Effects Of Age And Conditioning Status On Rest And Exercise Cardiac Performance

年龄和体能状态对休息和运动心脏功能的影响

• 批准号: 7732326
• 负责人: Samer Najjar
• 金额: $ 9.49万
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7732326
• 关键词: Acute; Age; Aging; Arteries; Attenuated; Blood; Blood Pressure; Blood Vessels; Cardiac; Cardiac Volume; Cardiovascular system; Coupled; Coupling; Ensure; Exercise; Gender; Habits; Heart; Heart failure; Hypertension; Individual; Laboratories; Left; Left ventricular structure; Life Style; Measures; Mechanics; Performance; Play; Printing; Property; Range; Recovery; Rest; Risk Factors; Role; Scanning; Stroke Volume; Structure; System; Techniques; Ventricular; Woman; age effect; concept; conditioning; indexing; insight; interest; men; normotensive; systolic hypertension; ventricular system

In healthy subjects the arterial system and the left ventricle (LV) are tightly coupled at rest to optimize cardiac performance. Systolic hypertension (SH) is a major risk factor for heart failure and is associated with structural and functional alterations in the arteries and the LV. The effects of SH and resting systolic blood pressure (SBP) on arterial-ventricular coupling (E(a)I/E(LV)I) at rest, at peak exercise, and during recovery are not well described. We noninvasively characterized E(a)I/E(LV)I as end-systolic volume index/stroke volume index in subjects who were normotensive (NT, n = 203) or had SH (brachial SBP > or =140 mmHg, n = 79). Cardiac volumes were measured at rest and throughout exhaustive upright cycle exercise with gated blood pool scans. E(a)I/E(LV)I reserve was calculated by subtracting peak from resting E(a)I/E(LV)I. At rest, E(a)I/E(LV)I did not differ between SH and NT men but was 23% (P = 0.001) lower in SH vs. NT women. E(a)I/E(LV)I did not differ between SH and NT men or women at peak exercise or during recovery. Nevertheless, E(a)I/E(LV)I reserve was 61% (P < 0.001) lower in SH vs. NT women. Similarly, resting SBP (as a continuous variable) was not associated with E(a)I/E(LV)I in men (beta = -0.12, P = 0.17) but was inversely associated with E(a)I/E(LV)I in women (beta = -0.47, P < 0.001). SH and a higher resting brachial SBP are associated with a lower E(a)I/E(LV)I at rest in women but not in men, and SH women have an attenuated E(a)I/E(LV)I reserve. Whether a smaller E(a)I/E(LV)I reserve leads to functional limitations warrants further examination. (Am J Physiol Heart Circ Physiol. 2008;295(1):H145-153). Understanding the performance of the left ventricle requires not only examining the properties of the left ventricle itself, but also investigating the modulating effects of the arterial system on left ventricular (LV) performance. The interaction of the left ventricle with the arterial system, termed arterial-ventricular coupling, is a central determinant of cardiovascular performance and cardiac energetics. Arterial-ventricular coupling (EA/ELV) can be indexed by the ratio of effective arterial elastance (EA; a measure of the net arterial load exerted on the left ventricle) to LV end-systolic elastance (ELV; a load independent measure of LV chamber performance). At rest, in healthy individuals, EA/ELV is maintained within a narrow range, which allows the cardiovascular system to optimize energetic efficiency at the expense of mechanical efficacy. During exercise, an acute mismatch between the arterial and ventricular systems occurs, due to a disproportionate increase in ELV (from an average of 4.3 to 13.2, and 4.7 to 15.5 mmHg/ml/m(2) in men and women, respectively) vs. EA (from an average of 2.3 to 3.2, and 2.3 to 2.9 mmHg/ml/m(2) in men and women, respectively), to ensure that sufficient cardiac performance is achieved to meet the increased energetic requirements of the body. As a result EA/ELV decreases from an average of 0.58 to 0.34, and 0.52 to 0.27 in men and women, respectively. In this review, we provide an overview of the concept of arterial-ventricular coupling, and examine the effects of age, hypertension, and heart failure on EA/ELV and its components (EA and ELV) in men and women. We discuss these effects both at rest and during exercise, and highlight the mechanistic insights that can be derived from studying arterial-ventricular coupling. (J Appl Physiol. 2008 Jul 10. Epub ahead of print).

