any VPA, and this protective influence was most notable among those that performed the most TIE. Perhaps as importantly, no subgroup of participants demonstrated an increased risk of incident AF with TIE. These results re-emphasize the beneficial role of exercise for cardiovascular health.

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The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis

Epidemiology and Health ◽

10.4178/epih.e2017024 ◽

2017 ◽

Vol 39 ◽

pp. e2017024

Author(s):

Yaser Mokhayeri ◽

Seyed Saeed Hashemi-Nazari ◽

Mohammad Ali Mansournia ◽

Hamid Soori ◽

Soheila Khodakarim

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Survival Analysis ◽

Heaviside Function ◽

Ethnic Study

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Anxiety-depressive disorders and quality of life in patients with atrial fibrillation

European Heart Journal ◽

10.1093/ehjci/ehaa946.0384 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Demenko ◽

G.A Chumakova

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Atrial Fibrillation ◽

Correlation Analysis ◽

Depressive Disorders ◽

Life Assessment ◽

Mild Depression ◽

Group 2 ◽

Group 1

Abstract Background Mental disorders in patients with cardiovascular disease have a significant impact on the course, the prognosis of the underlying disease and quality of life (QOL). Objective We aimed to examine the prevalence of anxiety and depressive disorders and their impact on the quality of life in patients with atrial fibrillation (AF). Materials and methods In 52 with permanent AF and 50 with paroxysmal AF patients, we administered the depression scale Tsung, the scale of situational anxiety (SA) and personal anxiety (PA) Spielberger-Hanin; QOL was assessed the SF-36 quality of life assessment scale. Correlation analysis using Spearman's rank correlation coefficient. Results The prevalence symptoms mild depression situational or neurotic genesis was 21.1% (12 patients) in Group 1 and 12.0% (6 patients) in Group 2 (p>0.05). Subdepressive state was two percents of patients in Group 1 and Group 2. The incidence SA was 59.6% (31 patients) in Group 1 and 52.0% (26 patients) in Group 2. The incidence PA was 74.0% (37 patients) in Group 2 and 67.3% (35 patients) in Group 1. The average score the physical component of health (PCH) was 29,8±4,3 in Group 1, the mental component of health (MCH) – 49.5±7.4 points; p<0.05. In Group 2: PCH – 44.8±6.6 points, MCH – 26.6±7.5 points; p<0.05. Correlation analysis showed negative strong correlations between SA and MCH (r=−0.64, p=0.0005) and between PA and MCH (r=−0.69, p<0.0001), between SA and PCH (r=−0.71, p=0.0001), between depression and PCH (r=−0.69, p=0.023). Negative statistically significant correlation between depression and MCH (r=−0.69, p=0.54) and negative medium correlation between depression and PCH (r=−0.64, p=0.23). Conclusion These findings suggest that we did not identify patients with symptoms of a true depressive (that can cause pseudodementia and influenced to complete tests). 16.5% patients with AF had mild depression of situational or neurotic genesis. Depression may be a pathogenetic factor of AF or develop because of paroxysms AF – psychological stress. More than 50% patients in Group 1 and Group 2 had an increased anxiety score. SA is more common in patients with permanent AF, probably because older people difficult to adapt to a new situation. PA is more common in patient with paroxysmal AF, probably because disease is sudden and causes anxiety. The PCH of QOL is more impairment in patients with permanent AF, because complications (for example heart failure) impairment physical activity. However, PCH also reduced in patient with paroxysmal AF, because disease is sudden may occur during physical activity. The MCH of QOL is more impairment in patients with paroxysmal AF, because waiting attack effect on mental health and social functioning. An increased level of anxiety and depression negatively affected the mental and physical health of patients with AF. Funding Acknowledgement Type of funding source: None

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Regular exercise is associated with a lower risk of developing dementia in patients with a new diagnosis of atrial fibrillation: a nationwide population-based study

European Heart Journal ◽

10.1093/ehjci/ehaa946.0534 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.H Lim ◽

S.R Lee ◽

E.K Choi ◽

J.P Yun ◽

H.J Ahn ◽

...

