Introduction
Materials and methods
Participant selection and identification of healthy controls
Young | Old | P value | |||||
---|---|---|---|---|---|---|---|
Recreationally active (YRA) | Trained (YT) | Recreationally active (ORA) | Trained (OT) | Age | Training | Interaction | |
Number of participants | 9 | 10 | 10 | 11 | |||
Age (years) | 28 ± 5 (21–35) | 27 ± 6 (18–36) | 68 ± 6 (60–80) | 64 ± 4 (59–70) | < 0.001 | 0.21 | 0.46 |
Exercise characteristics | |||||||
Minutes per week | 67 ± 87 | 450 ± 239 | 63 ± 67 | 540 ± 180 | 0.41 | < 0.001 | 0.37 |
Training years | – | 5 ± 4 | – | 34 ± 14 | |||
Training start age (years) | – | 23 ± 8 | – | 31 ± 11 | |||
Height (cm) | 177 ± 4 | 180 ± 8 | 175 ± 8 | 173 ± 4 | 0.02 | 0.65 | 0.31 |
Mass (kg) | 80.5 ± 7.8 | 75.0 ± 9.3 | 82.0 ± 20.2 | 67.0 ± 5.6 | 0.40 | 0.01 | 0.22 |
Systolic blood pressure (mmHg) | 131 ± 9 | 126 ± 10 | 131 ± 11 | 132 ± 16 | 0.47 | 0.63 | 0.34 |
Diastolic blood pressure (mmHg) | 77 ± 8 | 68 ± 7 | 74 ± 8 | 74 ± 8 | 0.47 | 0.09 | 0.06 |
Mean arterial pressure (mmHg) | 95 ± 8 | 87 ± 7 | 93 ± 8 | 94 ± 10 | 0.38 | 0.18 | 0.11 |
Resting heart rate (beats.min−1) | 61 ± 11 | 49 ± 11 | 54 ± 5 | 47 ± 7 | 0.14 | 0.001 | 0.35 |
Rate pressure product (mmHg/beats.min−1) | 8049 ± 1810 | 6084 ± 1063 | 7038 ± 571 | 6231 ± 1073 | 0.26 | < 0.001 | 0.13 |
Body surface area (m2) | 1.99 ± 0.11 | 1.94 ± 0.15 | 1.98 ± 0.27 | 1.79 ± 0.09 | 0.17 | 0.03 | 0.22 |
Body mass index (kg.m2) | 25.5 ± 1.7 | 23.1 ± 2.2 | 26.8 ± 5.1 | 22.3 ± 1.6 | 0.83 | < 0.001 | 0.31 |
\(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{m}\mathrm{a}\mathrm{x}}\) (L.min−1) | 3.9 ± 0.4 | 4.8 ± 0.7 | 2.7 ± 0.4 | 3.4 ± 0.3 | < 0.001 | < 0.001 | 0.40 |
\(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{m}\mathrm{a}\mathrm{x}}\) (mL.kg−1.min−1) | 48.5 ± 5.0 | 64.1 ± 7.7 | 34.9 ± 7.3 | 50.1 ± 3.6 | < 0.001 | < 0.001 | 0.93 |
Age predicted \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{m}\mathrm{a}\mathrm{x}}\) (%) | 92 ± 9 | 121 ± 12 | 94 ± 21 | 128 ± 8 | 0.32 | < 0.001 | 0.55 |
Protocol and experimental procedures
Echocardiography
