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Left ventricles of aging athletes: better untwisters but not more relaxed during exercise

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Abstract

Objective

With an aging population and the increasing prevalence of heart failure with preserved ejection fraction, developing strategies to prevent diastolic dysfunction is crucial. Regular endurance training has been suggested to be one such strategy. However, the underlying mechanisms of training, including the effect on left ventricular (LV) untwist, which promotes LV filling, are unclear and studies exploring the heart during exercise in the aging heart are lacking.

Methods

Cardiopulmonary exercise testing with speckle tracking echocardiography was realized in male subjects: 16 young athletes (YA), 19 young controls (YC), 22 middle-aged athletes (MA) with a lifelong history of endurance training, and 20 middle-aged controls (MC).

Results

During exercise, the early filling was lower in MC compared to YC, whereas it was preserved between YA and MA. At exercise, peak untwisting rate/peak twist ratio and the percentage of untwist during isovolumic relaxation time were decreased in senior groups but higher in YA and MA compared to age-matched controls. Early diastolic filling reserve correlated with untwisting rate/peak twist reserve in YA and MA (R 2 = 0.22, p < 0.05) but not in controls. LV relaxation indices in athletes at rest and during exercise were not improved compared to age-matched controls.

Conclusion

LV intrinsic relaxation was similarly lower with age, independently of training, while the age-related decrease of untwist during exercise was lower with lifelong exercise training. The preservation of untwist mechanics in MA could thus sustain the early filling during exercise. Further studies are needed to confirm the role of exercise training as a preventive strategy for diastolic dysfunction and heart failure.

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Acknowledgements

This work was co-sponsored by the Nimes University Hospital and by a Grant from the Clinical Research Hospital Program from the French Ministry of Health. We express our sincere thanks to the volunteers who participated in the study.

Author information

Author notes

  1. S. Nottin and I. Schuster, senior authors, have contributed equally to this work.

Authors and Affiliations

  1. Laboratoire de Pharm-écologie cardiovasculaire, Faculté des Sciences, LAPEC EA4278, Avignon University, 33 Rue Louis Pasteur, 84000, Avignon, France

    Claire Maufrais, G. Doucende, P. Obert & S. Nottin

  2. Laboratory of Exercise Physiology, University of Savoie, Chambery, France

    T. Rupp

  3. EA 2992, Dysfunction of Vascular Interfaces Research Laboratory, Faculty of Medicine, Montpellier I University and Nimes University Hospital Center, Nîmes, France

    M. Dauzat & I. Schuster

Authors
  1. Claire Maufrais
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  2. G. Doucende
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  4. M. Dauzat
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Corresponding author

Correspondence to Claire Maufrais.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All participants provided written informed consent prior to their inclusion in the study. The protocol was approved by the ethics committee and the institutional committee on human research and performed according to the Declaration of Helsinki (PHRC-I/2007/IS-05).

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The authors declare that no funding was obtained for this study.

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Maufrais, C., Doucende, G., Rupp, T. et al. Left ventricles of aging athletes: better untwisters but not more relaxed during exercise. Clin Res Cardiol 106, 884–892 (2017). https://doi.org/10.1007/s00392-017-1133-y

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  • DOI: https://doi.org/10.1007/s00392-017-1133-y

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