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Dose-response relationship of cardiorespiratory fitness with incident atrial fibrillation

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Abstract

The dose-response association between cardiorespiratory fitness and risk of atrial fibrillation (AF) is still not well known. Therefore, we performed a comprehensive meta-analysis to investigate the dose-response association between cardiorespiratory fitness and incident AF. We performed a comprehensive search in the databases of PubMed, Cochrane library, and Ovid from inception through August 2019. A one-stage robust error meta-regression method was used to summarize the dose-response association between cardiorespiratory fitness and AF. A total of 9 studies were included in this meta-analysis. In the categorical analysis, compared with the lowest level of cardiorespiratory fitness, both the intermediate (RR = 0.68, 95% CI 0.57–0.82) and highest (RR = 0.60, 95% CI 0.51–0.72) levels of cardiorespiratory fitness were associated with a decreased risk of AF. In the dose-response analysis, per 1 metabolic equivalent increase in cardiorespiratory fitness was associated with a decreased risk of AF (RR = 0.91, 95% CI 0.86–0.95). There was an inverse relationship between cardiorespiratory fitness and risk of AF with evidence of linearity (Pnon-linearity = 0.43). Current evidence suggests that there is an inverse relationship between cardiorespiratory fitness and risk of AF, manifesting as a higher level of cardiorespiratory fitness is associated with a decreased risk of AF.

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Contributors

ZB-X, Y-Z, and WG-Z performed the literature search, study selection and data extraction, quality assessment, and statistical analysis. CY-W, J-L, and X-L help check the data to ensure accuracy. ZB-X and Y-Z wrote the original draft, while WG-Z revised the draft. P-Y edited the manuscript prior to submission to ensure the standard English grammar.

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Authors and Affiliations

  1. Department of Critical Care Medicine, the First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, Jiangxi, China

    Zhengbiao Xue, Chaoyu Wu, Jie Lin & Xin Liu

  2. Department of Children’s Ophthalmology, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China

    Yue Zhou

  3. Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China

    Peng Yu

  4. Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China

    Wengen Zhu

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  1. Zhengbiao Xue
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  5. Xin Liu
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  6. Peng Yu
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Correspondence to Wengen Zhu.

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Zhengbiao Xue and Yue Zhou are co-first authors.

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Xue, Z., Zhou, Y., Wu, C. et al. Dose-response relationship of cardiorespiratory fitness with incident atrial fibrillation. Heart Fail Rev 25, 419–425 (2020). https://doi.org/10.1007/s10741-019-09871-5

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