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Vascular Dementia ◽

Lower Risk ◽

Alzheimer’S Dementia ◽

P Value ◽

Regular Exercise ◽

Newly Diagnosed ◽

Exercise Habit ◽

New Diagnosis

Abstract Introduction Regular exercise is known to decrease the risk of dementia. There is a paucity of information about the impact of the change of exercise habit on cardiovascular outcomes after a new diagnosis of atrial fibrillation (AF). We aimed to investigate whether regular exercise is associated with the risk of developing dementia in patients with AF. Methods Using the Korean National Health Insurance Service database, we enrolled patients with newly diagnosed AF who had undergone health screening between 2010 and 2016. The study population was divided into four groups based on the consistency of regular exercise before and after AF diagnosis: (1) persistent non-exerciser, (2) exercise starter, (3) exercise quitter, and (4) exercise maintainer. We investigated the association between exercise and the risk of dementia. Results A total of 126,555 patients were included (mean age 62.7 years, male 62.0%, and mean CHA2DS2-VASc Score 2.7). During a median follow-up duration of 3.0 years, 5,943 patients were newly diagnosed as dementia (1.57 per 100 person-years). Among patients with incident dementia, 4,410 patients had Alzheimer's dementia and 951 patients had vascular dementia (1.16 and 0.25 per 100 person-years, respectively). Persistent non-exerciser, exercise starter, quitter, and maintainer groups were 65.1%, 12.8%, 12.7%, and 9.4%, respectively. After multivariable adjustment, we found that exercise was associated with a lower risk of developing overall dementia. When compared to persistent non-exerciser, exercise starter and maintainer showed reduced risk of developing dementia (hazard ratio [HR] 0.80, 95% confidence interval [95% CI] 0.73–0.88 and HR 0.63, 95% CI 0.54–0.73, respectively, all p-value <0.0001), but exercise quitter showed no significant risk reduction (HR 0.95, 95% CI 0.88–1.03, Figure). Alzheimer's dementia showed consistent results: a 20% lower risk with exercise starter, and a 37% lower risk with exercise maintainer. Change of exercise habit, however, did not affect the risk of vascular dementia (all, p-value >0.05, Figure). Conclusions Regular exercise showed a lower risk of dementia in patients with new-onset AF. Starting exercise even after the diagnosis of AF was beneficial to patients who had little physical activity previously. These findings may support physicians to recommend that AF patients should start exercise or keep their physical activity to reduce the risk of dementia. Funding Acknowledgement Type of funding source: None

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Physical Activity, Sedentary Behavior, and Retirement: The Multi-Ethnic Study of Atherosclerosis

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2018.02.022 ◽

2018 ◽

Vol 54 (6) ◽

pp. 786-794 ◽

Cited By ~ 8

Author(s):

Sydney A. Jones ◽

Quefeng Li ◽

Allison E. Aiello ◽

Angela M. O’Rand ◽

Kelly R. Evenson

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Ethnic Study

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Physical Activity, Measures of Obesity, and Cardiometabolic Risk: The Multi-Ethnic Study of Atherosclerosis (MESA)

Journal of Physical Activity and Health ◽

10.1123/jpah.2012-0068a ◽

2014 ◽

Vol 11 (4) ◽

pp. 831-837 ◽

Cited By ~ 9

Author(s):

Paul A. McAuley ◽

Haiying Chen ◽

Duck-chul Lee ◽

Enrique Garcia Artero ◽

David A. Bluemke ◽

...

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Waist Circumference ◽

Impaired Fasting Glucose ◽

Central Obesity ◽

Cardiometabolic Risk ◽

Fasting Glucose ◽

Reference Group ◽

Model Assessment ◽

Ethnic Study

Background:The influence of higher physical activity on the relationship between adiposity and cardiometabolic risk is not completely understood.Methods:Between 2000–2002, data were collected on 6795 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Self-reported intentional physical activity in the lowest quartile (0–105 MET-minutes/week) was categorized as inactive and the upper three quartiles (123–37,260 MET-minutes/week) as active. Associations of body mass index (BMI) and waist circumference categories, stratified by physical activity status (inactive or active) with cardiometabolic risk factors (dyslipidemia, hypertension, upper quartile of homeostasis model assessment of insulin resistance [HOMA-IR] for population, and impaired fasting glucose or diabetes) were assessed using logistic regression analysis adjusting for age, gender, race/ethnicity, and current smoking.Results:Among obese participants, those who were physically active had reduced odds of insulin resistance (47% lower; P < .001) and impaired fasting glucose/diabetes (23% lower; P = .04). These associations were weaker for central obesity. However, among participants with a normal waist circumference, those who were inactive were 63% more likely to have insulin resistance (OR [95% CI] 1.63 [1.24–2.15]) compared with the active reference group.Conclusions:Physical activity was inversely related to the cardiometabolic risk associated with obesity and central obesity.

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