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健康老年男性在广泛健身水平范围内的心血管功能连续体。

Continuum of cardiovascular performance across a broad range of fitness levels in healthy older men.

作者信息

Schulman S P, Fleg J L, Goldberg A P, Busby-Whitehead J, Hagberg J M, O'Connor F C, Gerstenblith G, Becker L C, Katzel L I, Lakatta L E, Lakatta E G

机构信息

Gerontology Research Center, University of Maryland School of Medicine and Geriatrics Research, Baltimore, USA.

出版信息

Circulation. 1996 Aug 1;94(3):359-67. doi: 10.1161/01.cir.94.3.359.

Abstract

BACKGROUND

Although it has become clear that habitual exercise in older individuals can partially offset age-associated cardiovascular declines, it is not known whether the beneficial effects of exercise training in older individuals depend on their prior fitness level.

METHODS AND RESULTS

Ten sedentary men (S), age 60.0 +/- 1.6 years (mean +/- SEM), who were carefully screened to exclude cardiac disease underwent exercise training for 24 to 32 weeks, and eight age-matched endurance-trained men (ET) stopped their exercise training for 12 weeks. All underwent treadmill exercise and rest and maximal cycle exercise upright gated blood pool scans at baseline and after the lifestyle intervention. Before the intervention, the treadmill maximum rate of oxygen consumption (Vo2max) was 49.9 +/- 1.9 and 32.1 +/- 1.4 mL.kg-1.min-1 in ET and S, respectively. During upright cycle exercise at exhaustion, although heart rate did not differ between groups, cardiac index, stroke volume index, ejection fraction, and left ventricular contractility index (systolic blood pressure/end-systolic volume index) all were significantly higher, and end-systolic volume index, diastolic blood pressure, and total systemic vascular resistance all were significantly lower in ET versus S. After the partial deconditioning of ET men, Vo2max fell to 42 +/- 2.2 mL.kg-1.min-1, and training of S increased Vo2max to 36.2 +/- 1.6 mL.kg-1.min-1. Training of S had effects on cardiovascular function that were similar in magnitude but directionally opposite those of detraining ET. All initial differences in cardiovascular performance at peak work rate between S and ET were abolished with the intervention. Across the broad range of fitness levels encountered before and after change in training status (Vo2max of 26 to 58 mL.kg-1.min-1), cardiac index, stroke volume index, end-systolic volume index, ejection fraction, and the left ventricular contractility index were all linearly correlated with Vo2max.

CONCLUSIONS

Exercise training or detraining of older men results in changes in left ventricular performance that are qualitatively and quantitatively similar, regardless of the initial level of fitness before the intervention.

摘要

背景

尽管已经明确,老年人进行习惯性锻炼可部分抵消与年龄相关的心血管功能衰退,但尚不清楚老年人运动训练的有益效果是否取决于其先前的健康水平。

方法与结果

对10名久坐不动的男性(S组)进行了24至32周的运动训练,这些男性年龄为60.0±1.6岁(均值±标准误),经过仔细筛查以排除心脏病;8名年龄匹配的耐力训练男性(ET组)停止运动训练12周。所有人在基线时以及生活方式干预后均接受了跑步机运动及休息状态下的直立门控心血池扫描和最大周期运动扫描。干预前,ET组和S组在跑步机上的最大耗氧率(Vo2max)分别为49.9±1.9和32.1±1.4 mL·kg⁻¹·min⁻¹。在直立周期运动至疲惫时,尽管两组心率无差异,但ET组的心脏指数、每搏量指数、射血分数和左心室收缩性指数(收缩压/收缩末期容积指数)均显著更高,而收缩末期容积指数、舒张压和总全身血管阻力均显著低于S组。ET组男性部分失适应后,Vo2max降至42±2.2 mL·kg⁻¹·min⁻¹,S组训练后Vo2max升至36.2±1.6 mL·kg⁻¹·min⁻¹。S组的训练对心血管功能的影响在程度上相似,但方向与ET组的失训练相反。干预后,S组和ET组在峰值工作率时心血管性能的所有初始差异均被消除。在训练状态改变前后所遇到的广泛健康水平范围内(Vo2max为26至58 mL·kg⁻¹·min⁻¹),心脏指数、每搏量指数、收缩末期容积指数、射血分数和左心室收缩性指数均与Vo2max呈线性相关。

结论

无论干预前的初始健康水平如何,老年男性进行运动训练或失训练都会导致左心室性能发生质和量上相似的变化。

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