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Cardiorespiratory Fitness is associated with right ventricular geometry and function in the general population - SHIP (Study of Health in Pomerania)
Authors : J Drzyzga (Greifswald,DE), M Bahls (Greifswald,DE), H Voelzke (Greifswald,DE), R Buelow (Greifswald,DE), R Ewert (Greifswald,DE), S Glaeser (Berlin,DE), SB Felix (Greifswald,DE), M Doerr (Greifswald,DE), MRP Markus (Greifswald,DE)
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1University Medicine of Greifswald, Department Internal Medicine B - Greifswald - Germany
2University Medicine of Greifswald, Community Medicine - Greifswald - Germany
3University Medicine of Greifswald, Institute of Diagnostic Radiology and Neuroradiology - Greifswald - Germany
4Vivantes Clinics for Health, Vivantes Klinikum Spandau, Berlin, Germany - Berlin - Germany
Higher cardiorespiratory fitness (CRF) is associated with a reduced risk for cardiovascular disease (CVD) and morbidity. While previous research has explored the association between CRF and left ventricular (LV) structure and function, very little information is available for its association with right ventricular (RV) parameters. Most studies have focused on young male athletes. To improve our understanding of the clinical relevance of CRF for RV remodeling, we studied the association between CRF and RV structure and function in a large adult general population cohort.
We used cross-sectional data of 2,844 subjects from the population-based, prospective Study of Health in Pomerania (SHIP). A symptom-limited cardiopulmonary exercise test (CPET) was performed according to a modified Jones protocol. Two-dimensional, M-Mode and Doppler echocardiography and cardiac MR imaging on a 1.5-T MR system were performed to determine a variety of RV structural and functional parameters. We used linear regression models adjusted for age, sex (not when stratified by sex), body fat mass, height, systolic blood pressure, use of antihypertensive medication, glycated hemoglobin, use of hypoglycemic medication, smoking status and estimated glomerular filtration rate to relate CRF with RV parameters.
The median age of the sample was 51 (25th quartile: 40 and 75th quartile: 62) years, and 52% were women. A total of 2,844 subjects had echocardiographic data and 941 individuals also underwent cardiac MRI. A one liter higher in VO2 peak was associated with a 1.2 (95%-CI 0.7 to 1.7, p<0.001) mm greater RV end-diastolic diameter, a 1.4 (95%-CI 0.9 to 1.9, p<0.001) mm larger RV end-diastolic outflow tract diameter and a 0.84 (95%-CI 0.46 to 1.22, p<0.001) mm greater tricuspid annular plane systolic excursion. In addition, a one liter higher VO2 peak was associated with a 23.5 (95%-CI 18.7 to 28.4, p<0.001) ml larger RV end-diastolic volume and a 13.0 (95%-CI 9.8 to 16.2, p<0.001) ml greater RV end-systolic volume. There was no association between VO2 peak and lateral early and late tricuspid annular peak diastolic velocity ratio and RV ejection fraction.
Our results indicate a significant association between CRF and RV remodeling. Whether the same physiological mechanisms as previously described for the LV are also responsible for this association is unclear. Further research is warranted to explore the clinical relevance of the RV.
ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.
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