Speckle tracking echocardiography
Statistical analysis
Results
Baseline anthropometrics and exercise characteristics
Echocardiography
Influence of ageing and exercise on LV structure
Young | Old | P value | |||||
---|---|---|---|---|---|---|---|
Recreationally active (YRA) | Trained (YT) | Recreationally active (ORA) | Trained (OT) | Age | Training | Interaction | |
IVS (mm) | 9.7 ± 1.0 | 9.7 ± 1.0 | 9.6 ± 1.0 | 10.5 ± 1.1 | 0.29 | 0.18 | 0.21 |
IVS index [mm/(m2)0.5] | 6.9 ± 0.7 | 7.0 ± 0.5 | 6.8 ± 0.7 | 7.8 ± 0.8 | 0.07 | 0.02 | 0.06 |
LVEDD (mm) | 48.9 ± 2.0 | 51.6 ± 3.0 | 46.4 ± 2.7 | 49.6 ± 3.9 | 0.03 | 0.004 | 0.79 |
LVEDD index [mm/(m2)0.5] | 34.7 ± 1.3 | 37.1 ± 1.5 | 31.6 ± 4.6 | 37.0 ± 2.1 | 0.08 | < 0.01 | 0.10 |
PWT (mm) | 10.1 ± 0.8 | 10.5 ± 1.4 | 9.7 ± 1.3 | 10.2 ± 1.0 | 0.32 | 0.24 | 0.90 |
PWT index [mm/(m2)0.5] | 7.2 ± 0.5 | 7.5 ± 0.8 | 6.9 ± 1.0 | 7.6 ± 0.8 | 0.74 | 0.04 | 0.53 |
MWT (mm) | 9.9 ± 0.6 | 10.1 ± 1.1 | 9.7 ± 0.9 | 10.3 ± 0.9 | 0.97 | 0.14 | 0.44 |
MWT [mm/(m2)0.5] | 7.0 ± 0.4 | 7.3 ± 0.6 | 6.9 ± 0.7 | 7.7 ± 0.7 | 0.40 | 0.01 | 0.14 |
LVM (g) | 177 ± 21 | 201 ± 44 | 157 ± 26 | 192 ± 37 | 0.20 | 0.01 | 0.60 |
LVM (g/m2) | 89 ± 9 | 103 ± 16 | 80 ± 13 | 107 ± 17 | 0.59 | < 0.001 | 0.16 |
LVM [g/(m2)2.7] | 37 ± 4 | 41 ± 6 | 35 ± 6 | 44 ± 8 | 0.87 | 0.01 | 0.19 |
RWT | 0.41 ± 0.02 | 0.39 ± 0.03 | 0.42 ± 0.05 | 0.42 ± 0.05 | 0.11 | 0.52 | 0.51 |
LV length (mm) | 91 ± 5 | 96 ± 7 | 89 ± 5 | 91 ± 6 | 0.05 | 0.07 | 0.33 |
LV length [mm/(m2)0.5] | 64 ± 3 | 69 ± 6 | 63 ± 3 | 68 ± 4 | 0.31 | 0.002 | 0.86 |
Concentricity [g/mL)0.667] | 8.3 ± 1.2 | 7.5 ± 1.1 | 8.1 ± 1.5 | 7.9 ± 0.8 | 0.85 | 0.20 | 0.33 |
Sphericity index | 1.9 ± 0.1 | 1.9 ± 0.2 | 1.9 ± 0.1 | 1.8 ± 0.2 | 0.81 | 0.35 | 0.31 |
LVOT diameter (mm) | 21 ± 1 | 23 ± 2 | 21 ± 1 | 22 ± 2 | 0.25 | 0.09 | 0.42 |
LVEDV (mL) | 98 ± 9 | 139 ± 25 | 85 ± 15 | 123 ± 20 | 0.02 | < 0.001 | 0.82 |
LVEDV [mL/(m2)1.5] | 35 ± 4 | 52 ± 9 | 32 ± 5 | 51 ± 6 | 0.30 | < 0.001 | 0.58 |
LVESV (mL) | 39 ± 2 | 58 ± 13 | 33 ± 9 | 47 ± 14 | 0.02 | < 0.001 | 0.60 |
LVESV [mL/(m2)1.5] | 14 ± 2 | 21 ± 4 | 12 ± 2 | 19 ± 5 | 0.09 | < 0.001 | 0.99 |
