Stress related neural activity: potential mechanism contributing to benefit of physical activity on heart failure incidence

Abstract Background We previously observed that: 1) physical activity (PA) decreases stress-related neural (SNA) in a dose-dependent manner and 2) resting SNA predicts incident heart failure (HF). Thus, we hypothesize that PA may decrease the risk of HF part through its beneficial effect on SNA. Methods Self-reported data were acquired from Partners Biobank participants. Metabolic equivalent task-minutes per week (MET*minutes/week) calculated participants categorized according to their adherence current recommendations (<500 ≥500 MET-min/wk). In subset with clinically indicated 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging (n=744), was measured as ratio amygdalar ventromedial prefrontal cortical activity. Subsequent baseline CVD factor obtained using International Classification Diseases Codes. Kaplan-Meier Cox regression analyses used evaluate relationship between vs risk. Mediation analysis test whether PA's impact significantly mediated association HF. Results Among 50,363 (median age 59 years [IQR 42, 70], 40% male), 13,850 (11.6%) diagnosed over median period 3.1 years. within associated lower subsequent (hazard (HR) [95% confidence interval (CI)]: 0.849 [0.760, 0.948], p=0.004, Figure model adjusted for factors history myocardial infarction. As noted previously, higher (HR CI]: 1.34 [1.08, 1.66], p=0.007); guideline (vs.below) (Zscore ± SD: −0.14±0.92 0.02±1, p=0.037). Moreover, mediation shows exercise reduces via reductions SNA, accounting 9% total (p<0.05, 2). Conclusion associates in: A) stress-associated B) mechanism by which involve salutary effects pathways. Funding Acknowledgement Type funding sources: None.