Regular exercise prevented age-related left ventricular stiffening

In a new study, regular exercise was associated with preservation of left ventricular compliance and distensibility, but the same link was not observed with casual exercise.

Researchers studied whether moderate lifelong exercise training could preserve LV compliance and distensibility. They recruited 102 healthy people aged 65 years and older from prespecified backgrounds. Participants were stratified by lifelong pattern of exercise training: sedentary (no more than once per week; n=27), casual (two or three times per week; n=25), committed (four or five times per week; n=25) and competitive (six or seven times per week; n=25). The researchers performed right heart catheterization and echocardiography on all participants to determine LV compliance and distensibility and performed cardiac MRI to determine LV mass.

Normalized peak oxygen intake rose (P<.001) and body mass and BMI fell with increasing doses of lifelong exercise training, the researchers found.

LV mass index, resting LV end-diastolic index and resting LV end-diastolic index indexed to body surface area all increased with increasing doses of lifelong exercise training, Paul S. Bhella, MD, from the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital, Dallas, and colleagues found.

At baseline, LV distensibility was greater in committed (21%) and competitive (36%) exercisers compared with the sedentary group, according to the results.

LV stiffness constants by group were as follows: sedentary, 0.062; casual, 0.079; committed, 0.055; and competitive, 0.035. This showed “increased stiffness in sedentary subjects compared to competitive athletes, whereas lifelong casual exercise had no effect, and greater compliance in committed exercisers than in sedentary or casual exercisers,” Bhella and colleagues wrote.

“As LV stiffening has been implicated in the pathophysiology of many [CV] conditions affecting the elderly, this [committed] ‘dose’ of exercise training may have important implications for prevention of [CVD],” the researchers concluded.

The findings are “a major step in broadening the benefits of exercise on LV compliance from a small number of competitive athletes to a much wider population of recreational and healthy exercisers,” Wilbur Y.W. Lew, MD, from the cardiology section of the department of medicine at the Veterans’ Affairs San Diego Healthcare System and the University of California, San Diego, wrote in a related editorial. “This level of commitment to exercise [four to five] times per week is more realistic than becoming a competitive Master athlete and a feasible goal for casual exercisers.”

Unfortunately, from 1988 to 2010, physical activity declined and obesity rose in US adults, so “we face challenges to establishing causality, identifying mechanisms and applying these results to an increasingly sedentary population,” Lew wrote.

For more information:

Bhella PS. J Am Coll Cardiol. 2014;64:1257-1266.

Lew WYW. J Am Coll Cardiol. 2014;64:1267-1269.

Disclosure: The study was funded by the NIH. The researchers and Lew report no relevant financial disclosures.