Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers

Abhishek C Sawant; Anneline S J M Te Riele; Crystal Tichnell; Brittney Murray; Aditya Bhonsale; Harikrishna Tandri; Daniel P Judge; Hugh Calkins; Cynthia A James

doi:10.1016/j.hrthm.2015.08.035

Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers

Abhishek C Sawant, Anneline S J M Te Riele, Crystal Tichnell, Brittney Murray, Aditya Bhonsale, Harikrishna Tandri, Daniel P Judge, Hugh Calkins, Cynthia A James

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Endurance exercise is associated with adverse outcomes in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Exercise recommendations for family members remain undetermined.

OBJECTIVE: The purposes of this study were to determine if (1) endurance exercise (Bethesda class C) and exercise intensity (metabolic equivalent hours per year [MET-Hr/year]) increase the likelihood of fulfilling 2010 Task Force Criteria and ventricular arrhythmias/implantable cardioverter-defibrillator shock (ventricular tachycardia/ventricular fibrillation [VT/VF]), and (2) exercise restriction to the American Heart Association (AHA)-recommended minimum for healthy adults is associated with favorable outcomes of at-risk family members.

METHODS: Twenty-eight family members of 10 probands inheriting a PKP2 mutation were interviewed about exercise from age 10. Exercise threshold to maintain overall health was based on the 2007 AHA guidelines of a minimum 390 to 650 MET-Hr/year.

RESULTS: After adjustment for age, sex, and family membership, both participation in endurance athletics (odds ratio [OR] 7.4, P = .03) and higher-intensity exercise (OR = 4.2, P = .004) were associated with diagnosis (n = 13). Endurance athletes were also significantly more likely to develop VT/VF (n = 6, P = .02). Family members who restricted exercise at or below the upper bound of the AHA goal (≤650 MET-Hr/year) were significantly less likely to be diagnosed (OR = 0.07, P = .002) and had no VT/VF. At diagnosis and first VT/VF, family members had accumulated 2.8-fold (P = .002) and 3.5-fold (P = .03), respectively, greater MET-Hr exercise than the AHA-recommended minimum. Those who developed VT/VF had performed particularly high-intensity exercise in adolescence compared to unaffected family members (age 10-14: P = .04; age 14-19: P = .02).

CONCLUSION: The results of this study suggest restricting unaffected desmosomal mutation carriers from endurance and high-intensity athletics but potentially not from AHA-recommended minimum levels of exercise for healthy adults.

Original language	English
Pages (from-to)	199-207
Number of pages	9
Journal	Heart Rhythm
Volume	13
Issue number	1
DOIs	https://doi.org/10.1016/j.hrthm.2015.08.035
Publication status	Published - Jan 2016

Keywords

Adult
American Heart Association
Arrhythmogenic Right Ventricular Dysplasia
Desmosomes
Exercise
Family
Female
Heterozygote
Humans
Likelihood Functions
Male
Middle Aged
Physical Endurance
Physical Exertion
Plakophilins
Preventive Health Services
Risk Assessment
Tachycardia, Ventricular
United States
Arrhythmogenic right ventricular cardiomyopathy
Arrhythmia

Access to Document

10.1016/j.hrthm.2015.08.035

Cite this

@article{12568e07c32c4600a34e93ab1e3c752f,

title = "Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers",

abstract = "BACKGROUND: Endurance exercise is associated with adverse outcomes in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Exercise recommendations for family members remain undetermined.OBJECTIVE: The purposes of this study were to determine if (1) endurance exercise (Bethesda class C) and exercise intensity (metabolic equivalent hours per year [MET-Hr/year]) increase the likelihood of fulfilling 2010 Task Force Criteria and ventricular arrhythmias/implantable cardioverter-defibrillator shock (ventricular tachycardia/ventricular fibrillation [VT/VF]), and (2) exercise restriction to the American Heart Association (AHA)-recommended minimum for healthy adults is associated with favorable outcomes of at-risk family members.METHODS: Twenty-eight family members of 10 probands inheriting a PKP2 mutation were interviewed about exercise from age 10. Exercise threshold to maintain overall health was based on the 2007 AHA guidelines of a minimum 390 to 650 MET-Hr/year.RESULTS: After adjustment for age, sex, and family membership, both participation in endurance athletics (odds ratio [OR] 7.4, P = .03) and higher-intensity exercise (OR = 4.2, P = .004) were associated with diagnosis (n = 13). Endurance athletes were also significantly more likely to develop VT/VF (n = 6, P = .02). Family members who restricted exercise at or below the upper bound of the AHA goal (≤650 MET-Hr/year) were significantly less likely to be diagnosed (OR = 0.07, P = .002) and had no VT/VF. At diagnosis and first VT/VF, family members had accumulated 2.8-fold (P = .002) and 3.5-fold (P = .03), respectively, greater MET-Hr exercise than the AHA-recommended minimum. Those who developed VT/VF had performed particularly high-intensity exercise in adolescence compared to unaffected family members (age 10-14: P = .04; age 14-19: P = .02).CONCLUSION: The results of this study suggest restricting unaffected desmosomal mutation carriers from endurance and high-intensity athletics but potentially not from AHA-recommended minimum levels of exercise for healthy adults.",

keywords = "Adult, American Heart Association, Arrhythmogenic Right Ventricular Dysplasia, Desmosomes, Exercise, Family, Female, Heterozygote, Humans, Likelihood Functions, Male, Middle Aged, Physical Endurance, Physical Exertion, Plakophilins, Preventive Health Services, Risk Assessment, Tachycardia, Ventricular, United States, Arrhythmogenic right ventricular cardiomyopathy, Arrhythmia",

