Blog | Thursday, November 15, 2012

QD: News Every Day--Exercise may reduce biomarkers for heart failure

Moderate physical activity may reduce biomarkers associated with early heart failure, preventing cardiac injury and neurohormonal activation, a study found.

To evaluate the association between physical activity and changes in clinical biomarkers for heart failure in older adults, researchers enrolled nearly 3,000 people age 65 or older in the Cardiovascular Health Study.

Self-reported physical activity and walking pace were combined into a composite score. Highly sensitive troponin T (cTnT) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) were assessed at baseline and between 2 and 3 years. An increase was prespecified for NT-proBNP as a more than 25% increment from baseline to greater than or equal to 190 pg/mL and for cTnT as a more than 50% increment from baseline in participants with detectable levels (greater than or equal to 3 pg/mL).

Results appeared online Nov. 14 at the Journal of the American College of Cardiology.

Compared with participants with the lowest composite score, those with the highest score had an odds ratio of 0.50 (95% confidence interval [CI], 0.33 to 0.77) for an increase in NT-proBNP and an odds ratio of 0.30 (95% [CI], 0.16 to 0.55) for an increase in cTnT. A higher activity score was associated with a lower long-term incidence of heart failure. At each level of physicial activity, an increase in either biomarker still identified those at higher risk.

The findings support the hypothesis that regular moderate physical activity can prevent factors that ultimately result in symptomatic heart failure, the authors noted.

"Importantly, a significant increase in biomarkers remained associated with an increased incidence of [heart failure] HF at any level of physical activity," the authors wrote. "The association of greater self-reported physical activity with a lower probability of an increase in cardiac biomarkers of injury and hemodynamic stress also remained present when analyzing only subjects free of significant comorbidity or those participants who perceived their health to be good, very good, or excellent."

An editorial noted that exercise is an appealing intervention because it is personalized, cost-effective and has an "intuitive" appeal.

"[T]his treatment modality remains significantly underused in real-world settings, and its effectiveness in elderly patients with early stage heart failure has not been well studied," the editorial stated. "The current study adds credence to the notion that this population, too, may benefit from exercise."