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European Heart Journal 2003 24(24):2213-2220; doi:10.1016/j.ehj.2003.09.026
Copyright © 2003 by the European Society of Cardiology.
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Clinical research

Left ventricular structure and diastolic function with human ageing

Relation to habitual exercise and arterial stiffness

Phillip E. Gatesa,*, Hirofumi Tanakaa, Jayne Gravesa and Douglas R. Sealsa,b

a Human Cardiovascular Research Laboratory, Department of Integrative Physiology, University of Colorado, Boulder CO 80309, USA
b Department of Medicine (Cardiology and Geriatric Medicine), University of Colorado Health Sciences Center, Denver CO 80262, USA

* Correspondence to: Phillip E. Gates, Ph.D., Human Cardiovascular Research Laboratory, Department of Integrative Physiology, 354 UCB, University of Colorado, Boulder, Colorado, 80309, USA. Tel: +1 303-492-4568; Fax: +1 303-492-6778
E-mail address: phillip.gates{at}colorado.edu

Received 13 May 2003; revised 3 September 2003; accepted 25 September 2003

Abstract

Aim We sought to determine if attenuation of the age-associated increase in arterial stiffness by habitual aerobic-endurance exercise would have corresponding effects on left ventricular (LV) structure and diastolic function.

Methods and results We performed a cross-sectional study on 138 young, middle-aged, and older men who were either sedentary, recreationally active, or endurance exercise-trained. Ageing was associated with increased large artery stiffness (aortic pulse wave velocity) and habitual aerobic-endurance exercise was associated with decreased large artery stiffness (lower aortic pulse wave velocity; all P<0.05). Ageing was associated with increased mean LV wall thickness, chamber diameter, mass, concentric remodelling, and a decline in LV diastolic function (all P<0.05). Habitual aerobic-endurance exercise was independently associated with increased LV wall thickness, chamber diameter, and mass (echocardiography; P=0.05 or better). The largest LV mass was seen in older endurance trained men, suggesting an additive effect of exercise training and ageing on the LV. Indices of LV diastolic function declined with age, irrespective of habitual physical activity status. Aortic pulse wave velocity was an independent predictor of concentric LV remodelling in the pooled sample, but did not predict other properties of LV structure and diastolic function. In general, habitual aerobic-endurance exercise status was not uniformly associated with favourable modulation of age-associated changes in LV structure and diastolic function.

Conclusion We conclude that in contrast to its ability to favourably modulate the stiffness of large elastic arteries, regular aerobic-endurance exercise does not consistently modulate the changes in LV structure and diastolic function that occur with physiological ageing in men.

Key Words: Arterial stiffness • Left ventricle • Endurance training • Ultrasound • Pulse wave velocity


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