Impact of lifelong exercise "dose" on left ventricular compliance and distensibility

J Am Coll Cardiol. 2014 Sep 23;64(12):1257-66. doi: 10.1016/j.jacc.2014.03.062.


Background: Sedentary aging has deleterious effects on the cardiovascular system, including decreased left ventricular compliance and distensibility (LVCD). Conversely, Masters level athletes, who train intensively throughout adulthood, retain youthful LVCD.

Objectives: The purpose of this study was to test the hypothesis that preservation of LVCD may be possible with moderate lifelong exercise training.

Methods: Healthy seniors (n = 102) were recruited from predefined populations, screened for lifelong patterns of exercise training, and stratified into 4 groups: "sedentary" (<2 sessions/week); "casual" (2 to 3 sessions/week); "committed" (4 to 5 sessions/week); and "competitive" Masters level athletes (6 to 7 sessions/week). Right heart catheterization and echocardiography were performed while preload was manipulated using lower body negative pressure and rapid saline infusion to define LV pressure-volume relationships and Frank-Starling curves.

Results: Peak oxygen uptake and LV mass increased with escalating doses of lifelong exercise, with little change in systolic function. At baseline, LV distensibility was greater in committed (21%) and competitive (36%) exercisers than in sedentary subjects. Group LV stiffness constants (sedentary: 0.062 ± 0.039; casual: 0.079 ± 0.052; committed: 0.055 ± 0.033; and competitive: 0.035 ± 0.033) revealed: 1) increased stiffness in sedentary subjects compared to competitive athletes, whereas lifelong casual exercise had no effect; and 2) greater compliance in committed exercisers than in sedentary or casual exercisers.

Conclusions: Low doses of casual, lifelong exercise do not prevent the decreased compliance and distensibility observed with healthy, sedentary aging. In contrast, 4 to 5 exercise sessions/week throughout adulthood prevent most of these age-related changes. As LV stiffening has been implicated in the pathophysiology of many cardiovascular conditions affecting the elderly, this "dose" of exercise training may have important implications for prevention of cardiovascular disease.

Keywords: aging; diastolic function; distensibility; exercise training; hemodynamics; ventricular compliance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aging / physiology*
  • Athletes*
  • Cardiac Catheterization / methods
  • Cohort Studies
  • Compliance / physiology
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Risk Reduction Behavior*
  • Sedentary Behavior*
  • Stroke Volume / physiology
  • Ventricular Function, Left / physiology*