LVOT CSA (cm2) | 3.5 ± 0.5 | 4.0 ± 0.7 | 3.4 ± 0.4 | 3.6 ± 0.7 | 0.25 | 0.07 | 0.42 |
VTI (cm) | 21.6 ± 4.6 | 25.1 ± 3.5 | 19.5 ± 2.6 | 24.8 ± 5.0 | 0.34 | 0.002 | 0.49 |
SV (mL) | 75 ± 14 | 102 ± 24 | 67 ± 13 | 89 ± 21 | 0.10 | < 0.001 | 0.69 |
SV index [mL/(m2)1.5] | 27 ± 5 | 37 ± 7 | 24 ± 3 | 37 ± 9 | 0.47 | < 0.001 | 0.59 |
\(\dot{Q}\) (L min−1) | 4.57 ± 1.25 | 4.77 ± 0.63 | 3.64 ± 0.85 | 4.12 ± 0.79 | 0.009 | 0.24 | 0.63 |
\(\dot{Q}\) index (L min/(m2)1.5) | 1.65 ± 0.50 | 1.79 ± 0.30 | 1.30 ± 0.20 | 1.71 ± 0.30 | 0.06 | 0.01 | 0.22 |
Influence of ageing and exercise on conventional LV function
Young | Old | P value | |||||
---|---|---|---|---|---|---|---|
Recreationally active (YRA) | Trained (YT) | Recreationally active (ORA) | Trained (OT) | Age | Training | Interaction | |
Systolic function | |||||||
FS (%) | 33 ± 3 | 30 ± 6 | 35 ± 3 | 33 ± 6 | 0.16 | 0.11 | 0.52 |
EF (%) | 60 ± 4 | 59 ± 3 | 61 ± 6 | 61 ± 6 | 0.22 | 0.55 | 0.81 |
Septal s′ (cm/s) | 9 ± 1 | 8 ± 1 | 8 ± 1 | 8 ± 1 | 0.04 | 0.71 | 0.94 |
Lateral s′ (cm/s) | 10 ± 3 | 12 ± 3 | 9 ± 2 | 9 ± 3 | 0.03 | 0.36 | 0.57 |
Average s′ (cm/s) | 10 ± 2 | 10 ± 2 | 9 ± 1 | 9 ± 2 | 0.03 | 0.52 | 0.52 |
Average s′ index [(cm/s)/cm] | 1.04 ± 0.17 | 1.05 ± 0.21 | 0.95 ± 0.15 | 0.95 ± 0.21 | 0.11 | 0.94 | 0.94 |
Diastolic function | |||||||
E wave (cm/s) | 73 ± 15 | 73 ± 11 | 61 ± 13 | 59 ± 14 | 0.004 | 0.72 | 0.83 |
A wave (cm/s) | 40 ± 10 | 38 ± 7 | 56 ± 7 | 54 ± 12 | < 0.001 | 0.62 | 0.96 |
E/A | 1.98 ± 0.74 | 2.01 ± 0.56 | 1.13 ± 0.29 | 1.15 ± 0.42 | < 0.001 | 0.89 | 0.98 |
Septal e′ (cm/s) | 10 ± 3 | 12 ± 3 | 7 ± 1 | 8 ± 2 | < 0.001 | 0.09 | 0.51 |
Lateral e′ (cm/s) | 13 ± 4 | 17 ± 2* | 9 ± 2*† | 10 ± 2† | < 0.001 | 0.001 | 0.04 |
Septal a′ (cm/s) | 8 ± 2 | 6 ± 1 | 9 ± 1 | 9 ± 1 | < 0.001 | 0.09 | 0.09 |
Lateral a′ (cm/s) | 7 ± 2 | 7 ± 2 | 9 ± 1 | 9 ± 1 | < 0.001 | 0.42 | 0.42 |
Average e′ (cm/s) | 12 ± 3 | 15 ± 2 | 8 ± 2 | 9 ± 2 | < 0.001 | 0.01 | 0.10 |
Average a′ (cm/s) | 8 ± 2 | 7 ± 2 | 10 ± 1 | 10 ± 1 | < 0.001 | 0.12 | 0.12 |
