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Carrick-Ranson G, Howden EJ, Brazile TL, Levine BD, Reading SA. Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women. J Appl Physiol (1985) 2023; 135:1215-1235. [PMID: 37855034 DOI: 10.1152/japplphysiol.00798.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in women in developed societies. Unfavorable structural and functional adaptations within the heart and central blood vessels with sedentary aging in women can act as the substrate for the development of debilitating CVD conditions such as heart failure with preserved ejection fraction (HFpEF). The large decline in cardiorespiratory fitness, as indicated by maximal or peak oxygen uptake (V̇o2max and V̇o2peak, respectively), that occurs in women as they age significantly affects their health and chronic disease status, as well as the risk of cardiovascular and all-cause mortality. Midlife and older women who have performed structured endurance exercise training for several years or decades of their adult lives exhibit a V̇o2max and cardiac and vascular structure and function that are on par or even superior to much younger sedentary women. Therefore, regular endurance exercise training appears to be an effective preventative strategy for mitigating the adverse physiological cardiovascular adaptations associated with sedentary aging in women. Herein, we narratively describe the aging and short- and long-term endurance exercise training adaptations in V̇o2max, cardiac structure, and left ventricular systolic and diastolic function at rest and exercise in midlife and older women. The role of circulating estrogens on cardiac structure and function is described for consideration in the timing of exercise interventions to maximize beneficial adaptations. Current research gaps and potential areas for future investigation to advance our understanding in this critical knowledge area are highlighted.
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Affiliation(s)
- Graeme Carrick-Ranson
- Department of Surgery, the University of Auckland, Auckland, New Zealand
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| | - Erin J Howden
- Human Integrative Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Tiffany L Brazile
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stacey A Reading
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
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Systolic and diastolic function during cycling at the respiratory threshold between elderly and young healthy individuals. Sci Rep 2022; 12:3825. [PMID: 35264702 PMCID: PMC8907329 DOI: 10.1038/s41598-022-07933-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/28/2022] [Indexed: 11/20/2022] Open
Abstract
The hemodynamic consequences of aging have been extensively investigated during maximal incremental exercise. However, less is known about the effects of aging on hemodynamics during submaximal steady-state exercise. The aim of the present investigation was to compare the hemodynamics of healthy elderly and young subjects during an exercise bout conducted at the gas threshold (GET) intensity. Two groups of healthy, physically active subjects were studied: the elderly group—EG (n = 11; > 60 years old) and the young group—YG (n = 13; < 35 years old). Both groups performed a 5-min rectangular exercise test at the GET intensity. Hemodynamics were measured using echocardiography. The main finding was that stroke volume responses were higher in the YG than the EG (72.5 ± 16.7 vs. 52.4 ± 8.4 ml, respectively). The increased stroke volume capacity in the YG was the consequence of a greater capacity to increase cardiac preload and contractility and, to a lesser extent, to reduce systemic vascular resistance. Importantly, the atrial contribution to ventricular diastolic filling was substantially higher in the YG when compared to the EG.
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Izem O, Mourot L, Tordi N, Grandperrin A, Obert P, Rupp T, Nottin S. Key role of left ventricular untwisting in endurance cyclists at onset of exercise. J Appl Physiol (1985) 2021; 131:1565-1574. [PMID: 34590909 DOI: 10.1152/japplphysiol.00907.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The rise in oxygen consumption during the transition from rest to exercise is faster in those who are endurance-trained than those who have sedentary lifestyles, partly due to a more efficient cardiac response. However, data regarding this acute cardiac response in trained individuals are limited to heart rate (HR), stroke volume, and cardiac output. Considering this, we compared cardiac kinetics, including left ventricular (LV) strains and twist/untwist mechanics, between endurance-trained cyclists and their sedentary counterparts. Twenty young, male, trained cyclists and 23 untrained participants aged 18-25 yr performed five similar constant workload exercises on a cyclo-ergometer (target HR: 130 beats/min). During each session, LV myocardial diastolic and systolic linear strains, as well as torsional mechanics, were assessed using speckle-tracking echocardiography. Cardiac function was evaluated every 15 s during the first minute and every 30 s thereafter, until 240 s. Stroke volume increased during the first 30-45 s in both groups but to a significantly greater extent in trained cyclists (31% vs. 24%). Systolic parameters were similar in both groups. Transmitral peak filling velocity and peak filling rate responded faster to exercise and with greater amplitude in trained cyclists. Left ventricular filling pressure was lower in the former, whereas LV relaxation was greater but only at the base of the left ventricle. Basal rotation and peak untwisting rate responded faster and to a greater extent in the cyclists. This study provides new mechanical insights into the key role of LV untwisting in the more efficient acute cardiac response of endurance-trained athletes at onset of exercise.NEW & NOTEWORTHY Our study assessed for the first time, to our knowledge, the kinetics of left ventricular function during the transition from rest to constant-load exercise in endurance-trained subjects. We observed a faster cardiac response in cyclists characterized by a faster response of cardiac output, left ventricular transmitral filling, basal rotation, and untwisting. This study highlighted the key role of left ventricular twisting mechanics in the more efficient acute cardiac response of endurance-trained athletes at onset of exercise.