author = "Sawant, {Abhishek C} and {Te Riele}, {Anneline S J M} and Crystal Tichnell and Brittney Murray and Aditya Bhonsale and Harikrishna Tandri and Judge, {Daniel P} and Hugh Calkins and James, {Cynthia A}",

year = "2016",

month = jan,

doi = "10.1016/j.hrthm.2015.08.035",

language = "English",

volume = "13",

pages = "199--207",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier",

number = "1",

}

TY - JOUR

T1 - Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers

AU - Sawant, Abhishek C

AU - Te Riele, Anneline S J M

AU - Tichnell, Crystal

AU - Murray, Brittney

AU - Bhonsale, Aditya

AU - Tandri, Harikrishna

AU - Judge, Daniel P

AU - Calkins, Hugh

AU - James, Cynthia A

PY - 2016/1

Y1 - 2016/1

N2 - BACKGROUND: Endurance exercise is associated with adverse outcomes in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Exercise recommendations for family members remain undetermined.OBJECTIVE: The purposes of this study were to determine if (1) endurance exercise (Bethesda class C) and exercise intensity (metabolic equivalent hours per year [MET-Hr/year]) increase the likelihood of fulfilling 2010 Task Force Criteria and ventricular arrhythmias/implantable cardioverter-defibrillator shock (ventricular tachycardia/ventricular fibrillation [VT/VF]), and (2) exercise restriction to the American Heart Association (AHA)-recommended minimum for healthy adults is associated with favorable outcomes of at-risk family members.METHODS: Twenty-eight family members of 10 probands inheriting a PKP2 mutation were interviewed about exercise from age 10. Exercise threshold to maintain overall health was based on the 2007 AHA guidelines of a minimum 390 to 650 MET-Hr/year.RESULTS: After adjustment for age, sex, and family membership, both participation in endurance athletics (odds ratio [OR] 7.4, P = .03) and higher-intensity exercise (OR = 4.2, P = .004) were associated with diagnosis (n = 13). Endurance athletes were also significantly more likely to develop VT/VF (n = 6, P = .02). Family members who restricted exercise at or below the upper bound of the AHA goal (≤650 MET-Hr/year) were significantly less likely to be diagnosed (OR = 0.07, P = .002) and had no VT/VF. At diagnosis and first VT/VF, family members had accumulated 2.8-fold (P = .002) and 3.5-fold (P = .03), respectively, greater MET-Hr exercise than the AHA-recommended minimum. Those who developed VT/VF had performed particularly high-intensity exercise in adolescence compared to unaffected family members (age 10-14: P = .04; age 14-19: P = .02).CONCLUSION: The results of this study suggest restricting unaffected desmosomal mutation carriers from endurance and high-intensity athletics but potentially not from AHA-recommended minimum levels of exercise for healthy adults.

AB - BACKGROUND: Endurance exercise is associated with adverse outcomes in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Exercise recommendations for family members remain undetermined.OBJECTIVE: The purposes of this study were to determine if (1) endurance exercise (Bethesda class C) and exercise intensity (metabolic equivalent hours per year [MET-Hr/year]) increase the likelihood of fulfilling 2010 Task Force Criteria and ventricular arrhythmias/implantable cardioverter-defibrillator shock (ventricular tachycardia/ventricular fibrillation [VT/VF]), and (2) exercise restriction to the American Heart Association (AHA)-recommended minimum for healthy adults is associated with favorable outcomes of at-risk family members.METHODS: Twenty-eight family members of 10 probands inheriting a PKP2 mutation were interviewed about exercise from age 10. Exercise threshold to maintain overall health was based on the 2007 AHA guidelines of a minimum 390 to 650 MET-Hr/year.RESULTS: After adjustment for age, sex, and family membership, both participation in endurance athletics (odds ratio [OR] 7.4, P = .03) and higher-intensity exercise (OR = 4.2, P = .004) were associated with diagnosis (n = 13). Endurance athletes were also significantly more likely to develop VT/VF (n = 6, P = .02). Family members who restricted exercise at or below the upper bound of the AHA goal (≤650 MET-Hr/year) were significantly less likely to be diagnosed (OR = 0.07, P = .002) and had no VT/VF. At diagnosis and first VT/VF, family members had accumulated 2.8-fold (P = .002) and 3.5-fold (P = .03), respectively, greater MET-Hr exercise than the AHA-recommended minimum. Those who developed VT/VF had performed particularly high-intensity exercise in adolescence compared to unaffected family members (age 10-14: P = .04; age 14-19: P = .02).CONCLUSION: The results of this study suggest restricting unaffected desmosomal mutation carriers from endurance and high-intensity athletics but potentially not from AHA-recommended minimum levels of exercise for healthy adults.

KW - Adult

KW - American Heart Association

KW - Arrhythmogenic Right Ventricular Dysplasia

KW - Desmosomes

KW - Exercise

KW - Family

KW - Female

KW - Heterozygote

KW - Humans

KW - Likelihood Functions

KW - Male

KW - Middle Aged

KW - Physical Endurance

KW - Physical Exertion

KW - Plakophilins

KW - Preventive Health Services

KW - Risk Assessment

KW - Tachycardia, Ventricular

KW - United States

KW - Arrhythmogenic right ventricular cardiomyopathy

KW - Arrhythmia

U2 - 10.1016/j.hrthm.2015.08.035

DO - 10.1016/j.hrthm.2015.08.035

M3 - Article

C2 - 26321091

SN - 1547-5271

VL - 13

SP - 199

EP - 207

JO - Heart Rhythm

JF - Heart Rhythm

IS - 1

ER -

Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers

Abstract

Keywords

Access to Document

Fingerprint

Cite this