Prospective Association of Physical Activity and Heart Failure Hospitalizations Among Black Adults With Normal Ejection Fraction: The Jackson Heart Study

Introduction: Diastolic dysfunction (DD) with normal ejection fraction is prevalent in the African-American population due to a higher prevalence of associated risk factors. The potential benefit of moderate to vigorous physical activity (MVPA) to prevent heart failure admissions in African-American adults with normal ejection fraction is under-researched. The purpose of this study is to investigate the associations of DD and MVPA with heart failure hospitalizations (HFH). Hypothesis: We hypothesized that MVPA reduces the risk of HFH among African-American adults with normal ejection fraction. Methods: We performed a prospective analysis of 2,427 African-American adults who participated in the Jackson Heart Study and who had 2D echo and physical activity data and normal ejection fraction. MVPA per week is defined as the following: poor health [[Unable to Display Character: –]] 0 minutes; intermediate health [[Unable to Display Character: –]] 1-149 minutes; and ideal health [[Unable to Display Character: –]] ≥ 150 minutes. DD is defined as using ratio of the early to late ventricular filling velocities, ratio of pulmonary venous systolic to diastolic velocities, and pulmonary venous atrial reversal velocity. We employed multiple variable logistic and cox proportional regression analyses adjusted for age, gender, BMI, smoking, hypertension, DM, COPD, CKD, and CHD to determine the associations of DD and MVPA with HFH. Results: Of the eligible population, 1,209 (50%) have DD. There were 171 HFH. DD is associated with HFH in the crude analysis (OR=2.24, 95% CI 1.40-3.57). The association was markedly attenuated after adjusting for age (OR=1.03, CI 0.63-1.71). Intermediate and ideal health MVPA in the crude analysis were associated with lower risk of HFH (HR=0.50, 95% CI 0.35-0.71 and HR=0.18, 95% CI 0.09-0.36, respectively), and full models revealed HR=0.71, 95% CI 0.49-1.04 and HR=0.31, 95% CI 0.16-0.63, respectively. There was no interaction between physical activity level and DD on HFH. Conclusion: In conclusion, ideal health MVPA is associated with reduced risk of HFH, whereas, intermediate health MVPA revealed a trend in risk reduction in African-American with normal ejection fraction.

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Relation of Low Normal Left Ventricular Ejection Fraction to Heart Failure Hospitalization in Blacks (From the Jackson Heart Study)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2020.08.025 ◽

2020 ◽

Vol 136 ◽

pp. 100-106

Author(s):

Daisuke Kamimura ◽

Karen A. Valle ◽

Chad Blackshear ◽

Robert J. Mentz ◽

Joseph Yeboah ◽

...

Keyword(s):

Heart Failure ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Jackson Heart Study ◽

Heart Failure Hospitalization ◽

Ventricular Ejection Fraction ◽

Normal Left Ventricular ◽

Heart Study

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Regional Adiposity and Risk of Heart Failure and Mortality: The Jackson Heart Study

Journal of the American Heart Association ◽

10.1161/jaha.121.020920 ◽

2021 ◽

Author(s):

Vishal N. Rao ◽

Christopher G. Bush ◽

Morgana Mongraw‐Chaffin ◽

Michael E. Hall ◽

Donald Clark ◽

...

Keyword(s):

Heart Failure ◽

Computed Tomography ◽

Adipose Tissue ◽

Ejection Fraction ◽

Preserved Ejection Fraction ◽

Jackson Heart Study ◽

Heart Study ◽

Pericardial Adipose Tissue ◽

All Cause Mortality ◽

Regional Adiposity

Background Visceral adipose tissue (VAT) is associated with incident heart failure (HF) and HF with preserved ejection fraction, yet it is unknown how pericardial and abdominal adiposity affect HF and mortality risks in Black individuals. We examined the associations of pericardial adipose tissue (PAT), VAT, and subcutaneous adipose tissue (SAT) with incident HF hospitalization and all‐cause mortality in a large community cohort of Black participants. Methods and Results Among the 2882 Jackson Heart Study Exam 2 participants without prevalent HF who underwent body computed tomography, we used Cox proportional hazards models to examine associations between computed tomography–derived regional adiposity and incident HF hospitalization and all‐cause mortality. Fully adjusted models included demographics and cardiovascular disease risk factors. Median follow‐up was 10.6 years among participants with available VAT (n=2844), SAT (n=2843), and PAT (n=1386). Fully adjusted hazard ratios (95% CIs) of distinct computed tomography–derived adiposity measures (PAT per 10 cm 3 , VAT or SAT per 100 cm 3 ) were as follows: for incident HF, PAT 1.08 (95% CI, 1.02–1.14) and VAT 1.04 (95% CI, 1.01–1.08); for HF with preserved ejection fraction, PAT 1.13 (95% CI, 1.04–1.21) and VAT 1.07 (95% CI, 1.01–1.13); for mortality, PAT 1.07 (95% CI, 1.03–1.12) and VAT 1.01 (95% CI, 0.98–1.04). SAT was not associated with either outcome. Conclusions High PAT and VAT, but not SAT, were associated with incident HF and HF with preserved ejection fraction, and only PAT was associated with mortality in the fully adjusted models in a longitudinal community cohort of Black participants. Future studies may help understand whether changes in regional adiposity improves HF, particularly HF with preserved ejection fraction, risk predictions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00005485.

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