Circulation, Vol 89, 1648-1655, Copyright © 1994 by American Heart Association
JR Stratton, WC Levy, MD Cerqueira, RS Schwartz and IB Abrass
BACKGROUND: Cardiac aging alters many of the acute responses to exercise
stress, but the extent to which chronic exercise (ie, training) can alter
or improve the effects of aging in humans is largely unknown. METHODS AND
RESULTS: Cardiovascular responses to graded supine exercise stress
(beginning at 200 kpm and increasing by 200 kpm every 3 minutes till
exhaustion) were assessed using radionuclide ventriculography in 13 older
(age, 60 to 82 years) and 11 young (age, 24 to 32 years) rigorously
screened healthy men before and after 6 months of endurance training.
Repeated-measures ANOVA was used to test significance. During exercise, the
old group had a lesser increase in heart rate (+105% old versus +166%
young), a greater increase in mean blood pressure (+35% old versus +22%
young), lesser increases in ejection fraction (+3 ejection fraction units
old versus +11 units young) and peak ejection rate (+62% old versus +119%
young), a greater increase in end-diastolic volume index (+8% old versus
-10% young), a lesser fall in end-systolic volume index (-0% old versus
-32% young), and a lesser increase in cardiac index (+135% old versus +189%
young) (all P < .01 young/old versus exercise stage). Stroke volume
index response to exercise was not different with aging (+14% old versus
+6% young, P = NS). Exercise training increased maximal oxygen intake by
21% in the older group (28.9 +/- 4.6 to 35.1 +/- 3.8 mL.kg- 1.min-1, P <
.001) and by 17% in the young (44.5 +/- 5.1 to 52.1 +/- 6.3 mL.kg-1.min-1,
P < .001) and increased peak workload by 24% in the old and 28% in the
young. Exercise training had no differential effects on old versus young
men. Among all subjects, training significantly reduced the resting heart
rate by 12% (-8 beats per minute) and increased resting end-diastolic
volume index by 13% (+9 mL/M2) and resting stroke volume index by 18% (+7
mL/M2) (all P < .01). At peak exercise, cardiac index increased by 16%
(+1.07 L.M-2.min-1) compared with before training, which was the result of
an increase in stroke volume of 18% (+7 mL/M2) (P < .001); peak heart
rate was unchanged. The increase in stroke volume index at peak exercise
was the result of both a 12% increase in end-diastolic volume index (+8
mL/M2) (P < .01) and an increase in ejection fraction (+3 ejection
fraction units) (P < .05) at peak exercise. The increased ejection
fraction at peak exercise occurred despite a 9% increase in systolic blood
pressure (+18 mm Hg) (P < .01), suggesting an increase in contractility.
Thus, both the young and old increased peak exercise cardiac output by use
of the Frank-Starling mechanism (ie, cardiac dilatation) as well as an
increase in ejection fraction. CONCLUSIONS: We conclude that there is an
age-associated decline in heart rate, ejection fraction, and cardiac output
responses to supine exercise in healthy men. Although the stroke volume
responses of the young and old are similar, the old tend to augment stroke
volume during exercise more through cardiac dilatation, with an increase in
end-diastolic volume (+8%) but without much change in ejection fraction (+3
ejection fraction units), whereas the young rely more on an increase in the
ejection fraction (+11 ejection fraction units) with no cardiac dilatation
(-10%). Despite the significant cardiovascular changes that occur in the
response to a single bout of exercise with aging, adaptations to chronic
exercise training were not different with aging and included improvements
in maximal workload and increases in ejection fraction, stroke volume
index, and cardiac index at peak exercise.
ARTICLES
Cardiovascular responses to exercise. Effects of aging and exercise training in healthy men
Division of Cardiology, Seattle VA Medical Center, WA 98108.
This article has been cited by other articles:
 |
|
 |
|
  R. F. Zoeller Jr. Gender Differences in Cardiorespiratory Fitness With Advancing Age: Is the Age-Associated Decline in VO2max More Rapid in Men and Do Older Men and Women Respond Differently to Exercise? American Journal of Lifestyle Medicine, November 1, 2008; 2(6): 492 - 499. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Otsuki, S. Maeda, M. Iemitsu, Y. Saito, Y. Tanimura, R. Ajisaka, and T. Miyauchi Systemic arterial compliance, systemic vascular resistance, and effective arterial elastance during exercise in endurance-trained men Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2008; 295(1): R228 - R235. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Deschenes, J. A. Carter, E. N. Matney, M. B. Potter, and M. H. Wilson Aged Men Experience Disturbances in Recovery Following Submaximal Exercise J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2006; 61(1): 63 - 71. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. F. Tops, A. A. W. Roest, H. J. Lamb, H. W. Vliegen, W. A. Helbing, E. E. van Der Wall, and A. de Roos Intraatrial Repair of Transposition of the Great Arteries: Use of MR Imaging after Exercise to Evaluate Regional Systemic Right Ventricular Function Radiology, December 1, 2005; 237(3): 861 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Hay, J. Rich, P. Ferber, D. Burkhoff, and M. S. Maurer Role of impaired myocardial relaxation in the production of elevated left ventricular filling pressure Am J Physiol Heart Circ Physiol, March 1, 2005; 288(3): H1203 - H1208. