title: Association Between Sedentary Lifestyle and Diastolic Dysfunction Among Outpatients With Normal Left Ventricular Systolic Function Presenting to a Tertiary Referral Center in the Middle East.
abstract: BACKGROUND
  Sedentary lifestyle has become prevalent in our community. Recent data showed controversy on the effect of regular exercise on left ventricular compliance and myocardial relaxation.
  
  
  OBJECTIVE
  We sought to assess whether physical inactivity is an independent predictor of diastolic dysfunction in or community, after adjustment for several covariates.
  
  
  METHODS
  Consecutive outpatients presenting to the echocardiography laboratory between July 2013 and June 2014 were prospectively enrolled. Clinical variables were collected prospectively at enrollment. Patients were considered physically active if they exercised regularly ≥3× a week, ≥30 minutes each time. The primary endpoint was presence of diastolic dysfunction.
  
  
  RESULTS
  The final cohort included 1356 patients (mean age [SD] 52.9 [17.4] years, 51.3% female). Compared with physically active patients, the 1009 (74.4%) physically inactive patients were older, more often female, and had more comorbidities and worse diastolic function (51.3% vs 38.3%; P < 0.001). On univariate analysis, physical inactivity was associated with 70% increased odds of having diastolic dysfunction (odds ratio: 1.70, 95% confidence interval: 1.32-2.18, P < 0.001). There was significant interaction between physical activity and left ventricular mass index (LVMI; P = 0.026). On multivariate analysis, patients who were physically inactive and had LVMI ≥ median had significantly higher odds of having diastolic dysfunction (odds ratio: 2.82, 95% confidence interval: 1.58-5.05, P < 0.001).
  
  
  CONCLUSIONS
  In a large, prospectively enrolled cohort from a single tertiary center in the Middle East, physically inactive patients with increased LVMI had 2- to 3-fold increased odds of having diastolic dysfunction after multivariate adjustment.
authors.affiliation: Division of Cardiovascular Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Matta
authors.affiliation: Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon.
authors.forename: Elie
authors.initials: E
authors.lastname: Chammas
authors.affiliation: Division of Cardiovascular Medicine, University of Minneapolis, Minneapolis, Minnesota.
authors.forename: Chadi
authors.initials: C
authors.lastname: Alraies
authors.affiliation: Division of Cardiovascular Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Antoine
authors.identifier: http://orcid.org/0000-0003-0878-4682
authors.initials: A
authors.lastname: Abchee
authors.affiliation: Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon.
authors.forename: Wael
authors.initials: W
authors.lastname: AlJaroudi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D016208:Databases, Factual; D003971:Diastole; D015150:Echocardiography, Doppler; D015444:Exercise; D005260:Female; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010045:Outpatients; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012737:Sex Factors; D013599:Systole; D062606:Tertiary Care Centers; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016277:Ventricular Function, Left