Impact of Lifelong Exercise Training Dose on Ventricular-Arterial Coupling
Key result
Lifelong exercise of ~4 weekly sessions is linked to optimal ventricular-arterial coupling in older adults.
- n=102
Why the study?
Ventricular-arterial coupling deteriorates with age but is preserved in masters athletes, and it remains unclear how much lifelong exercise is required to preserve it.
Does lifelong exercise training dose improve ventricular-arterial coupling in healthy seniors?
Key Points
- This study aims to explore the relationship between lifelong exercise training and the efficiency of the dynamic Starling mechanism in healthy seniors.
- One hundred two seniors were stratified into 4 groups based on 25 years of exercise training history.
- The dynamic Starling mechanism was estimated using transfer function gain between beat-by-beat changes in diastolic pulmonary artery pressure and stroke volume index.
- Participants included sedentary subjects, casual exercisers, committed exercisers, and competitive Masters Athletes.
- Sedentary adults showed greater power spectral density of pulmonary artery pressure compared to committed and competitive exercisers.
- Competitive exercisers had a higher power spectral density of stroke volume index than other groups.
- The optimal dose of lifelong endurance exercise appears to be at least 4 to 5 sessions per week to preserve ventricular-arterial coupling.
Study Design
Type
Cross-Sectional (n=102)
Structured PICO
Does lifelong exercise training dose improve ventricular-arterial coupling in healthy seniors?
P
Population
102 healthy seniors stratified into 4 groups based on 25 years of exercise training history to assess the dose-dependent relationship with ventricular-arterial coupling.
E
Exposure
Lifelong exercise training at varying doses (casual: 2-3 sessions/week, committed: 4-5 sessions/week, competitive Masters Athletes: 6-7 sessions/week)
C
Comparator
Sedentary subjects (<2 sessions/week)
O
Outcome
Dynamic Starling mechanism (estimated by transfer function gain between beat-by-beat changes in diastolic pulmonary artery pressure and stroke volume index)surrogate
Lifelong endurance exercise of at least 4 to 5 sessions per week is associated with preserved ventricular-arterial coupling and dynamic Starling mechanism in healthy older individuals.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We have already defined the optimal dose of exercise required to preserve the youthful structure of the heart as well as the time in the aging process when cardiovascular stiffening begins. However, in previous studies we were unable to reverse these effects if we started exercise much later in life.”
“These authors previously reported that 4–5 days week−1 among the 'committed exercisers' was sufficient to prevent sedentary ageing-associated decreases in left ventricular (LV) compliance in older adults”
Implication
Lifelong exercise may support ventricular-arterial coupling in seniors; leaves open optimal dose and causality for prospective trials.
Abstract
BACKGROUND: The dynamic Starling mechanism, as assessed by beat-by-beat changes in stroke volume and left ventricular end-diastolic pressure, reflects ventricular-arterial coupling. It deteriorates with age, and is preserved in highly trained masters athletes. Currently, it remains unclear how much exercise over a lifetime is necessary to preserve efficient ventricular-arterial coupling. The purpose of this study was to assess the dose-dependent relationship between lifelong exercise training and the dynamic Starling mechanism in healthy seniors. METHODS: One hundred two seniors were recruited and stratified into 4 groups based on 25 years of exercise training history: sedentary subjects (n=27, <2 sessions/week), casual exercisers (n=25, 2-3 sessions/week), committed exercisers (n=25, 4-5 sessions/week), and competitive Masters Athletes (n=25, 6-7 sessions/week). The dynamic Starling mechanism was estimated by transfer function gain between beat-by-beat changes in diastolic pulmonary artery pressure, a surrogate for left ventricular end-diastolic pressure, and stroke volume index. RESULTS: ) and lower left ventricular stiffness. The power spectral density of pulmonary artery pressure was greater in sedentary adults than in committed and competitive exercisers, whereas the power spectral density of stroke volume index was greater in competitive exercisers than in the other groups. CONCLUSIONS: There is a graded, dose-dependent improvement in ventricular-arterial coupling with increasing amounts of lifelong regular exercise in healthy older individuals. Our data suggest that the optimal dose of lifelong endurance exercise to preserve ventricular-arterial coupling with age appears to be at least 4 to 5 sessions per week.
Discussion
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Cite This Study
Hieda et al. (2018) conducted a cross-sectional in Healthy seniors (n=102). Lifelong exercise training vs. Sedentary subjects (<2 sessions/week) was evaluated on Dynamic Starling mechanism (ventricular-arterial coupling). Lifelong regular exercise improved ventricular-arterial coupling in a dose-dependent manner, with an optimal dose of at least 4 to 5 sessions per week in healthy older individuals.