Spinal cord involvement in posterior reversible encephalopathy syndrome

Introduction Aortic stiffening increases with sedentary age and is associated with cardiovascular disease. Lifelong exercise counteracts this – at least in male masters athletes, but the impact in females is unknown. Methods We measured aortic compliance in male and female masters athletes (n=305, mean age 53.9) and healthy controls (n=50), measuring Pulse Wave Velocity (PWV), aortic distensibility and beta-stiffness (β, a blood pressure independent measure of aortic stiffening). Masters athletes were defined as age ≥40, exercised systematically for >10 years and competed in >10 endurance events. Male and female athletes were recruited from the same sporting bodies. CMR was performed at 1.5T, measuring arterial stiffness at ascending, proximal descending and distal descending aorta (Ao-A, Ao-P, Ao-D. Biological vascular age was derived from correlating distensibility with chronological age. Results All central blood pressure parameters were lower in athletes. Athletes demonstrated expected cardiac adaptation (higher indexed end diastolic, end systolic and stroke volumes, and indexed LV mass, all P<0.005). PWV and aortic distensibility was equivalent to controls at every aortic level. β was also equivalent, except at Ao-D, where athletes were stiffer (median (IQ range) 3.06 x10–3 mmHg-1 (2.54–3.81) vs 2.63 x10–3 mmHg-1 (2.18–3.21), P<0.005. Masters athletes demonstrated sex differences in aortic stiffness with female athletes demonstrating increased distensibility at Ao-P and Ao-D compared with male athletes (P=0.008, P<0.001 respectively), and lower β (P=0.009, P<0.001). PWV was equivalent between both sexes. Male masters athletes were biologically older than their chronological age at each aortic level (3.8 years at Ao-A, 8.7 years at Ao-P and 1.0 years at Ao-D). Female masters athletes were biologically younger than their chronological age in the Ao-A (-0.5 years) and Ao-D (-6.2 years) and older in the Ao-P, but by a smaller order of magnitude than males (2.5 years). Conclusion Regular exercise to masters athlete level in older age is associated with a sex specific effect on aortic compliance compared with matched non-athletes, with males demonstrating a significant increase in vascular age at each aortic level compared with females. Female masters athletes exhibit age-reversal in the distal descending aorta (-6.2 years). Conflict of Interest nil