Fleg J L, Shapiro E P, O'Connor F, Taube J, Goldberg A P, Lakatta E G
Laboratory of Cardiovascular Science, National Institute on Aging, Baltimore, MD, USA.
JAMA. 1995 May 3;273(17):1371-5.
To determine whether older men who have undergone intensive endurance training over many years demonstrate less age-associated impairment of early diastolic left ventricular (LV) filling performance than their sedentary peers.
Cross-sectional prospective study.
Community-dwelling research volunteers.
Sixteen older competitive male endurance athletes aged 52 through 76 years and 17 young (< 40 years) and 23 older (52 through 76 years) sedentary control subjects from the Baltimore Longitudinal Study of Aging.
All subjects underwent resting Doppler echocardiography and determination of maximal aerobic capacity (VO2max) during graded treadmill exercise. Doppler echocardiographic studies were interpreted without knowledge of the subject's age or exercise habits.
Doppler-derived measures of LV diastolic filling performance: peak early (E) filling velocity, peak late (A) filling velocity, ratio of peak E to peak A velocities (E/A), and atrial filling fraction.
Older athletes demonstrated higher VO2max (47 +/- 6 mL/kg per minute [mean +/- SD]) than either the young controls (41 +/- 7 mL/kg per minute) or older controls (30 +/- 7 mL/kg per minute) (P < .05) as evidence of their superior conditioning status. However, peak E diastolic LV filling velocity was higher in young controls (79 +/- 17 cm/s) than in older athletes (56 +/- 15 cm/s) or older controls (68 +/- 18 cm/s) (P < .001). This age difference persisted after normalizing peak E velocity for mitral stroke volume. Peak E/A ratio and atrial filling fraction were also similar in older athletes (1.2 +/- 0.5 and 0.41 +/- 0.1, respectively) and older controls (1.1 +/- 0.4 and 0.41 +/- 0.1, respectively), and differed significantly from corresponding values of 1.7 +/- 0.4 and 0.33 +/- 0.1 in young controls (P < .001 and P < .05, respectively). By multiple regression analysis, age but not treadmill VO2max was a significant predictor of peak E velocity, peak A velocity, peak E/A ratio, and atrial filling fraction.
Older men with a long history of intensive endurance training demonstrate impaired early diastolic LV filling similar to that of their sedentary peers. Thus, impairment of early diastolic filling appears to be intrinsic to normative aging and not secondary to the reduction in aerobic capacity that accompanies the aging process.
确定多年来接受强化耐力训练的老年男性与久坐不动的同龄人相比，舒张早期左心室（LV）充盈功能的年龄相关损害是否更少。
横断面前瞻性研究。
社区居住的研究志愿者。
16名年龄在52至76岁之间的老年男性竞技耐力运动员，以及来自巴尔的摩纵向衰老研究的17名年轻（<40岁）和23名老年（52至76岁）久坐对照者。
所有受试者均接受静息多普勒超声心动图检查，并在分级跑步机运动期间测定最大有氧能力（VO2max）。多普勒超声心动图研究在不知道受试者年龄或运动习惯的情况下进行解读。
通过多普勒测量的左心室舒张期充盈功能指标：舒张早期峰值（E）充盈速度、舒张晚期峰值（A）充盈速度、E峰值与A峰值速度之比（E/A）以及心房充盈分数。
老年运动员的VO2max（47±6毫升/千克每分钟[平均值±标准差]）高于年轻对照组（41±7毫升/千克每分钟）或老年对照组（30±7毫升/千克每分钟）（P<.05），证明他们的身体状况更好。然而，年轻对照组的舒张早期左心室E峰值充盈速度（79±17厘米/秒）高于老年运动员（56±15厘米/秒）或老年对照组（68±18厘米/秒）（P<.001）。在将E峰值速度标准化为二尖瓣搏出量后，这种年龄差异仍然存在。老年运动员的E/A峰值比和心房充盈分数（分别为1.2±0.5和0.41±0.1）与老年对照组（分别为1.1±0.4和0.41±0.1）也相似，与年轻对照组的相应值1.7±0.4和0.33±0.1有显著差异（分别为P<.001和P<.05）。通过多元回归分析，年龄而非跑步机VO2max是E峰值速度、A峰值速度、E/A峰值比和心房充盈分数的重要预测指标。
有长期强化耐力训练史的老年男性舒张早期左心室充盈功能受损，与久坐不动的同龄人相似。因此，舒张早期充盈功能受损似乎是正常衰老的固有特征，而非衰老过程中伴随的有氧能力下降的继发结果。
