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Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications For Heart Failure Prevention.
- Source :
-
Circulation . 4/10/2018, Vol. 137 Issue 15, p1549-1560. 12p. - Publication Year :
- 2018
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Abstract
- <bold>Background: </bold>Poor fitness in middle age is a risk factor for heart failure, particularly heart failure with a preserved ejection fraction. The development of heart failure with a preserved ejection fraction is likely mediated through increased left ventricular (LV) stiffness, a consequence of sedentary aging. In a prospective, parallel group, randomized controlled trial, we examined the effect of 2 years of supervised high-intensity exercise training on LV stiffness.<bold>Methods: </bold>Sixty-one (48% male) healthy, sedentary, middle-aged participants (53±5 years) were randomly assigned to either 2 years of exercise training (n=34) or attention control (control; n=27). Right heart catheterization and 3-dimensional echocardiography were performed with preload manipulations to define LV end-diastolic pressure-volume relationships and Frank-Starling curves. LV stiffness was calculated by curve fit of the diastolic pressure-volume curve. Maximal oxygen uptake (Vo2max) was measured to quantify changes in fitness.<bold>Results: </bold>Fifty-three participants completed the study. Adherence to prescribed exercise sessions was 88±11%. Vo2max increased by 18% (exercise training: pre 29.0±4.8 to post 34.4±6.4; control: pre 29.5±5.3 to post 28.7±5.4, group×time P<0.001) and LV stiffness was reduced (right/downward shift in the end-diastolic pressure-volume relationships; preexercise training stiffness constant 0.072±0.037 to postexercise training 0.051±0.0268, P=0.0018), whereas there was no change in controls (group×time P<0.001; pre stiffness constant 0.0635±0.026 to post 0.062±0.031, P=0.83). Exercise increased LV end-diastolic volume (group×time P<0.001), whereas pulmonary capillary wedge pressure was unchanged, providing greater stroke volume for any given filling pressure (loading×group×time P=0.007).<bold>Conclusions: </bold>In previously sedentary healthy middle-aged adults, 2 years of exercise training improved maximal oxygen uptake and decreased cardiac stiffness. Regular exercise training may provide protection against the future risk of heart failure with a preserved ejection fraction by preventing the increase in cardiac stiffness attributable to sedentary aging.<bold>Clinical Trial Registration: </bold>URL: https://www.clinicaltrials.gov. Unique identifier: NCT02039154. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CATHETERIZATION
*THERAPEUTICS
*RANDOMIZED controlled trials
*HEART failure
*PHYSICAL fitness
*HEART ventricle diseases
*AGE distribution
*BEHAVIOR
*CARDIAC catheterization
*COMPARATIVE studies
*ECHOCARDIOGRAPHY
*CARDIAC contraction
*LEFT heart ventricle
*HEART physiology
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*PROBABILITY theory
*RESEARCH
*STATISTICAL sampling
*TIME
*EVALUATION research
*VENTRICULAR remodeling
*TREATMENT effectiveness
*OXYGEN consumption
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 00097322
- Volume :
- 137
- Issue :
- 15
- Database :
- Academic Search Index
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 128953233
- Full Text :
- https://doi.org/10.1161/CIRCULATIONAHA.117.030617