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Affiliation(s)
| | - Laurent Mourot
- University of Bourgogne Franche-Comté, Besançon, France.,Tomsk Polytechnic University, Tomsk, Russia
| | - Nicolas Tordi
- University of Bourgogne Franche-Comté, Besançon, France
| | | | | | - Thomas Rupp
- LIBM, Inter-university Laboratory of Human Movement Science, University Savoie Mont Blanc, Chambéry, France
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Shibata S, Hirabuki K, Hata N, Suzuki R, Suda T, Uechi T, Hirasawa A. Pivotal Role of Heart for Orthostasis: Left Ventricular Untwisting Mechanics and Physical Fitness. Exerc Sport Sci Rev 2021; 49:88-98. [PMID: 33720910 DOI: 10.1249/jes.0000000000000247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Augmentation of left ventricular (LV) untwisting due to central hypovolemia is likely to be a compensatory mechanism for maintaining stroke volume, which is reduced by a decrease in cardiac filling during orthostatic stress. Orthostatic intolerance observed in both high and low fitness levels may be explained by the impaired response of LV untwisting due to central hypovolemia.
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Affiliation(s)
| | | | | | - Rina Suzuki
- Emergency Department, Kyorin University Hospital
| | - Tomoya Suda
- Emergency Department, Kyorin University Hospital
| | | | - Ai Hirasawa
- Department of Health and Welfare, Faculty of Health Sciences, Kyorin University, Tokyo, Japan
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Beaumont A, Campbell A, Unnithan V, Grace F, Knox A, Sculthorpe N. Long-term athletic training does not alter age-associated reductions of left-ventricular mid-diastolic lengthening or expansion at rest. Eur J Appl Physiol 2020; 120:2059-2073. [PMID: 32623518 PMCID: PMC7419356 DOI: 10.1007/s00421-020-04418-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/05/2020] [Indexed: 01/03/2023]
Abstract
Purpose The interaction of ageing and exercise training status on left-ventricular (LV) peak strain is unclear. Additionally, strain analysis across the entire cardiac cycle facilitates a more detailed assessment of deformation, yet this has not been implemented to characterize the ageing LV and in association with training status. This study investigated healthy ageing and training status on LV systolic and diastolic strain utilizing novel echocardiographic applications. Methods Forty healthy males were included and allocated into four groups; young recreationally active (YRA,n = 9; 28 ± 5 years), old recreationally active (ORA, n = 10; 68 ± 6), young trained (YT,n = 10; 27 ± 6 years), and old trained (OT, n = 11, 64 ± 4 years) groups. Two-dimensional speckle-tracking echocardiography was performed to ascertain peak LV longitudinal and circumferential strain (base and apex) strain within each myocardial layer and at 5% increments across the cardiac cycle. Results Older groups had lower diastolic longitudinal lengthening and circumferential expansion between 40–85% mid-diastole, regardless of training status (P < 0.05). Whereas, strain throughout systole was similar between groups (P > 0.05). Longitudinal and circumferential (base and apex) peak and layer-specific strain did not differ between groups (P > 0.05). Conclusion Novel applications of diastolic strain revealed lower age-associated LV longitudinal lengthening and circumferential expansion in older age. Yet, diastolic strain profiles did not differ based on chronic habits of exercise training and, thus, older trained men did not demonstrate an attenuation of age-associated differences in mid-diastolic LV strain. Electronic supplementary material The online version of this article (10.1007/s00421-020-04418-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Amy Campbell
- Institute of Clinical Exercise and Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park Blantyre, Glasgow, UK
| | - Viswanath Unnithan
- Institute of Clinical Exercise and Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park Blantyre, Glasgow, UK
| | - Fergal Grace
- Faculty of Health, School of Health Science and Psychology, Federation University Australia, Ballarat, VIC, Australia
| | - Allan Knox
- Exercise Science Department, California Lutheran University, Thousand Oaks, CA, USA
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park Blantyre, Glasgow, UK.
