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Effect of age on left ventricular function during exercise in patients with coronary artery disease
Insights
Age does not impact left ventricular function in patients with coronary artery disease. Both younger and older individuals with coronary artery disease exhibit similar cardiac performance and responses to exercise.
Area of Science:
- Cardiology
- Gerontology
- Exercise Physiology
Background:
- Coronary artery disease (CAD) affects myocardial function.
- The influence of aging on cardiac performance in CAD patients requires further elucidation.
Purpose of the Study:
- To evaluate the impact of age on left ventricular (LV) function during exercise in patients with established coronary artery disease.
Main Methods:
- Seventy-nine patients with CAD were divided into two groups: <60 years (Group I) and ≥60 years (Group II).
- Radionuclide angiograms were performed at rest and during symptom-limited exercise.
- Hemodynamic variables, LV ejection fraction, volumes, and cardiac index were assessed.
Main Results:
- No significant differences were observed in LV function or hemodynamic variables between age groups.
- Exercise tolerance was significantly higher in younger patients (Group I).
- Abnormal LV function or response to exercise was prevalent and similar in both groups.
Conclusions:
- Age does not appear to be a significant determinant of left ventricular function at rest or during exercise in patients with coronary artery disease.
- Older patients with CAD demonstrate comparable LV functional changes to younger counterparts with similar disease severity.
Abstract:
The purpose of this study was to assess the effect of age on left ventricular performance during exercise in 79 patients with coronary artery disease (greater than or equal to 50% narrowing of one or more major coronary arteries). Fifty patients under the age of 60 years (group I) and 29 patients 60 years or older (group II) were studied. Radionuclide angiograms were obtained at rest and during symptom-limited upright bicycle exercise. The history of hypertension, angina or Q wave myocardial infarction was similar in both groups. Multivessel coronary artery disease was present in 30 patients (60%) in group I and in 19 patients (66%) in group II (p = not significant). There were no significant differences between the two groups in the hemodynamic variables (at rest or during exercise) of left ventricular ejection fraction, end-diastolic volume, end-systolic volume and cardiac index. Exercise tolerance was higher in group I than in group II (7.8 +/- 0.4 versus 5.7 +/- 0.4 minutes, p = 0.009), although the exercise heart rate and rate-pressure product were not significantly different between the groups. There was poor correlation between age and ejection fraction, end-diastolic volume and end-systolic volume at rest and during exercise. Abnormal left ventricular function at rest or an abnormal response to exercise was noted in 42 patients (84%) in group I and in 25 patients (86%) in group II (p = not significant). Thus, in patients with coronary artery disease, age does not influence left ventricular function at rest or response to exercise. Older patients with coronary artery disease show changes in left ventricular function similar to those in younger patients with corresponding severity of coronary artery disease.