Circulation, Vol 89, 198-205, Copyright © 1994 by American Heart Association
DR Seals, JM Hagberg, RJ Spina, MA Rogers, KB Schechtman and AA Ehsani
BACKGROUND: The age-associated decline in aerobic exercise capacity is
partially reversible by endurance exercise training. Moderate-intensity
endurance exercise training increases aerobic exercise capacity mediated,
in part, by improvement of stroke volume and left ventricular performance
in older men. The present study was designed to characterize the nature of
cardiovascular adaptations to strenuous endurance exercise of long duration
and to delineate the mechanisms underlying increased stroke volume and
cardiac output in highly trained older endurance athletes. METHODS AND
RESULTS: Nine male master athletes (MA: 64 +/- 2 years old, mean +/- SEM)
and 9 older sedentary healthy men (controls: 63 +/- 1 year) were studied.
Left ventricular systolic function was evaluated with the use of cardiac
blood pool imaging and echocardiography. Maximal O2 uptake (VO2max) was
50.4 +/- 1.7 mL.kg-1 x min-1 in the MA and 29.6 +/- 1.4 mL.kg-1 x min-1 (P
= .0001) in controls. Systolic and mean blood pressures at rest and during
exercise were not different in the two groups. Left ventricular systolic
function at peak exercise was higher in the MA than in sedentary controls
as evidenced by (1) a higher left ventricular functional reserve (delta EF:
12.4 +/- 2 versus 5.6 +/- 2.5, P = .05), (2) a large decrease in
end-systolic volume during exercise (MA: 56 +/- 4 mL at rest and 42 +/- 5
mL at peak exercise, P = .007; controls: 43 +/- 2 mL at rest and 42 +/- 6
mL at peak exercise, P = .35) with no differences in systolic blood
pressure, (3) a higher left ventricular fractional shortening at peak
exercise (MA: 52 +/- 2.6%; controls: 45 +/- 1%, P = .046) at comparable
values for end-systolic wall stress (MA: 56 +/- 12 g/cm2; controls: 53 +/-
7 g/cm2, P = .50), and (4) a greater decrease in end-systolic diameter at
peak exercise in the MA than in controls (MA: -1.2 +/- 0.16 cm versus -0.57
+/- 0.13 cm, P = .014) despite no significant differences between the
changes in end- systolic wall stress during exercise (MA: -15.5 +/- 7.5
g/cm2, controls: -11.0 +/- 9.0 g/cm2, P = .6). MA had a larger
end-diastolic volume at rest (153 +/- 6 versus 132 +/- 4 mL, P = .009) with
a normal wall thickness-to-radius ratio (0.34 +/- 0.02). Peak exercise
stroke volume was higher (P = .023) in the MA (132 +/- 6 mL/min) than in
the sedentary controls (111 +/- 6 mL/min). Changes in stroke volume
correlated strongly with changes in ejection fraction in the MA (r = .80, P
= .010) but not in sedentary controls (r = .59, P = .097). Further, changes
in stroke volume from rest to exercise correlated strongly with changes in
end-diastolic volume in both MA (r = .78, P = .013) and sedentary controls
(r = .73, P = .026), suggestive of reliance of stroke volume on
end-diastolic volume and preload. However, for a given increase in
end-diastolic volume, the rise in stroke volume during exercise was
significantly larger in the MA than in controls, which, in the absence of
differences in mean blood pressures, indicates that enhanced left
ventricular systolic function independent of preload plays an additional
role in maintaining a higher stroke volume at peak exercise in the highly
trained older men. CONCLUSIONS: Cardiac adaptations in older endurance
trained men are characterized by volume- overload left ventricular
hypertrophy and enhancement of left ventricular systolic performance at
peak exercise. These adaptive responses contribute to enhanced stroke
volume at peak exercise in older endurance trained men.
ARTICLES
Enhanced left ventricular performance in endurance trained older men
Section of Applied Physiology, Washington University School of Medicine, St Louis, Mo. 63110.
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