Abstract
Diastolic function get worse with increasing age. Aim of this study was to investigate the impact of aerobic training on diastolic function with increasing age with speckle tracking echocardiography. We enrolled 125 amateur swimmers (AG), divided in three groups at increasing age: young athletes, adult athletes (AG2), old athletes (AG3). We enrolled 95 sedentary controls (SG) age-matched with athletes and divided into three groups: young sedentary group, adult sedentary group (SG2) and old sedentary group (SG3). AG had better diastolic function than SG. AG showed lower left ventricular twist than controls. E/A ratio got worse at increasing of age in all population (r = −0.34; p < 0.001); particularly in SG2 and SG3 there was a worsening of diastolic function respect to diastolic function of AG2 and AG3; in fact E/A ratio decreased with aging. Furthermore in SG E/A ratio showed a linear correlation with age (r = −0.54; p < 0.001); in AG this correlation was lost. Therefore the training and age were independent predictor of E/A (respectively β = −0.27; p = 0.004; β = −0.24, p = 0.008). Regular and aerobic training may minimize aging changes of diastolic function. This training-effect may play a key role to preserve diastolic filling in older athletes.
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Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193
Klein AL, Burstow DJ, Tajik AJ, Zachariah PK, Bailey KR, Seward JB (1994) Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons. Mayo Clin Proc 69:212–224
Bradshaw AD, Baicu CF, Rentz TJ, Van Laer AO, Bonnema DD, Zile MR (2010) Age-dependent alterations in fibrillar collagen content and myocardial diastolic function: role of SPARC in post-synthetic procollagen processing. Am J Physiol Heart Circ Physiol 298(2):H614–H622
Pavlik G, Major Z, Varga-Pintser B, Jeserich M, Kneffell ZS (2010) The athlete’s heart part I (review). Acta Physiol Hung 97:337–353
Arbab-Zadeh A, Dijk E, Prasad A, Fu Q, Torres P, Zhang R, Thomas JD, Palmer D, Levine BD (2004) Effect of aging and physical activity on left ventricular compliance. Circulation 110(13):1799–1805
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W, American Society of Echocardiography’s Nomenclature and Standards Committee, Task Force on Chamber Quantification, American College of Cardiology Echocardiography Committee, American Heart Association, European Association of Echocardiography, European Society of Cardiology (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7(2):79–108
Biswas M, Sudhakar S, Nanda NC, Buckberg G, Pradhan M, Roomi AU, Gorissen W, Houle H (2013) Two- and three-dimensional speckle tracking echocardiography: clinical application and future directions. Echocardiography 30:88–105
Burns AT, La Gerche A, Prior DL, Macisaac AL (2009) Left ventricular untwisting is an important determinant of early diastolic function. JACC Cardiovasc Imaging 2:709–716
Schulman S, Lakatta EG, Fleg JL, Lakatta L, Becker LC, Gerstenblith G (1992) Age-relateddecline in left ventricular filling at rest and exercise. Am J Physiol 263:H1932–H1938
Benjamin EJ, Levy D, Anderson KM, Wolf PA, Plehn JF, Evans JC, Comai K, Fuller DL, Sutton MS (1992) Determinants of Doppler indexes of left ventricular diastolic function in normal subjects (the Framingham Heart Study). Am J Cardiol 70:508–515
Brenner DA, Apstein CS, Saupe KW (2001) Exercise training attenuates age-associated diastolic dysfunction in rats. Circulation 104:221–226
Santoro A, Alvino F, Antonelli G, Zacà V, Benincasa S, Lunghetti S, Mondillo S (2014) Left ventricular twisting modifications in patients with left ventricular concentric hypertrophy at increasing after-load conditions. Echocardiography 31(10):1265–1273
Kass DA (2005) Ventricular arterial stiffening: integrating the pathophysiology. Hypertension 46:185–193
Oxenham H, Sharpe N (2003) Cardiovascular aging and heart failure. Eur J Heart Fail 5:427–434
Saito M, Okayama H, Yoshii T, Hiasa G, Sumimoto T, Inaba S, Nishimura K, Inoue K, Ogimoto A, Ohtsuka T, Funada J, Shigematsu Y, Higaki J (2011) The differences in left ventricular torsional behavior between patients with hypertrophic cardiomyopathy and hypertensive heart disease. Int J Cardiol 150:301–306
Beyar R, Sideman S (1985) Effect of the twisting motion on the nonuniformities of transmyocardial fiber mechanics and energy demand—a theoretical study. IEEE Trans Biomed Eng 32:764–769
