title: Sex differences regarding the impact of physical activity on left ventricular systolic function in elderly patients with an acute coronary event.
abstract: BACKGROUND
  Regular physical activity has been associated with less severity of an acute coronary syndrome (ACS), lower in-hospital mortality rates, and an improved short term prognosis. This study evaluated the relationship between physical activity status and the development of left ventricular systolic dysfunction (LVSD) according to inflammation and sex in elderly patients who had had an ACS.
  
  
  METHODS
  We analyzed prospectively collected data from 355 male (age 74 ± 6 years) and 137 female (76 ± 6 years) patients who were hospitalized with an ACS. LVSD was evaluated by echocardiography on the 5th day of hospitalization and physical activity status was assessed by a self-reported questionnaire. Inflammatory response was evaluated by measuring C-reactive protein levels. Logistic regression models were applied to evaluate the effect of physical activity status on the development of LVSD and inflammatory response at entry.
  
  
  RESULTS
  Physical inactivity had a higher prevalence in women who developed LVSD than in the female patients with preserved systolic function (46% vs. 20%, p=0.02). There was a significant positive association between physical activity levels and ejection fraction in women (p=0.06), but not in men (p=0.30). Multiadjusted logistic regression showed that women who were physically active had 76% lower odds (95%CI: 1-94%) of developing LVSD compared to their sedentary counterparts. Furthermore, physical activity was inversely associated with C-reactive protein levels in both sexes (p=0.08).
  
  
  CONCLUSIONS
  Long-term involvement in a physically active lifestyle seems to confer further cardio-protection by reducing the inflammatory response and preserving left ventricular systolic function in elderly female, but not male patients with an ACS.
authors.affiliation: First Cardiology Clinic, School of Medicine, University of Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Aggelopoulos
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Stella
authors.initials: S
authors.lastname: Brili
authors.forename: George
authors.initials: G
authors.lastname: Lazaros
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavouranakis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006115:Greece / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D009043:Motor Activity; D011379:Prognosis; D012720:Severity of Illness Index; D017678:Sex Distribution; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
chemical_list: D002097:C-Reactive Protein