Effects of healthy aging on the cardiopulmonary hemodynamic response to exercise.
This study aimed to define the influence of healthy aging on the central hemodynamic response to exercise. Advancing age results in numerous alterations to the cardiovascular system and is a major risk factor to develop heart failure. In patients with suspected heart failure with preserved ejection fraction, there is an increasing interest in the incorporation of stress hemodynamic studies into the diagnostic evaluation pathway. However, many patients with suspected heart failure with preserved ejection fraction are older, and there are few data regarding the effect of aging on the normal central hemodynamic responses to exercise. Therefore, we examined 55 healthy patients using right-sided cardiac catheterization with exercise. Mean age was 49.6 years, with 36% older than 55 years. On exercise, the mean pulmonary artery pressure was higher with advancing age (r = 0.412, p = 0.002). Additionally, age was negatively associated with cardiac index (r = 0.407, p = 0.005). The exercise-induced rise in pulmonary capillary wedge pressure (r = 0.378, p = 0.004) was greater with advancing age. Pulse pressure measured during exercise (r = 0.541, p <0.01) increased with age, as did diastolic dysfunction assessed by E/A ratio (r = 0.569, p <0.001). In conclusion, aging was associated with decreased cardiac output and increased pulmonary artery pressure during exercise, which developed as the consequence of both increased pulmonary vasculature resistance and higher left ventricular filling pressures.
Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Vanessa P M
VP
van Empel
Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia. Electronic address: david.kaye@bakeridi.edu.au.
David M
DM
Kaye
Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic and Foundation, Rochester.
Barry A
BA
Borlaug
D000367:Age Factors; D000375:Aging / Q000502:physiology*; D001315:Australia; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D015897:Comorbidity; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D013318:Stroke Volume / Q000502:physiology; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000502:physiology