Moderate-to-vigorous Intensity Physical Activity and Incident Left-sided Degenerative Valvular Heart Disease
Notice bibliographique
Résumé
Abstract Background Despite the escalating incidence of degenerative valvular heart disease (VHD), recommended preventive interventions are conspicuously absent. Physical activity has proven effective in preventing atherosclerotic cardiovascular disease, but its role in preventing VHD remains uncertain. This study aimed to explore the association between moderate-to-vigorous intensity physical activity (MVPA) and incident left-sided degenerative VHD in middle-aged adults from the UK biobank. Methods Data from wrist-worn accelerometer and self-reported questionnaires were utilized to assess the impact of MVPA volume on the incidence of aortic valve stenosis (AS), aortic valve regurgitation (AR), and mitral valve regurgitation (MR). Incident VHD were ascertained from hospital admissions and death reports. Cox proportional hazards regression models were employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for sociodemographic characteristics, lifestyle risk factors, and comorbidities. Results In the accelerometer-derived MVPA cohort (n=90,865; median age 63; 43% male; median follow-up 8.1 years), the age- and sex-adjusted incidence rates per 1000 person-years were 0.70 for AS, 0.29 for AR, and 0.84 for MR. In the questionnaire-based MVPA cohort (n=397,335; median age 57; 47% male; median follow-up 13.8 years), the corresponding rates were 0.76 for AS, 0.29 for AR, and 0.76 for MR. The accelerometer-measured MVPA volume showed a curvilinear relationship with reduced risk of AS, plateauing above 300 min/week. Participants engaging in 150-299 minutes of MVPA per week, meeting the guideline recommendation, had the most significant reduction in AS risk compared to those with no MVPA [adjusted HR, 0.53 (95% CI, 0.37-0.76)]. Similar results were found in the questionnaire-based MVPA cohort, with 150-299 minutes of MVPA showing a relatively smaller reduction in HR [adjusted HR, 0.82 (95% CI, 0.73-0.91)]. The association remained consistent across subgroups at high risk for AS. However, there was no significant inverse association of MVPA with risk of AR or MR. Conclusion Adhering to the recommended MVPA duration (150-299 min/week) was associated with the lowest risk of developing AS. Encouraging the utilization of wearable devices to monitor activity levels enhances AS risk reduction. Nonetheless, MVPA’s efficacy in preventing valvular regurgitation is limited, revealing distinctive pathological mechanisms in valvular stenotic and regurgitation lesions. Clinical Perspective What Is New? Engaging in 150-299 minutes of moderate-to-vigorous intensity physical activity per week can reduce the risk of aortic valve stenosis by nearly 50% in middle-aged individuals. Using wearable devices to measure activity levels may improve the risk stratification of aortic valve stenosis compared to assessments based on questionnaires. No significant association is observed between moderate-to-vigorous intensity physical activity and risks of aortic valve regurgitation and mitral valve regurgitation. What Are the Clinical Implications? Objective activity monitoring through wearable devices shows promise as an effective nonpharmaceutical intervention to alleviate the healthcare burdens associated with aortic valve stenosis. Encouraging middle-aged individuals at higher risk for aortic valve stenosis to engage in moderate volume (150-299 minutes per week) and moderate intensity physical activity (e.g., walking at a speed of 2.5 miles per hour) is recommended. Engaging in physical activity beyond the recommended volume and intensity does not yield additional benefits nor pose additional risks for aortic valve stenosis.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».