{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:12Z","timestamp":1787018112986,"version":"build-2736575974"},"reference-count":81,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Adverse left ventricular diastolic function (LVDF) is an early marker of cardiac dysfunction that worsens with age and can lead to heart failure. It is unclear when this deterioration begins and whether physical activity (PA) influences it. We assessed the independent relationships of adverse LVDF in adolescents with different PA intensities, compared to the association with adiposity. The impact of adverse LVDF from low PA on cardiorespiratory fitness was examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In 127 adolescents (aged 11\u201018 years), we assessed LVDF by echocardiography, 7\u2010day PA by wrist\u2010worn accelerometry, adiposity\n                      <jats:italic toggle=\"no\">Z<\/jats:italic>\n                      scores by bioimpedance, and peak oxygen consumption by cardiopulmonary exercise testing (OxSOCRATES [Oxfordshire Sedentariness, Obesity, and Cardiometabolic Risk in Adolescents: A Trial of Exercise in Schools] study; NCT04118543). Adverse LVDF was defined using a body surface area\u2013adjusted septal early diastolic tissue peak velocity\n                      <jats:italic toggle=\"no\">Z<\/jats:italic>\n                      score (&lt;\u22122) based on pediatric reference values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Most participants with overweight (96%) or obesity (90%) had low vigorous PA (VPA). Rates of adverse LVDF were higher in groups with normal weight\/low VPA (22%), overweight (28%), and obesity (45%) compared with the normal weight\/high VPA group (0%; all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Greater VPA\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      score reduced the odds of adverse LVDF (odds ratio [OR], 0.20 [0.10\u20130.40]), independent (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016) of the weaker relationship with adiposity\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      score (OR, 0.57 [0.40\u20130.82]). Less intense PA was not associated with LVDF. Causal mediation analysis showed that those who do 5 versus 15\u2009minutes of daily VPA had 2.4\u2009mL\/kg\u2009per\u2009minute lower peak oxygen consumption because of adverse LVDF (indirect effect).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Low VPA in adolescence, independent of adiposity, is linked to adverse LVDF. Such impairment predicts worse peak oxygen consumption. VPA appears important for preserving LVDF in the young.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041806","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T10:35:01Z","timestamp":1755513301000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Early Cardiac Dysfunction in Adolescents With Low Vigorous Physical Activity"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-8878","authenticated-orcid":false,"given":"Samuel J.","family":"Burden","sequence":"first","affiliation":[{"name":"University of Oxford, John Radcliffe Hospital","place":["Oxford, UK"]},{"name":"King\u2019s College London","place":["London, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1946-9533","authenticated-orcid":false,"given":"Najmeh","family":"Zare","sequence":"additional","affiliation":[{"name":"University of Oxford, John Radcliffe Hospital","place":["Oxford, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1295-7769","authenticated-orcid":false,"given":"Oliver J.","family":"Rider","sequence":"additional","affiliation":[{"name":"University of Oxford, John Radcliffe Hospital","place":["Oxford, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2933-5213","authenticated-orcid":false,"given":"Helen","family":"Dawes","sequence":"additional","affiliation":[{"name":"University of Exeter","place":["Exeter, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1732-0057","authenticated-orcid":false,"given":"Alexander","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Oxford, John Radcliffe Hospital","place":["Oxford, 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