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Age and gender affect ventricular-vascular coupling during aerobic exercise
Samer S Najjar1, Steven P Schulman, Gary Gerstenblith
1Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, Maryland 21224, USA. NajjarSa@grc.nia.nih.gov
Journal of the American College of Cardiology
|September 11, 2004
Summary
Ventricular-vascular coupling (EaI/E(LV)I) differences emerge during exercise in older adults, contributing to reduced ejection fraction reserve. These age-related changes in coupling mechanisms vary between men and women.
Area of Science:
- Cardiovascular Physiology
- Aging Research
- Exercise Physiology
Background:
- Ejection fraction (EF) reserve declines with age, impacting cardiac performance during exercise.
- Ventricular-vascular coupling, quantified by arterial elastance (EaI) to left ventricular systolic elastance (E(LV)I) ratio, is a key determinant of cardiac function.
- Age-related changes in this coupling may explain diminished EF reserve in older individuals.
Purpose of the Study:
- To investigate age-associated differences in ventricular-vascular coupling (EaI/E(LV)I) at rest and during exercise.
- To analyze the components of ventricular-vascular coupling, namely arterial elastance (EaI) and left ventricular systolic elastance (E(LV)I), in relation to age.
- To elucidate how age-related alterations in ventricular-vascular coupling contribute to the reduced ejection fraction reserve during physical exertion.
Main Methods:
- Noninvasive assessment of EaI/E(LV)I, EaI, and E(LV)I in 239 healthy adults aged 21–87 years.
- Measurements were taken at rest and during exercise using cuff sphygmomanometry for blood pressure and gated blood pool scintigraphy for cardiac volumes.
- Calculations included end-systolic volume index (ESVI)/stroke volume index (SVI) for EaI/E(LV)I, end-systolic pressure/SVI for EaI, and end-systolic pressure/ESVI for E(LV)I.
Main Results:
- Resting EaI/E(LV)I showed no age-related differences in either sex.
- During exercise, EaI/E(LV)I decreased in both sexes but to a lesser extent in older subjects.
- Gender-specific differences emerged during exercise: older women had higher EaI, while younger individuals exhibited a greater increase in E(LV)I.
Conclusions:
- Ventricular-vascular coupling exhibits age-associated differences during exercise in both men and women.
- Suboptimal ventricular-vascular coupling during exercise contributes to the age-related decline in maximal ejection fraction.
- The underlying mechanisms driving these age-related changes in ventricular-vascular coupling appear to differ between genders.