Abstract
The aim of this study is to test our hypothesis that normal exercise tolerance differs according to gender and to identify potential functional cardiac relationships, which could explain those differences. A total of 44 healthy individuals with mean age of 49 ± 12 years (28–74 years, 22 males) constituted the study cohort. All individuals underwent resting and exercise Doppler echocardiogram simultaneously with peak oxygen uptake analysis (pVO2). At equal pVO2, males achieved higher peak exercise workload (p < 0.001) and females higher heart rate (p < 0.001) but the two groups maintained similar indexed left ventricular (LV) stroke volume (SV) and cardiac output. Indexed LV end-diastolic (LVDVI) and end-systolic volumes (LVSVI) were smaller in females (p < 0.001 and p < 0.01, respectively), but filling time (FT) was shorter (p < 0.001) and they had higher early diastolic (E) velocity (p = 0.004), E/E m (myocardial E velocity) (p < 0.001) and global longitudinal strain rate atrial velocity (GLSRa′) (p = 0.02), compared to males. In males, workload (p < 0.01), LVDVI (p < 0.01), LVSVI (p < 0.05), SVI (p < 0.001) directly but LV myocardial isovolumic relaxation time (IVRTm) (p < 0.01) inversely correlated with pVO2. In females, mitral E velocity (p < 0.01), GLSRs′ (p < 0.05) positively and LVFT negatively (p < 0.05) correlated with pVO2. In a multivariable analysis SVI in males (p < 0.01) and GLSRs′ in females (p < 0.01) were the strongest predictors for pVO2. Thus, normal exercise capacity as determined by pVO2 is related to the indexed stroke volume in males and left atrial pressure in females. These native normal differences between genders may explain the known vulnerability of women to endurance exercise compared to men.
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Acknowledgments
Karin Holmström and Maria Backlund for supervising the oxygen consumption test and blood samples. This study was supported by The Swedish Heart and Lung Foundation, The Medical Faculty at Umeå University and The Heart Foundation of Northern Sweden.
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Communicated by Niels H. Secher.
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Lindqvist, P., Mörner, S. & Henein, M.Y. Cardiac mechanisms underlying normal exercise tolerance: gender impact. Eur J Appl Physiol 112, 451–459 (2012). https://doi.org/10.1007/s00421-011-1992-2
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DOI: https://doi.org/10.1007/s00421-011-1992-2