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May moderate dynamic exercise training over a lifetime benefit left ventricular compliance and distensibility?

Comment by Luis Serratosa, EACPR Sports Cardiology Section

Impact of Lifelong Exercise “Dose” on Left Ventricular Compliance and Distensibility 
Paul S. Bhella et al.
J Am Coll Cardiol. 2014;64(12):1257-1266. doi:10.1016/j.jacc.2014.03.062


Ventricular stiffening has been implicated in the pathophysiology of many common cardiovascular conditions affecting the elderly including atrial fibrillation and heart failure with preserved ejection fraction (HFpEF). Lifelong dynamic exercise training appears to be an effective strategy to prevent these deleterious effects of aging, but the minimal effective dose still remains to be fully elucidated.

In this cross-sectional study, left ventricular compliance and distensibility (LVCD), was invasively assessed in a cohort of 102 healthy subjects (> 64 yrs of age), stratified in four groups according to number of training sessions (>30 mins) per week during the previous 25 years: “Sedentary” subjects (no more than 1 session per week); “casual” exercisers (2 to 3 sessions per week); “committed” exercisers (4 to 5 sessions per week); and “competitive” Masters level athletes (6 to 7 sessions per week).

The key finding of this study is that at least 30 min of dynamic exercise per session, for 4 to 5 days per week over a lifetime, can sufficiently prevent most of the decreases in LV compliance and distensibility observed with sedentary aging, regardless of the intensity, duration, or mode of exercise, that were not recorded. As LV systolic function indexes remained relatively unaffected by lifelong exercise dose, increases in functional capacity (peak VO2*) were probably more related to both morphological (LV mass and end diastolic volume) and diastolic function improvements (LVCD).

With an aging global population and a high prevalence of HFpEF in the elderly, developing strategies to prevent HFpEF as well as other CV diseases should be a priority.

* VO2: oxygen consumption