Objectives

This study sought to evaluate the independent associations and interactions between high-sensitivity cardiac troponin I (hs-cTnI) and physical activity (PA) with risk of heart failure (HF) subtypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF).

Background

Black adults are at high risk for developing HF. Physical inactivity and subclinical myocardial injury, as assessed by hs-cTnI concentration, are independent risk factors for HF.

Methods

Black adults from the Jackson Heart Study without prevalent HF who had hs-cTnI concentration and self-reported PA assessed at baseline were included. Adjusted Cox models were used to evaluate the independent and joint associations and interaction between hs-cTnI concentrations and PA with risk of HFpEF and HFrEF.

Results

Among 3,959 participants, 25.1% had subclinical myocardial injury (hs-cTnI ≥4 and ≥6 ng/l in women and men, respectively), and 48.2% were inactive (moderate-to-vigorous PA = 0 min/week). Over 12.0 years of follow-up, 163 and 150 participants had an incident HFpEF and HFrEF event, respectively. In adjusted analysis, higher hs-cTnI concentration (per 1-U log increase) was associated with higher risk of HFpEF (hazard ratio [HR]: 1.47; 95% confidence interval [CI]: 1.25 to 1.72]) and HFrEF (HR: 1.57; 95% CI: 1.35 to 1.83]). In contrast, higher PA (per 1-U log increase) was associated with a lower risk of HFpEF (HR: 0.93; 95% CI: 0.88 to 0.99]) but not HFrEF. There was a significant interaction between hs-cTnI and PA for risk of HFpEF (p interaction = 0.04) such that inactive participants with subclinical myocardial injury were at higher risk of HFpEF but active participants were not.

Conclusions

Among Black adults with subclinical myocardial injury, higher levels of PA were associated with attenuated risk of HFpEF.

中文翻译：

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黑人成人的体力活动、亚临床心肌损伤和心力衰竭亚型的风险

目标

本研究旨在评估高敏心肌肌钙蛋白 I (hs-cTnI) 和体力活动 (PA) 与心力衰竭 (HF) 亚型风险、射血分数保留的 HF (HFpEF) 和射血分数降低的 HF 之间的独立关联和相互作用。射血分数（HFrEF）。

背景

黑人成年人患心力衰竭的风险很高。通过 hs-cTnI 浓度评估，身体缺乏活动和亚临床心肌损伤是心力衰竭的独立危险因素。

方法

杰克逊心脏研究中没有流行心力衰竭且具有 hs-cTnI 浓度和自我报告的基线 PA 评估的黑人成人也被纳入其中。调整后的 Cox 模型用于评估 hs-cTnI 浓度和 PA 与 HFpEF 和 HFrEF 风险之间的独立关联和联合关联以及相互作用。

结果

在 3,959 名参与者中，25.1% 患有亚临床心肌损伤（女性和男性的 hs-cTnI 分别≥4 和 ≥6 ng/l），48.2% 不活动（中度至剧烈 PA = 0 分钟/周）。经过 12 年的随访，分别有 163 名和 150 名参与者发生了 HFpEF 和 HFrEF 事件。在调整分析中，较高的 hs-cTnI 浓度（每增加 1-U 对数）与较高的 HFpEF（风险比 [HR]：1.47；95% 置信区间 [CI]：1.25 至 1.72]）和 HFrEF（HR ：1.57；95% CI：1.35 至 1.83]）。相反，较高的 PA（每增加 1-U 对数）与较低的 HFpEF 风险相关（HR：0.93；95% CI：0.88 至 0.99]），但与 HFrEF 无关。hs-cTnI 和 PA 之间存在显着的 HFpEF 风险交互作用（p 交互作用 = 0.04），因此患有亚临床心肌损伤的不活动参与者发生 HFpEF 的风险较高，但活动参与者则不然。

结论

在患有亚临床心肌损伤的黑人成年人中，PA 水平较高与 HFpEF 风险降低相关。