Author:
Liu Hongmin,Li Xinmu,Liu Peipei,Zhao Haiyan,Lin Liming,Tse Gary,Chan Jeffrey Shi Kai,Lip Gregory Y. H.,Wu Shouling,Liu Tong
Abstract
AbstractPhysical activity (PA) and obesity may alter the risks of cardiac conduction disease. Participants from the Kailuan cohort, who were free of cardiac conduction disease and with repeated measurements of electrocardiogram from 2006 to 2019, were included. The primary outcome was cardiac conduction disease. The secondary outcomes were atrioventricular block and intraventricular block. Cox regression was used to assess the association between obesity, PA, and the risks of the outcomes. Influences of PA on the associations between BMI and incident outcomes were evaluated. A total of 84,022 participants (mean age 50.15 years, SD 11.69; 80.3% male) were included. Over a median follow-up of 11.83 years (IQR 8.87–13.04), 3236 participants developed the primary outcome. After multivariable adjustment, a higher body mass index (BMI) and a higher waist circumference (WC) were associated with increased risks of conduction disease, but more PA was associated with a lower risk. For obese patients defined by BMI with low PA, the risk of conduction disease was higher than that of obese patients with high PA (HR: 1.42, CI: 1.21-1.66 vs. HR: 1.16, CI: 1.03–1.31). For central obese patients defined by WC with low PA, the risk of conduction disease was also higher compared to central obese patients with high PA (HR: 1.31, CI: 1.17–1.48 vs. HR: 1.12, CI: 1.03–1.23). Besides, compared to obesity with high PA, obesity with low PA was associated with a higher risk of atrioventricular block (HR: 1.70, CI: 1.28-2.27 vs. HR: 1.45, CI: 1.16-1.81) and intraventricular block (HR: 1.37, CI: 1.13-1.65 vs. HR: 1.03, CI: 0.92–1.15). Higher PA can reduce the risks of developing cardiac conduction disease, both in the obese and non-obese groups. (Clinical Trial Registration URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489).
Funder
National Natural Science Foundation of China
Tianjin Key Medical Discipline(Specialty) Construction Project
Publisher
Springer Science and Business Media LLC
Reference42 articles.
1. Kusumoto, F. M. et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 140, e382–e482 (2019).
2. Bussink, B. E. et al. Right bundle branch block: prevalence, risk factors, and outcome in the general population: results from the Copenhagen City Heart Study. Eur. Heart J. 34, 138–146 (2013).
3. Cheng, S. et al. Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block. JAMA 301, 2571–2577 (2009).
4. Mandyam, M. C., Soliman, E. Z., Heckbert, S. R., Vittinghoff, E. & Marcus, G. M. Long-term outcomes of left anterior fascicular block in the absence of overt cardiovascular disease. JAMA 309, 1587–1588 (2013).
5. Kerola, T. et al. Risk factors associated with atrioventricular block. JAMA Netw. Open 2, e194176 (2019).