Average e′ index [(cm/s)/cm] | 1.27 ± 0.34 | 1.53 ± 0.15 | 0.89 ± 0.17 | 0.97 ± 0.20 | < 0.001 | 0.02 | 0.20 |
Average a′ index [(cm/s)/cm] | 0.85 ± 0.18 | 0.68 ± 0.22 | 1.05 ± 0.14 | 1.03 ± 0.10 | < 0.001 | 0.09 | 0.13 |
Average e′/a′ | 1.58 ± 0.68 | 2.45 ± 0.64* | 0.87 ± 0.23*† | 0.95 ± 0.27*† | < 0.001 | 0.01 | 0.02 |
Average E/e′ | 6.66 ± 1.51 | 4.99 ± 0.78 | 7.81 ± 0.98 | 6.94 ± 1.31 | 0.03 | 0.10 | 0.13 |
Influence of ageing and exercise on peak left-ventricular strain and strain rate
Longitudinal strain and strain rate
Young | Old | P value | |||||
---|---|---|---|---|---|---|---|
Recreationally active (YRA) | Trained (YT) | Recreationally active (ORA) | Trained (OT) | Age | Training | Interaction | |
Apical 4-chamber | |||||||
Endocardium (%) | − 22.0 ± 3.0 | − 20.8 ± 1.4 | − 21.1 ± 2.1 | − 21.7 ± 2.9 | 0.99 | 0.67 | 0.25 |
Myocardium (%) | − 19.9 ± 2.4 | − 18.5 ± 1.3 | − 19.2 ± 1.8 | − 19.2 ± 2.6 | 0.95 | 0.31 | 0.32 |
Epicardium (%) | − 17.9 ± 2.1 | − 16.4 ± 1.3 | − 17.5 ± 1.5 | − 17.0 ± 2.4 | 0.83 | 0.12 | 0.45 |
Layer gradient | 4.2 ± 1.5 | 4.4 ± 0.5 | 3.6 ± 0.8 | 4.7 ± 1.3 | 0.69 | 0.07 | 0.22 |
SRS (s−1) | − 1.05 ± 0.14 | -0.94 ± 0.06 | − 0.94 ± 0.09 | − 0.89 ± 0.09 | 0.01 | 0.01 | 0.30 |
SRE (s−1) | 1.45 ± 0.44 | 1.50 ± 0.18 | 0.92 ± 0.22 | 1.05 ± 0.34 | < 0.001 | 0.37 | 0.71 |
SRA (s−1) | 0.70 ± 0.19 | 0.53 ± 0.18 | 0.86 ± 0.21 | 0.90 ± 0.17 | < 0.001 | 0.27 | 0.09 |
Apical 2-chamber | |||||||
Endocardium (%) | − 22.0 ± 3.0 | − 23.2 ± 1.4 | − 23.5 ± 3.3 | − 21.5 ± 4.1 | 0.95 | 0.70 | 0.14 |
Myocardium (%) | − 20.0 ± 2.4 | − 20.7 ± 1.2 | − 21.0 ± 2.9 | − 19.3 ± 3.7 | 0.80 | 0.56 | 0.18 |
Epicardium (%) | − 18.2 ± 2.0 | − 18.4 ± 1.1 | − 18.8 ± 2.7 | − 17.2 ± 3.4 | 0.65 | 0.38 | 0.27 |
Layer gradient | 3.8 ± 1.5 | 4.7 ± 1.0 | 4.7 ± 1.8 | 4.4 ± 1.0 | 0.49 | 0.48 | 0.14 |
SRS (s−1) | − 1.03 ± 0.13 | − 0.97 ± 0.10 | − 1.04 ± 0.14 | − 0.90 ± 0.19 | 0.46 | 0.04 | 0.43 |
SRE (s−1) | 1.39 ± 0.25 | 1.62 ± 0.20 | 1.04 ± 0.23*† | 0.90 ± 0.29*† | < 0.001 | 0.55 | 0.03 |
SRA (s−1) | 0.70 ± 0.16 | 0.55 ± 0.10 | 1.01 ± 0.24*† | 0.87 ± 0.16† | < 0.001 | 0.01 | 0.93 |
Apical 4- and 2-chamber average | |||||||