在健康受试者中，动脉系统和左心室（LV）在静止状态紧密耦合，以优化心脏性能。收缩压（SH）是心力衰竭的主要危险因素，与动脉和LV的结构和功能改变有关。 SH和静息收缩压（SBP）对动脉 - 室里耦合（E（a）I/E（LV）I）的影响在静止时，在峰值运动时和恢复过程中没有很好地描述。我们非侵入性地将E（A）I/E（LV）I表征为正常量的受试者（NT，n = 203）或具有SH（臂sbp> or = 140 mmHg，n = 79）的受试者中的末期音量指数/中风量指数。在静止和整个详尽的直立循环运动中，通过封闭的血池扫描测量心脏体积。 E（a）I/E（LV）I储备是通过从静止E（a）I/E（LV）i中减去峰来计算的。在休息时，E（a）I/E（LV）我在SH和NT男性之间没有差异，但SH与NT女性的23％（P = 0.001）。 E（a）I/E（LV）在运动高峰时或康复过程中，SH和NT男女之间没有差异。然而，E（a）I/E（LV）我保留在SH与NT妇女中的61％（p <0.001）。同样，静止的SBP（作为连续变量）与男性中的e（a）i/e（lv）i无关（beta = -0.12，p = 0.17），但与女性中的E（a）i/e（lv）I成反比（beta = -0.47，p <0.001）。 SH和较高的静息SBP与较低的E（A）I/E（LV）I（LV）在女性中，但在男性中不存在，而SH妇女的E（A）I/E（LV）我保留了i（A）I/E（LV）。较小的E（A）I/E（LV）是否保留导致功能限制需要进一步检查。 （Am J Physiol Heart CircPhysiol。2008; 295（1）：H145-153）。了解左心室的性能不仅需要检查左心室本身的特性，还需要研究动脉系统对左心室（LV）性能的调节作用。左心室与动脉系统的相互作用称为动脉 - 室性耦合，是心血管性能和心脏能量学的中心决定因素。动脉 - 室室耦合（EA/ELV）可以通过有效的动脉弹性（EA；左室上施加的净动脉负荷的量度）与LV末端性局势施加弹性（ELV； ELV； ELV; lv腔室性能的载荷量量）的比率来索引。在健康的个体中，EA/ELV保持在狭窄范围内，这使心血管系统可以以机械功效为代价优化能量效率。在锻炼过程中，由于ELV的不成比例增加（从平均4.3到13.2到4.7，男性和女性的EA（分别为4.3 mmHg/ml/m（2）），动脉和心室系统之间的急性不匹配发生了实现了足够的心脏表现，以满足人体的能量需求增加。结果，EA/ELV从平均0.58降低到0.34，男女分别降低到0.52至0.27。在这篇综述中，我们概述了动脉 - 室性耦合的概念，并检查年龄，高血压和心力衰竭对EA/ELV及其成分（EA和ELV）对男性和女性的影响。我们在休息和运动过程中讨论这些效果，并强调研究动脉 - 室里耦合可以得出的机械见解。 （J ApplPhysiol。20087月10日。

项目成果

Effect of light-to-moderate alcohol consumption on age-associated arterial stiffening.

轻度至中度饮酒对年龄相关动脉硬化的影响。

• DOI: 10.1016/j.amjcard.2004.12.051
• 发表时间: 2005
• 期刊: The American journal of cardiology
• 作者: Hougaku,Hidetaka;Fleg,JeromeL;Lakatta,EdwardG;Scuteri,Angelo;Earley,ChristopherJ;Najjar,Samer;Deb,Saswata;Metter,EJeffrey
• 通讯作者: Metter,EJeffrey