Long-term athletic training does not alter age-associated reductions of left-ventricular mid-diastolic lengthening or expansion at rest

Abstract

Purpose: The interaction of ageing and exercise training status on left-ventricular (LV) peak strain is unclear. Additionally, strain analysis across the entire cardiac cycle facilitates a more detailed assessment of deformation, yet this has not been implemented to characterize the ageing LV and in association with training status. This study investigated healthy ageing and training status on LV systolic and diastolic strain utilizing novel echocardiographic applications.

Methods: Forty healthy males were included and allocated into four groups; young recreationally active (Y_RA, n = 9; 28 ± 5 years), old recreationally active (O_RA, n = 10; 68 ± 6), young trained (Y_T, n = 10; 27 ± 6 years), and old trained (O_T, n = 11, 64 ± 4 years) groups. Two-dimensional speckle-tracking echocardiography was performed to ascertain peak LV longitudinal and circumferential strain (base and apex) strain within each myocardial layer and at 5% increments across the cardiac cycle.

Results: Older groups had lower diastolic longitudinal lengthening and circumferential expansion between 40-85% mid-diastole, regardless of training status (P < 0.05). Whereas, strain throughout systole was similar between groups (P > 0.05). Longitudinal and circumferential (base and apex) peak and layer-specific strain did not differ between groups (P > 0.05).

Conclusion: Novel applications of diastolic strain revealed lower age-associated LV longitudinal lengthening and circumferential expansion in older age. Yet, diastolic strain profiles did not differ based on chronic habits of exercise training and, thus, older trained men did not demonstrate an attenuation of age-associated differences in mid-diastolic LV strain.

Keywords: Ageing; Exercise; Mechanics; Speckle-tracking echocardiography; Ventricular strain.

Fig. 1

Longitudinal strain (a) and strain rate (b) across the cardiac cycle in 5% increments of systole and diastole for young recreationally active (Y_RA), young trained (Y_T), old recreationally active (O_RA), and old trained (O_T). Light shaded areas indicate a statistically significant main effect of age and dark shaded areas signify a training effect, both at P ≤ 0.05. AVC, aortic valve closure (end-systole [100%]). Data are presented as group means with error bars omitted for clarity

Fig. 2

Circumferential strain [base (a); apex (c)] and strain rate [base (b); apex (d)] across the cardiac cycle in 5% increments of systole and diastole for young recreationally active (Y_RA), young trained (Y_T), old recreationally active (O_RA), and old trained (O_T). Light shaded areas indicate a statistically significant main effect of age and dark shaded areas signify a training effect, both at P ≤ 0.05. * represents a significant interaction effect with post hoc comparisons detailed in text. AVC, aortic valve closure (end-systole [100%]). Data are presented as group means with error bars omitted for clarity