Exercising below the AHA recommended minimum was associated with a lower risk of meeting ARVC diagnostic criteria or experiencing sustained ventricular arrhythmias (adjusted OR 0.03; 95% CI 0.003-0.26).
Cohort (n=101)
Does exercise restriction prevent disease manifestation and sustained ventricular arrhythmias in genotype-positive family members of ARVC patients?
Exercise restriction below the AHA recommended minimum is highly protective against disease penetrance and ventricular arrhythmias in genotype-positive ARVC family members, with exercise playing a potentially greater role in promoting disease in females.
Odds Ratio: 0.03 (95% CI 0.003–0.26)
AIMS: In arrhythmogenic right ventricular cardiomyopathy (ARVC) patients, exercise worsens disease course, so exercise restriction is recommended. However, recommendations for genotype-positive ARVC family members is incompletely resolved. We aimed to provide evidence for exercise recommendations for genotype-positive ARVC family members. METHODS AND RESULTS: Arrhythmogenic right ventricular cardiomyopathy family members inheriting a pathogenic desmosomal variant were interviewed about exercise history from age 10. Exercise was characterized by duration, intensity, and dose (duration*intensity). Associations between exercise and (i) diagnosis by 2010 Task Force Criteria and (ii) development of sustained ventricular arrhythmias were examined. The study included 101 family members (age: 40.5 ± 19.3 years, male: 41%, Plakophilin-2 variant: 81%). Forty-four individuals (44%) met diagnostic criteria and 16 (16%) experienced sustained ventricular arrhythmia. Individuals who met diagnostic criteria had significantly higher average exercise duration and dose, but not peak intensity than those who did not. Only one individual who exercised below the American Heart Association recommended minimum (650 metabolic equivalent of task-hours/year) met diagnostic criteria or experienced sustained ventricular arrhythmia as opposed to 50% of individuals who exceeded it (adjusted odds ratio = 0.03, 95% confidence interval 0.003-0.26). The difference in exercise exposure between affected and unaffected individuals was more striking in females than in males. Females who had done high-dose exercise in adolescence had the worst survival free from diagnosis (P < 0.01). CONCLUSIONS: In phenotype-negative ARVC family members with a pathogenic desmosomal variant, athletic activities should be limited, particularly exercise dose. Exercise may play a greater role in promoting disease in female family members.
Wang et al. (Wed,) conducted a cohort in Arrhythmogenic right ventricular cardiomyopathy (ARVC) (n=101). Exercising below the AHA recommended minimum (650 MET-hours/year) vs. Exceeding the AHA recommended minimum was evaluated on Diagnosis by 2010 Task Force Criteria or development of sustained ventricular arrhythmias (adjusted OR 0.03, 95% CI 0.003-0.26). Exercising below the AHA recommended minimum was associated with a lower risk of meeting ARVC diagnostic criteria or experiencing sustained ventricular arrhythmias (adjusted OR 0.03; 95% CI 0.003-0.26).
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