Endocardium (%) | − 22.0 ± 2.7 | − 22.0 ± 1.1 | − 22.5 ± 2.2 | − 21.8 ± 3.3 | 0.85 | 0.63 | 0.66 |
Myocardium (%) | − 19.9 ± 2.2 | − 19.6 ± 1.0 | − 20.3 ± 1.8 | − 19.4 ± 2.9 | 0.91 | 0.38 | 0.68 |
Epicardium (%) | − 18.0 ± 1.9 | − 17.4 ± 0.9 | − 18.3 ± 1.6 | − 17.3 ± 2.6 | 0.96 | 0.18 | 0.73 |
Layer gradient | 4.0 ± 1.4 | 4.5 ± 0.5 | 4.2 ± 1.2 | 4.5 ± 1.2 | 0.74 | 0.23 | 0.68 |
SRS (s−1) | − 1.05 ± 0.12 | − 0.96 ± 0.07 | − 0.99 ± 0.10 | − 0.90 ± 0.12 | 0.11 | 0.01 | 0.90 |
SRE (s−1) | 1.42 ± 0.32 | 1.56 ± 0.13 | 0.97 ± 0.18 | 1.00 ± 0.27 | < 0.001 | 0.27 | 0.51 |
SRA (s−1) | 0.70 ± 0.17 | 0.51 ± 0.17 | 0.97 ± 0.14 | 0.90 ± 0.15 | < 0.001 | 0.02 | 0.33 |
Circumferential and radial strain and strain rate
Young | Old | P value | |||||
---|---|---|---|---|---|---|---|
Recreationally active (YRA) | Trained (YT) | Recreationally active (ORA) | Trained (OT) | Age | Training | Interaction | |
Circumferential–base | |||||||
Endocardium (%) | − 24.5 ± 4.7 | − 23.3 ± 4.7 | − 21.5 ± 6.6 | − 27.8 ± 5.6 | 0.66 | 0.16 | 0.04 |
Myocardium (%) | − 16.2 ± 3.3 | − 16.3 ± 4.0 | − 13.2 ± 4.6 | − 17.2 ± 4.0 | 0.41 | 0.12 | 0.13 |
Epicardium (%) | − 10.2 ± 3.0 | − 11.1 ± 3.8 | − 7.4 ± 3.5 | − 9.5 ± 3.4 | 0.05 | 0.18 | 0.60 |
Layer gradient | 14.3 ± 3.9 | 12.2 ± 2.9 | 14.2 ± 4.5 | 18.3 ± 4.3 † | 0.02 | 0.43 | 0.02 |
SRS (s−1) | − 0.99 ± 0.14 | − 1.02 ± 0.20 | − 0.75 ± 0.20 | − 0.95 ± 0.21 | 0.02 | 0.07 | 0.17 |
SRE (s−1) | 1.35 ± 0.43 | 1.25 ± 0.33 | 0.94 ± 0.28 | 1.18 ± 0.30 | 0.03 | 0.49 | 0.12 |
SRA (s−1) | 0.47 ± 0.32 | 0.32 ± 0.16 | 0.57 ± 0.14 | 0.71 ± 0.26 | 0.002 | 0.99 | 0.05 |
Circumferential–apex | |||||||
Endocardium (%) | − 38.4 ± 8.4 | − 37.8 ± 6.7 | − 42.9 ± 6.3 | − 40.4 ± 6.9 | 0.13 | 0.49 | 0.69 |
Myocardium (%) | − 26.3 ± 6.4 | − 25.7 ± 5.4 | − 26.4 ± 5.7 | − 27.9 ± 5.9 | 0.53 | 0.81 | 0.59 |
Epicardium (%) | − 17.5 ± 6.3 | − 18.1 ± 4.8 | − 17.7 ± 5.9 | − 20.2 ± 6.5 | 0.53 | 0.42 | 0.63 |
Layer gradient | − 21.0 ± 6.7 | − 19.7 ± 5.4 | − 25.1 ± 6.8 | − 20.2 ± 6.9 | 0.27 | 0.14 | 0.38 |
SRS (s−1) | − 1.67 ± 0.36 | − 1.42 ± 0.17 | − 1.50 ± 0.49 | − 1.48 ± 0.31 | 0.60 | 0.23 | 0.31 |
