Left ventricular diastolic filling and systolic function of young and older trained and untrained men

Abstract

Left ventricular diastolic filling and systolic function of young and older trained and untrained men. J Appl Physiol 95: 2570-2575. First published July 25, 2003 10.1152/japplphysiol.00441.2003.-Aging is associated with impaired early diastolic filling; however, the effect of endurance training on resting diastolic function in older subjects is unclear. Heart rate and ventricular loading conditions affect mitral inflow velocities measured by Doppler echocardiography; therefore, tissue Doppler imaging of mitral annular velocity, which is relatively preload independent, was combined with mitral inflow velocity and maximal oxygen consumption (V O2 max) in young (20-35 yr) and older (60-80 yr) trained and untrained men to determine whether endurance training is associated with an attenuation of age-associated changes in diastolic filling. As expected, V O2 max was higher in trained men (P Ͻ 0.01) and lower in older men (P Ͻ 0.01). Peak early mitral inflow velocity (E) and early-to-late mitral inflow velocity ratios were lower in older vs. young men (P Ͻ 0.01); however, there was no training effect (P Ͼ 0.05). Peak early mitral annular velocity (EЈ) was higher and peak late mitral annular velocity (AЈ) was lower in young vs. older men (P Ͻ 0.01). A significant interaction effect was found for AЈ, EЈ/AЈ, and peak systolic mitral annular velocity (SЈ). Training was associated with lower AЈ in young and higher AЈ in older men. SЈ was greater in trained vs. untrained older men (P Ͻ 0.05), but it was similar in trained and untrained young men. These findings suggest that early diastolic filling is not affected by training in older men, and the effect of training on AЈ and SЈ is different in young and older men. diastolic function; aging; endurance training; maximal aerobic capacity (maximal oxygen consumption), tissue Doppler imaging AGING IS ASSOCIATED WITH AN increase in left ventricular stiffness (7), which results in a prolongation of isovolumic relaxation time (9) and incomplete relaxation of the ventricle during early diastolic filling (25). Numerous investigations have shown that peak early diastolic mitral inflow velocity (E) is reduced in aged individuals (2,10,17,18,34). To maintain ventricular filling and stroke volume, peak late diastolic filling velocity (A) increases with age (2, 17), resulting in an age-associated decline in the early-to-late mitral inflow velocity ratio (E/A) ratio (17).Aerobic fitness is associated with improved early diastolic function in young healthy subjects. Young trained athletes have increased E (20) and E/A (8, 11, 22, 26) compared with their nontrained counterparts. However, evidence to suggest that training has a similar effect in older athletes, or that training attenuates the normal age-associated decrease in E/A is inconclusive (8,10,28,31). Endurance training has been shown to improve peak filling rate in older healthy men (19), and the E/A has been shown to be higher in highly trained older endurance athletes compared with agematched healthy controls (8). However, Fleg et...

Diastolic function in healthy humans: non-invasive assessment and the impact of acute and chronic exercise

“…In similar subjects, almost identical data (E/A athletes 1.9 ± 0.5 vs. control 1.6 ± 0.2) were either significant (Pluim et al 1998) or non-significant (Pluim et al 1999) based on sample size (21 vs. 12 male cyclists). Cross-sectional or flow propagation data from TDI studies tend to mirror the Doppler flow data described above, with limited differences in E 0 (Caso et al 2000;Schmidt-Trucksäss et al 2001;Pelà et al 2004;Baldi et al 2003), A 0 being similar or lower (Caso et al 2000;Schmidt-Trucksäss et al 2001;Pelà et al 2004;Tümüklü et al 2008;Kasikcioglu et al 2005;Zoncu et al 2002) and generally small improvement in the E 0 /A 0 ratio in athletes compared to untrained subjects. Nonetheless, studies of Olympic speed skaters (Poh et al 2008), professional soccer players (Tümüklü et al 2008) and endurance trained individuals (Vinereanu et al 2002;Zoncu et al 2002;Nottin et al 2004;Kasikcioglu et al 2005;Palka et al 1999;Poulsen et al 2007;Koç et al 2007) have reported elevated tissue Doppler measures of E 0 , E 0 /A 0 or Vp.…”

“…Of the studies to specifically report peak E filling velocities, most concluded that there were no differences between athletes and controls (Douglas et al 1986;Caso et al 2000;Sharma et al 2002;Triposkiadis et al 2002;Baldi et al 2003), although a few studies have reported increased E wave velocities in athletes (Karjalainen et al 1997). Conversely, peak A filling velocity is decreased in athletes compared to matched controls (Karjalainen et al 1997;Caso et al 2000;Schmidt-Trucksäss et al 2001;Guazzi et al 2001;Sharma et al 2002;Triposkiadis et al 2002), with only two suggesting no differences (Fagard et al 1987;Baldi et al 2003).…”

“…Of the studies to specifically report peak E filling velocities, most concluded that there were no differences between athletes and controls (Douglas et al 1986;Caso et al 2000;Sharma et al 2002;Triposkiadis et al 2002;Baldi et al 2003), although a few studies have reported increased E wave velocities in athletes (Karjalainen et al 1997). Conversely, peak A filling velocity is decreased in athletes compared to matched controls (Karjalainen et al 1997;Caso et al 2000;Schmidt-Trucksäss et al 2001;Guazzi et al 2001;Sharma et al 2002;Triposkiadis et al 2002), with only two suggesting no differences (Fagard et al 1987;Baldi et al 2003). The E/A ratio is more commonly reported as an index of diastolic function and, as a consequence of the changes in E and A described above, most publications and review articles report that the resting E/A ratio is either unchanged (Maron 1986;Fleck 1988;Effron 1989;George et al 1999;Pluim et al 1999;Guazzi et al 2001;Sharma et al 2002;Baldi et al 2003;Fagard 2003;Gates et al 2004;Pelà et al 2004), or slightly increased in athletes compared to controls (Douglas et al 1986;Douglas 1989;MacFarlane et al 1991;Karjalainen et al 1997;Pluim et al 1998;Caso et al 2000;Schmidt-Trucksäss et al 2001;Triposkiadis et al 2002).…”

Tissue Doppler annular velocities, NT-proBNP and exercise capacity in healthy elderly

“…The maximal oxygen uptake (V O 2 max ) was measured using the Schiller CS 200 metabolic analyser. A test was accepted as a 'true maximum' according to published criteria [17]. Subject who failed to meet these criteria, or had any other pathological findings during exercise stress testing were not included in the study.…”

Optimal health and function among the elderly: lessening severity of ADL disability

“…It was recently suggested [3] that following training, the mechanism most likely to be involved is a change in the cardiac autonomic balance producing an increase or a relative dominance of the vegal component. It has long been known that exercise training reduces resting and submaximal heart rate.…”