Key to strong heart could be strong legs — here’s why

[Elderberry]

Study Finds by John Anderer 5/22/2023

 Need some motivation not to skip leg day? Look no further. Researchers working with the European Society of Cardiology report that patients with especially strong legs are less likely to develop heart failure following a heart attack.

Myocardial infarction (a heart attack) is actually the most common cause of heart failure, with roughly six to nine percent of heart attack patients going on to develop a form of heart failure. Prior studies, meanwhile, reveal that having strong quadriceps has an association with a lower risk of death among patients with coronary artery disease.

For this latest project, study authors tested their hypothesis that leg strength does indeed have a link to a lower risk of heart failure post-acute myocardial infarction. This study encompassed 932 patients hospitalized between 2007 and 2020 with acute myocardial infarction. All of the patients did not have heart failure before entering the hospital, and did not develop heart failure complications during their hospital stay. The average age of these patients was 66 and 81 percent of the participants were men.

More: https://studyfinds.org/skipping-leg-day-bad-for-heart/

[Kamaji]

Any idea of the causal mechanism?

[Elderberry]

Any idea of the causal mechanism?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6664502/

Physical fitness components and aging in health and heart failure

Endurance capacity

Several prospective studies on endurance capacity show a strong predictive value for overall and CV mortality. Kodama et al.’s meta-analysis [19] involving 102,980 participants and 6,910 outcomes for all-cause mortality revealed a substantial contribution of cardiorespiratory fitness that was independent of classical risk factors. As compared with participants with high fitness, those with low fitness had a 70% higher risk for all-cause mortality and a 56% higher risk for CV mortality. A recently published follow-up study of 22,878 participants with a baseline mean [standard deviation (SD)] age of 47.4 (10.3) years and a follow-up of 9.2 (SD: 4.1) years and 505 deaths added cardiorespiratory fitness to the Systematic Coronary Risk Evaluation (SCORE) risk model. The study revealed a substantial improvement of the combined risk model of SCORE. Cardiorespiratory fitness alone was also a better risk predictor than the SCORE value alone [20]. People with high SCORE values and low fitness (metabolic equivalents < 11) showed a relative hazard ratio for death of 35.6 versus the low SCORE value and high fitness group. However, those with high SCORE values but high fitness (metabolic equivalents ≥11) had only a hazard ratio of 8.5. A recent analysis of a Finnish population confirmed these results for incident fatal myocardial infarction and CHF. From 2,089 participants with a baseline age of 53.1 (SD: 4.9) years and a follow-up of 19.1 (SD: 8.4) years, the rate of fatal myocardial infarction (n = 522) and nonfatal heart failure increased with a reduction in cardiorespiratory fitness [24]. The Mayo Clinic’s patient database recently included cardiorespiratory fitness in a treadmill score in the risk prediction for CV mortality. Out of 58,020 participants with a mean age of 53 years (49% women), 6,456 patients (11%) died by the median follow-up point over 10 years. When cardiorespiratory fitness was considered in the risk prediction, traditional CV risk factors did not contribute incrementally to survival discrimination [25].

In heart failure, the most important and often used parameter for risk prediction is peak oxygen uptake (V̇O2peak). Different studies have shown an incremental value of V̇O2peak to other risk factors [21, 26, 27].

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Muscle strength

Muscle strength is determined by muscle mass and fibre composition as well as intra- and intermuscular coordination. Muscle power decreases more significantly in men and women from the age of 40 years onward, a phenomenon that can only partly be explained by the loss of muscle mass [30]. Rather, the change in fibre composition is decisive for the contraction velocity that determines muscle power. Muscle strength reaches its peak around the age of 30 years and remains almost constant until the age of 50 years and then decreases continuously between 2 and 5% per year depending on the individual’s age [31]. The loss of muscle mass and strength that occurs with advanced age is defined as sarcopenia. Traditionally, sarcopenia has been defined as a loss of appendicular muscle mass of less than two SDs below the mean muscle mass of a person aged 35 years old [32]. Other thresholds used for the definition include low grip strength or a low usual gait speed of less than 0.8 to 1 m/s [14, 33, 34]. Sarcopenia syndrome is characterized by a progressive and generalized loss of skeletal muscle mass and strength and associated with an increased risk of adverse outcomes such as physical disability, poor quality of life, and death [35].

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Neuromuscular coordination

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In heart failure patients, gait speed is an independent predictor of mortality [51]. In a recent study, gait speed was associated with a lower risk for all-cause mortality independent of age; EF of less than 20%; and other parameters such as systolic blood pressure, anaemia, and the absence of beta-blocker therapy [52].

Arterial stiffness

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Vigorous physical activity and higher cardiorespiratory fitness are inversely associated with age-related arterial stiffening [55]. Improvements in cardiorespiratory fitness may, therefore, be a useful measure for preventing age-related increases in arterial stiffness [62].

Retinal vessels

To date, very little is known about the association of physical fitness with microvascular health. The only available exercise intervention study showed that higher physical fitness levels are associated with higher retinal AVR and that exercise-induced arteriolar dilatation as well as venular constriction lead to a significantly improved AVR in middle-aged lean and obese individuals [78]. In particular, the obese group seemed to benefit the most from the exercise training, with significantly dilated retinal arteries observed after a 10-week exercise program

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