SRE (s−1) | 2.39 ± 1.00 | 2.42 ± 0.70 | 1.81 ± 0.49 | 1.95 ± 0.71 | 0.03 | 0.73 | 0.81 |
SRA (s−1) | 0.86 ± 0.28 | 0.75 ± 0.20 | 1.26 ± 0.42 | 1.15 ± 0.23 | < 0.001 | 0.22 | 0.99 |
Circumferential–global | |||||||
Endocardium (%) | − 31.5 ± 4.2 | − 30.5 ± 4.2 | − 32.2 ± 5.3 | − 34.1 ± 5.7 | 0.18 | 0.77 | 0.37 |
Myocardium (%) | − 21.3 ± 3.4 | − 21.0 ± 3.5 | − 19.8 ± 4.5 | − 22.5 ± 4.8 | 0.96 | 0.35 | 0.26 |
Epicardium (%) | − 13.8 ± 3.8 | − 14.6 ± 3.0 | − 12.6 ± 4.1 | − 14.8 ± 4.4 | 0.68 | 0.23 | 0.54 |
Gradient | 17.7 ± 2.9 | 15.9 ± 2.6 | 19.7 ± 4.2 | 19.3 ± 3.8 | 0.02 | 0.34 | 0.54 |
SRS (s−1) | − 1.33 ± 0.21 | − 1.22 ± 0.15 | − 1.13 ± 0.31 | − 1.22 ± 0.21 | 0.15 | 0.87 | 0.17 |
SRE (s−1) | 1.87 ± 0.51 | 1.84 ± 0.40 | 1.37 ± 0.31 | 1.56 ± 0.40 | 0.01 | 0.55 | 0.39 |
SRA (s−1) | 0.66 ± 0.27 | 0.54 ± 0.16 | 0.91 ± 0.25† | 0.93 ± 0.14 | < 0.001 | 0.41 | 0.28 |
Radial–base | |||||||
Strain (%) | 38.9 ± 11.5 | 34.9 ± 10.6 | 34.6 ± 16.2 | 46.0 ± 11.6 | 0.40 | 0.36 | 0.06 |
SRS (s−1) | 2.75 ± 0.83 | 2.36 ± 1.07 | 2.77 ± 0.59 | 2.42 ± 1.13 | 0.89 | 0.22 | 0.94 |
SRE (s −1) | − 2.27 ± 0.60 | − 1.99 ± 0.81 | − 2.45 ± 0.87 | − 2.09 ± 1.20 | 0.61 | 0.28 | 0.89 |
SRA (s−1) | − 1.67 ± 0.50 | − 0.79 ± 0.74 | − 1.99 ± 0.94† | − 2.51 ± 1.12† | < 0.001 | 0.52 | 0.02 |
Radial–apex | |||||||
Strain (%) | 32.4 ± 20.9 | 24.6 ± 16.2 | 24.7 ± 16.2 | 22.6 ± 11.9 | 0.39 | 0.37 | 0.60 |
SRS (s−1) | 2.04 ± 0.89 | 1.43 ± 0.46 | 1.82 ± 0.93 | 1.55 ± 0.74 | 0.85 | 0.10 | 0.51 |
SRE (s−1) | − 2.65 ± 0.65 | − 2.98 ± 1.56 | − 2.49 ± 1.21 | − 1.83 ± 0.76 | 0.09 | 0.67 | 0.19 |
SRA (s−1) | − 0.52 ± 0.35 | − 0.33 ± 0.30 | − 1.07 ± 0.91 | − 0.71 ± 0.59 | 0.03 | 0.19 | 0.69 |
Radial–global | |||||||
Strain (%) | 34.6 ± 10.7 | 30.9 ± 8.9 | 29.7 ± 9.9 | 34.2 ± 7.8 | 0.79 | 0.90 | 0.19 |
SRS (s−1) | 2.38 ± 0.55 | 1.77 ± 0.26 | 2.29 ± 0.52 | 2.02 ± 0.76 | 0.66 | 0.02 | 0.37 |
SRE (s−1) | − 2.45 ± 0.52 | − 2.36 ± 0.77 | − 2.47 ± 0.80 | − 2.02 ± 0.84 | 0.52 | 0.29 | 0.46 |
SRA (s−1) | − 1.09 ± 0.36 | − 0.58 ± 0.35 | − 1.53 ± 0.54 | − 1.47 ± 0.65 | < 0.001 | 0.09 | 0.19 |