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Eze-Nliam C, Schiller NB, Hayami D, Ghahghaie F, Bibby D, Fang Q, Marcus GM, Åström Aneq M. Endurance exercise in seniors: Tonic, toxin or neither? Clin Physiol Funct Imaging 2020; 40:320-327. [PMID: 32364658 DOI: 10.1111/cpf.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/08/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cardiac adaptation to sustained exercise in the athletes is established. However, exercise-associated effect on the cardiac function of the elderly has to be elucidated. The aim of this study was to analyse left (LV) and right ventricular (RV) characteristics at different levels of chronic exercise in the senior heart. MATERIALS AND METHODS We studied 178 participants in the World Senior Games (mean age 68 ± 8 years, 86 were men; 48%). Three groups were defined based on the type and intensity of sports: low-, moderate- and high-intensity level. Exclusion criteria were coronary artery disease, atrial fibrillation, valvular heart disease or uncontrolled hypertension. LV and RV size and function were evaluated with an echocardiogram. RESULTS LV trans-mitral inflow deceleration time decreased in parallel to the intensity of chronic exercise: 242 ± 54 ms in low-, 221 ± 52 ms in moderate- and 215 ± 58 ms in high-intensity level, p = .03. Left atrial volume index (LAVI) was larger in high-intensity group, p = .001. The LAVI remained significantly larger when adjusting for age, gender, heart rate, hypertension and diabetes (p = .002). LV and RV sizes were larger in the high-intensity group. LV ejection fraction and RV systolic function evaluated by tissue Doppler velocity, atrioventricular plane displacement and strain did not differ between groups. CONCLUSION Left ventricular diastolic filling is not only preserved, but may also be enhanced in long-term, top-level senior athletes. Moreover, LV and RV systolic function remain unchanged at different levels of exercise. This supports the beneficial effects of endurance exercise participation in senior hearts.
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Affiliation(s)
- Chete Eze-Nliam
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Nelson B Schiller
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - Doug Hayami
- Division of Cardiology, Queen Elizabeth II Health Sciences Center, Halifax Infirmary Site, Halifax, NS, Canada
| | - Farzin Ghahghaie
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - Dwight Bibby
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - Qizhi Fang
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - Gregory M Marcus
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - Meriam Åström Aneq
- Department of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Beaumont AJ, Grace FM, Richards JC, Campbell AK, Sculthorpe NF. Aerobic Training Protects Cardiac Function During Advancing Age: A Meta-Analysis of Four Decades of Controlled Studies. Sports Med 2020; 49:199-219. [PMID: 30374946 PMCID: PMC6513799 DOI: 10.1007/s40279-018-1004-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. Electronic supplementary material The online version of this article (10.1007/s40279-018-1004-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander J Beaumont
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK
| | - Fergal M Grace
- Human Movement and Sports Science Group, Faculty of Health, Federation University Australia, Ballarat, VIC, Australia
| | - Joanna C Richards
- School of Sport Science and Physical Activity, Institute of Sport and Physical Activity Research, University of Bedfordshire, Bedford, UK
| | - Amy K Campbell
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK
| | - Nicholas F Sculthorpe
- School of Health and Life Science, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK.
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Jeremic N, Weber GJ, Theilen NT, Tyagi SC. Cardioprotective effects of high-intensity interval training are mediated through microRNA regulation of mitochondrial and oxidative stress pathways. J Cell Physiol 2019; 235:5229-5240. [PMID: 31823395 DOI: 10.1002/jcp.29409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 08/26/2019] [Indexed: 12/14/2022]
Abstract
Human studies have shown high-intensity interval training (HIIT) has beneficial cardiovascular effects and is typically more time-efficient compared with traditional endurance exercise. The main goal of this study is to show the potential molecular and functional cardiovascular benefits of HIIT compared with endurance training (ET). Three groups of mice were used including sedentary-control, ET mice, and HIIT mice groups. Results indicated ejection fraction was increased in HIIT compared with ET while fractional shortening was increased in the HIIT group compared with both groups. Blood flow of the abdominal aorta was increased in both exercise groups compared with control. Increases in cross-sectional area and mitochondrial and antioxidative markers in HIIT compared with control were observed, along with several microRNAs. These findings indicate HIIT has specific cardiac-protective effects and may be a viable alternative to traditional ET as a cardiovascular preventative medicine intervention.
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Affiliation(s)
- Nevena Jeremic
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Gregory J Weber
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Nicholas T Theilen
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Suresh C Tyagi
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
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Trenkwalder T, Rübsamen N, Schmitt VH, Arnold N, Kaess BM, Sinning CR, Zeller T, Beutel ME, Schmidtmann I, Nickels S, Pfeiffer N, Leuschner A, Münzel T, Lackner KJ, Hengstenberg C, Blankenberg S, Wild PS, Reinhard W, Schnabel R. Left ventricular geometry and function in early repolarization: results from the population-based Gutenberg Health Study. Clin Res Cardiol 2019; 108:1107-1116. [DOI: 10.1007/s00392-019-01445-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 02/19/2019] [Indexed: 12/18/2022]
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Beaumont A, Campbell A, Grace F, Sculthorpe N. Cardiac Response to Exercise in Normal Ageing: What Can We Learn from Masters Athletes? Curr Cardiol Rev 2018; 14:245-253. [PMID: 30095058 PMCID: PMC6300801 DOI: 10.2174/1573403x14666180810155513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. CONCLUSION This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy.
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Affiliation(s)
- A. Beaumont
- Address correspondence to this author at the Institute of Clinical Exercise and Health Science, University of the West of Scotland, G72 0LH, Scotland; E-mail:
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Samuel TJ, Stöhr EJ. Clarification on the role of LV untwisting in LV “relaxation” and diastolic filling. Clin Res Cardiol 2017; 106:935-937. [DOI: 10.1007/s00392-017-1143-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022]
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