Cardiorespiratory Fitness and the Risk of Serious Ventricular Arrhythmias: A Prospective Cohort Study

Abstract

Cardiorespiratory fitness (CRF) is an established risk factor for cardiovascular disease (CVD) outcomes. However, the relationship of CRF with risk of ventricular arrhythmias (VAs) is unknown. We aimed to assess the prospective association of CRF with the risk of serious VAs. CRF, as measured by maximal oxygen uptake, was assessed using a respiratory gas exchange analyser in 2,299 middle-aged men in the Kuopio Ischemic Heart Disease prospective cohort.We corrected for within-person variability in CRF levels using data from repeat measurements taken 11 years apart.During a median follow-up of 25.3 (interquartile range, 18.7-27.2) years, 73 serious VAs were recorded. The age-adjusted regression dilution ratio of CRF was 0.58 (95% confidence interval [CI]: 0.53-0.64). In analysis adjusted for age, the hazard ratio (HR) (95% CI) for serious VAs per 1 standard deviation increase in CRF was 0.64 (0.49-0.84). The association persisted on additional adjustment for body mass index, systolic blood pressure, history of hypertension, prevalent coronary heart disease (CHD), smoking, history of diabetes, cholesterol, alcohol consumption, and physical activity 0.64 (0.47 to 0.86). The corresponding adjusted HRs (95% CIs) were 0.29 (0.14-0.59) and 0.29 (0.13-0.62), respectively, when comparing the top versus bottom tertiles. The associations were stronger on correction for regression dilution bias, remained consistent on exclusion of men with a history of CHD, and did not vary importantly in several relevant clinical subgroups. CRF is inversely associated with future risk of serious VAs, independently of several CVD risk factors. Further research is needed to assess the causal relevance of these findings.

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

“…Another factor which could influence outcomes from OHCA is the individual's cardiorespiratory fitness level of the patients before cardiac arrest. According to Laukkanen et al [34], it plays an essential role as the risk factor of VT/VF, arrhythmias (AF, atrial fibrillation), and sudden cardiac death (SCD) [35,36]. Since such data are not recorded by EMTs, we were unable to take into account in our analyses.…”

Comparison of the Ekblom-Bak Submaximal Test to a Maximal Test in a Cohort of Healthy Younger and Older Adults in the United States

“…Cardiorespiratory fitness (CRF) and physical activity are important physiological and behavioral measures that predict health outcomes throughout the lifespan. In adulthood, poor CRF and sedentary lifestyle are associated with risk for cardiovascular disease (Kodama et al, 2009;Khan et al, 2015;Laukkanen et al, 2019), Type 2 diabetes (Lavie et al, 2014;Zaccardi et al, 2015), and Alzheimer disease (Kurl et al, 2018;Silva et al, 2019). Improvement of CRF, through engagement in regular physical activity, leads to a significant improvement in health outcomes including lowering risk of all-cause mortality (Harber et al, 2017), cardiovascular disease (Safdar and Mangi, 2020), and diabetes (Tuomilehto et al, 2001).…”

“…Cardiorespiratory fitness (CRF) and physical activity are important physiological and behavioral measures that predict health outcomes throughout the lifespan. In adulthood, poor CRF and sedentary lifestyle are associated with risk for cardiovascular disease ( Kodama et al, 2009 ; Khan et al, 2015 ; Laukkanen et al, 2019 ), Type 2 diabetes ( Lavie et al, 2014 ; Zaccardi et al, 2015 ), and Alzheimer disease ( Kurl et al, 2018 ; Silva et al, 2019 ).…”

Cardiorespiratory fitness is not associated with fracture risk in middle‐aged men

“…4 Cardiorespiratory fitness (CRF) measured by maximal oxygen uptake (VO 2max ), is the gold standard for assessing aerobic capacity and is an indicator of habitual physical activity. 5 Like physical activity, a wealth of epidemiologic evidence consistently shows CRF to be independently and inversely associated with adverse vascular outcomes, other chronic diseases and mortality. 5,6 One of the pathways by which physical activity reduces fracture risk is by increasing or maintaining bone mineral density (BMD).…”

“…5 Like physical activity, a wealth of epidemiologic evidence consistently shows CRF to be independently and inversely associated with adverse vascular outcomes, other chronic diseases and mortality. 5,6 One of the pathways by which physical activity reduces fracture risk is by increasing or maintaining bone mineral density (BMD). 7 A limited number of studies have reported increased levels of CRF to be associated with reduced risk of low BMD 8,9 ; however, whether this translates to a reduced risk of fractures is uncertain.…”