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Spina, T. E. Meyer, L. R. Peterson, D. T. Villareal, M. R. Rinder, and A. A. Ehsani Absence of left ventricular and arterial adaptations to exercise in octogenarians J Appl Physiol, November 1, 2004; 97(5): 1654 - 1659. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A A W Roest, H J Lamb, E E van der Wall, H W Vliegen, J G van den Aardweg, P Kunz, A de Roos, and W A Helbing Cardiovascular response to physical exercise in adult patients after atrial correction for transposition of the great arteries assessed with magnetic resonance imaging Heart, June 1, 2004; 90(6): 678 - 684. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Banerjee, A. L. Clark, N. Nikitin, and J. G.F. Cleland Diastolic heart failure. Paroxysmal or chronic? Eur J Heart Fail, June 1, 2004; 6(4): 427 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Ehsani, R. J. Spina, L. R. Peterson, M. R. Rinder, K. L. Glover, D. T. Villareal, E. F. Binder, and J. O. Holloszy Attenuation of cardiovascular adaptations to exercise in frail octogenarians J Appl Physiol, November 1, 2003; 95(5): 1781 - 1788. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Oxenham and N. Sharpe Cardiovascular aging and heart failure Eur J Heart Fail, August 1, 2003; 5(4): 427 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-W. Ha, E. M. Juracan, D. W. Mahoney, J. K. Oh, C. Shub, J. B. Seward, and P. A. Pellikka Hypertensive response to exercise: a potential cause for new wall motion abnormality in the absence of coronary artery disease J. Am. Coll. Cardiol., January 16, 2002; 39(2): 323 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. K. McGuire, B. D. Levine, J. W. Williamson, P. G. Snell, C. G. Blomqvist, B. Saltin, and J. H. Mitchell A 30-Year Follow-Up of the Dallas Bed Rest and Training Study: II. Effect of Age on Cardiovascular Adaptation to Exercise Training Circulation, September 18, 2001; 104(12): 1358 - 1366. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z.-W. WANG, W.-T. PAN, Y. LEE, T. KAKUMA, Y.-T. ZHOU, and R. H. UNGER The role of leptin resistance in the lipid abnormalities of aging FASEB J, January 1, 2001; 15(1): 108 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Spina, S. Rashid, V. G. Davila-Roman, and A. A. Ehsani Adaptations in beta -adrenergic cardiovascular responses to training in older women J Appl Physiol, December 1, 2000; 89(6): 2300 - 2305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Jin, R. Yang, W. Li, H. Lu, A. M. Ryan, A. K. Ogasawara, J. Van Peborgh, and N. F. Paoni Effects of exercise training on cardiac function, gene expression, and apoptosis in rats Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H2994 - H3002. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O.-E. Brodde and M. C. Michel Adrenergic and Muscarinic Receptors in the Human Heart Pharmacol. Rev., December 1, 1999; 51(4): 651 - 690. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Beere, S. D. Russell, M. C. Morey, D. W. Kitzman, and M. B. Higginbotham Aerobic Exercise Training Can Reverse Age-Related Peripheral Circulatory Changes in Healthy Older Men Circulation, September 7, 1999; 100(10): 1085 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Thomas, J. M. Pierzga, and W. L. Kenney Aerobic training and cutaneous vasodilation in young and older men J Appl Physiol, May 1, 1999; 86(5): 1676 - 1686. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Warner Jr., D. C. Metzger, D. W. Kitzman, D. J. Wesley, and W. C. Little Losartan improves exercise tolerance in patients with diastolic dysfunction and a hypertensive response to exercise J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1567 - 1572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-H. Chen, M. Nakayama, M. Talbot, E. Nevo, B. Fetics, G. Gerstenblith, L. C. Becker, and D. A. Kass Verapamil acutely reduces ventricular-vascular stiffening and improves aerobic exercise performance in elderly individuals J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1602 - 1609. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Oskvig Special Problems in the Elderly Chest, May 1, 1999; 115 (2009): 158S - 164S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Jones, P M Elliott, S Sharma, W J McKenna, and B J Whipp Cardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy Heart, July 1, 1998; 80(1): 60 - 67. [Abstract] [Full Text]
|
|
|
|
|
|
R. J. Spina, M. J. Turner, and A. A. Ehsani beta -Adrenergic-mediated improvement in left ventricular function by exercise training in older men Am J Physiol Heart Circ Physiol, February 1, 1998; 274(2): H397 - H404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Schulman, J. L. Fleg, A. P. Goldberg, J. Busby-Whitehead, J. M. Hagberg, F. C. O'Connor, G. Gerstenblith, L. C. Becker, L. I. Katzel, L. E. Lakatta, et al. Continuum of Cardiovascular Performance Across a Broad Range of Fitness Levels in Healthy Older Men Circulation, August 1, 1996; 94(3): 359 - 367. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. E. Montgomery, P. Clarkson, O.M. Nwose, D.P. Mikailidis, I.A. Jagroop, C. Dollery, J. Moult, F. Benhizia, J. Deanfield, M. Jubb, et al. The Acute Rise in Plasma Fibrinogen Concentration With Exercise Is Influenced by the G-453-A Polymorphism of the ß-Fibrinogen Gene Arterioscler Thromb Vasc Biol, March 1, 1996; 16(3): 386 - 391. [Abstract] [Full Text]
|
|
|
|
|
|
A. A. W. Roest, W. A. Helbing, P. Kunz, J. G. van den Aardweg, H. J. Lamb, H. W. Vliegen, E. E. van der Wall, and A. de Roos Exercise MR Imaging in the Assessment of Pulmonary Regurgitation and Biventricular Function in Patients after Tetralogy of Fallot Repair Radiology, April 1, 2002; 223(1): 204 - 211. [Abstract] [Full Text] [PDF]
|
|