van Dalen BM, Soliman OI, Vletter WB, ten Cate FJ, Geleijnse ML (2008) Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography. Am J Physiol Heart Circ Physiol 295:H1705–H1711
Santoro A, Caputo M, Antonelli G, Lisi M, Padeletti M, D’Ascenzi F, Cameli M, Giacomin E, Mondillo S (2011) Left ventricular twisting as determinant of diastolic function: a speckle tracking study in patients with cardiac hypertrophy. Echocardiography 28(8):892–898
Knackstedt C, Hildebrandt U, Schmidt K, Syrocki L, Lang A, Bjarnason Wehrens B, Schummers G, Stapf D, Becker M, Predel HG (2014) Analysis of right and left ventricular deformation in former world class swimmers evaluation using speckle tracking. J Sports Med Phys Fitness. PMID: 24710395 (epub ahead of print)
Santoro A, Alvino F, Antonelli G, Cameli M, Bertini M, Molle R, Mondillo S (2014) Left ventricular strain modification after maximal exercise in athletes: a speckle tracking study. Echocardiography. doi:10.1111/echo.12791
Nottin S, Doucende G, Schuster I, Tanguy S, Dauzat M, Obert P (2009) Alteration in left ventricular strains and torsional mechanics after ultralong duration exercise in athletes. Circ Cardiovasc Imaging 2:323–330
Lieu FK, Lin CY, Wang PS, Jian CY, Yeh YH, Chen YA, Wang KL, Lin YC, Chang LL, Wang GJ, Wang SW (2014) Effect of swimming on the production of Aldosterone in rats. PLoS ONE 9(10):e87080
Prasad A, Popovic ZB, Arbab-Zadeh A, Fu Q, Palmer D, Dijk E, Greenberg NL, Garcia MJ, Thomas JD, Levine BD (2007) The effects of aging and physical activity on Doppler measures of diastolic function. Am J Cardiol 99(12):1629–1636
Doucende G, Schuster I, Rupp T, Startum A, Dauzat M, Obert P, Nottin S (2010) Kinetics of left ventricular strains and torsion during incremental exercise in healthy subjects. Circ Cardiovasc Imaging 3:586–594
Esc BT, Scott JM, Warburton DE, Thompson R, Taylor D, Cheng Baron J, Paterson I, Haykowsky MJ (2009) Left ventricular torsion and untwising during exercise in heart transplant recipients. J Physiol 587(Pt 10):2375–2386
Grassi G, Seravalle G, Quarti-Trevano F (2010) The neuroadrenergic hypothesis’ in hypertension: current evidence. Exp Physiol 95:581–586
Fujimoto N, Prasad A, Hastings JL, Arbab-Zadeh A, Bhella PS, Shibata S, Palmer D, Levine BD (2010) Cardiovascular effects of 1 year of progressive and vigorous exercise training in previously sedentary individuals older than 65 years of age. Circulation 122:1797–1805
Lee LS, Mariani JA, Sasson Z, Goodman JM (2012) Exercise with a twist: left ventricular twist and recoil in healthy young and middle-aged men, and middle-aged endurance-trained men. J Am Soc Echocardiogr 25(9):986–993
Notomi Y, Srinath G, Shiota T, Martin-Miklovic MG, Beachler L, Howell K, Oryszak SJ, Deserranno DG, Freed AD, Greenberg NL, Younoszai A, Thomas JD (2006) Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. Circulation 113:2534–2541
MacGowanGA Burkhoff D, Rogers WJ, Salvador D, Azhari H, Hees PS, Zweier JL, Halperin HR, Siu CO, Lima JA, Weiss JL, Shapiro EP (1996) Effects of afterload on regional left ventricular torsion. Cardiovasc Res 31:917–925
Maufrais C, Schuster I, Doucende G, Vitiello D, Rupp T, Dauzat M, Obert P, Nottin S (2014) Endurance training minimizes age-related changes of left ventricular twist–untwist mechanics. J Am Soc Echocardiogr 27(11):1208–1215
Franzen E, Mangold S, Erz G, Claussen CD, Niess AM, Kramer U, Burgstahler C (2013) Comparison of morphological and functional adaptations of the heart in highly trained triathletes and long-distance runners using cardiac magnetic resonance imaging. Heart Vessels 28(5):626–631
Acknowledgments
The authors wish to thank the staff and young and master athletes of UISP Siena Nuoto and Master Olimpia Colle Nuoto.
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My coauthors and I have no conflict of interest
Ethical standard
This study has been performed in accordance with ethical standards of Declaration of Helsinki. The athletes gave their informed consent prior to inclusion in this study.
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Santoro, A., Alvino, F., Antonelli, G. et al. Age related diastolic function in amateur athletes. Int J Cardiovasc Imaging 31, 567–573 (2015). https://doi.org/10.1007/s10554-015-0592-3
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DOI: https://doi.org/10.1007/s10554-015-0592-3