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Age and gender affect ventricular-vascular coupling during aerobic exercise

Samer S. Najjar, MD^*,*, Steven P. Schulman, MD, Gary Gerstenblith, MD, FACC, Jerome L. Fleg, MD, FACC^*, David A. Kass, MD, Frances O'Connor, MPH^*, Lewis C. Becker, MD and Edward G. Lakatta, MD^*

^* Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, Maryland, USA
Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

View larger version (18K): [in a new window]   Figure 1 Comparisons by analysis of variance of rest and exercise ejection fraction (EF) (A) and effective arterial elastance index (EaI)/left ventricular systolic elastance index (ELVI) (B) in men (dashed lines) and women (solid lines) <40 years of age (solid triangles) (mean age, 32.4 ± 4.7 years and 31.2 ± 4.9 years, respectively) and >60 years of age (solid squares) (mean age, 68.9 ± 6.8 years and 70.4 ± 7.1 years, respectively). Ejection fraction increases with exercise in both age groups and genders (p 0.0001). In both men and women, there is a greater increase in EF at maximal exercise in younger than in older subjects (p 0.001 for men and women); EaI/ELVI decreases with exercise in both age groups and genders (p 0.0001). In both men and women, there is a greater decrease in EaI/ELVI at maximal exercise in younger than in older subjects (p 0.0001 for men and women).

View larger version (16K): [in a new window]   Figure 2 Comparisons by analysis of variance of rest and exercise effective arterial elastance index (EaI) (A) and ventricular elastance index (ELVI) (B) in men (dashed lines) and women (solid lines) <40 years of age (solid triangles) (mean age, 32.4 ± 4.7 years and 31.2 ± 4.9 years, respectively) and >60 years of age (solid squares) (mean age, 68.9 ± 6.8 years and 70.4 ± 7.1 years, respectively); EaI increases from rest to exercise in both age groups and genders (p 0.0001). At maximal exercise, EaI is greater in older women than in younger women (p 0.002), even though heart rate, which is a determinant of EaI, is greater at peak exercise in younger versus older women. In contrast, there is no difference in the EaI between the two age groups in men, even though heart rate is also significantly higher in younger versus older men at peak exercise; ELVI increases with exercise (p 0.0001) in both age groups and genders. At maximal exercise, ELVI is greater in younger men compared with older men (p 0.0001) and tended to be greater in younger women than in older women (p = 0.07).