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(Circulation. 1996;94:359-367.)
© 1996 American Heart Association, Inc.

Articles

Continuum of Cardiovascular Performance Across a Broad Range of Fitness Levels in Healthy Older Men

Steven P. Schulman, MD; Jerome L. Fleg, MD; Andrew P. Goldberg, MD; Jan Busby-Whitehead, MD; James M. Hagberg, PhD; Frances C. O'Connor, MPH; Gary Gerstenblith, MD; Lewis C. Becker, MD; Leslie I. Katzel, MD; Loretta E. Lakatta, BSN; Edward G. Lakatta, MD

the Gerontology Research Center (J.L.F., F.C.O., E.G.L.), National Institute on Aging, and the Division of Gerontology (A.P.G., L.I.K., J.M.H., L.E.L.), University of Maryland School of Medicine and Geriatrics Research, Education and Clinical Center, Veterans Administration Medical Center, Baltimore; the Divisions of Geriatric Medicine and Gerontology (J.B.-W.) and Cardiology (S.P.S., G.G., L.C.B.), The Johns Hopkins Medical Institutions; and the Center on Aging (J.M.H.), University of Maryland, College Park, Md.

Correspondence to Edward G. Lakatta, MD, Gerontology Research Center, Laboratory of Cardiovascular Science, 4940 Eastern Ave, Baltimore, MD 21224.

Background Although it has become clear that habitual exercise in older individuals can partially offset age-associated cardiovascular declines, it is not known whether the beneficial effects of exercise training in older individuals depend on their prior fitness level.

Methods and Results Ten sedentary men (S), age 60.0±1.6 years (mean±SEM), who were carefully screened to exclude cardiac disease underwent exercise training for 24 to 32 weeks, and eight age-matched endurance-trained men (ET) stopped their exercise training for 12 weeks. All underwent treadmill exercise and rest and maximal cycle exercise upright gated blood pool scans at baseline and after the lifestyle intervention. Before the intervention, the treadmill maximum rate of oxygen consumption (O_2max) was 49.9±1.9 and 32.1±1.4 mL·kg^-1·min^-1 in ET and S, respectively. During upright cycle exercise at exhaustion, although heart rate did not differ between groups, cardiac index, stroke volume index, ejection fraction, and left ventricular contractility index (systolic blood pressure/end-systolic volume index) all were significantly higher, and end-systolic volume index, diastolic blood pressure, and total systemic vascular resistance all were significantly lower in ET versus S. After the partial deconditioning of ET men, O_2max fell to 42±2.2 mL·kg^-1·min^-1, and training of S increased O_2max to 36.2±1.6 mL·kg^-1·min^-1. Training of S had effects on cardiovascular function that were similar in magnitude but directionally opposite those of detraining ET. All initial differences in cardiovascular performance at peak work rate between S and ET were abolished with the intervention. Across the broad range of fitness levels encountered before and after change in training status (O_2max of 26 to 58 mL·kg^-1·min^-1), cardiac index, stroke volume index, end-systolic volume index, ejection fraction, and the left ventricular contractility index were all linearly correlated with O_2max.

Conclusions Exercise training or detraining of older men results in changes in left ventricular performance that are qualitatively and quantitatively similar, regardless of the initial level of fitness before the intervention.

Key Words: aging • exercise • cardiac volume

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