Effect of Aging and Physical Activity on Left Ventricular Compliance

TLDR

Left‑ventricular compliance declines with age, but it is unclear whether this is an inevitable senescence effect or a consequence of reduced physical activity. The study compared 12 sedentary seniors, 12 Masters athletes, and 14 young sedentary controls using pulmonary artery catheterization and echocardiography to derive Starling and pressure‑volume curves under varying preload conditions. Masters athletes maintained young‑like compliance and higher stroke volume for a given filling pressure, whereas sedentary seniors showed reduced compliance, higher pressures, and greater wall stress, indicating that endurance training preserves diastolic function with aging.

Abstract

Background— Left ventricular compliance appears to decrease with aging, which may contribute to the high incidence of heart failure in the elderly. However, whether this change is an inevitable consequence of senescence or rather secondary to reduced physical activity is unknown. Methods and Results— Twelve healthy sedentary seniors (69.8±3 years old; 6 women, 6 men) and 12 Masters athletes (67.8±3 years old; 6 women, 6 men) underwent pulmonary artery catheterization to define Starling and left ventricular pressure-volume curves. Data were compared with those obtained in 14 young but sedentary control subjects (28.9±5 years old; 7 women, 7 men). Pulmonary capillary wedge pressures and left ventricular end-diastolic volumes by use of echocardiography were measured at baseline, during decreased cardiac filling by use of lower-body negative pressure (−15 and −30 mm Hg), and after saline infusion (15 and 30 mL/kg). Stroke volume for any given filling pressure was greater in Masters athletes compared with the age-matched sedentary subjects, whereas contractility, as assessed by preload recruitable stroke work, was similar. There was substantially decreased left ventricular compliance in healthy but sedentary seniors compared with the young control subjects, which resulted in higher cardiac pressures for a given filling volume and higher myocardial wall stress for a given strain. The pressure-volume curve for the Masters athletes was indistinguishable from that of the young, sedentary control subjects. Conclusions— A sedentary lifestyle during healthy aging is associated with decreased left ventricular compliance, leading to diminished diastolic performance. Prolonged, sustained endurance training preserves ventricular compliance with aging and may help to prevent heart failure in the elderly.