Age-related decline in mitral peak diastolic velocities is unaffected in well-trained runners

Figures & data

Table I. Anthropometric characteristics of participants.

	Young		Senior		P-value^§
	Sedentary (n = 12)	Athlete (n = 10)	Sedentary (n = 11)	Athlete (n = 17)
Age [years], median (range)	23 (21–31)	26 (20–36)	66 (60–73)	63 (59–75)	0.274/0.246^†
Height [cm]	178 (6)	179 (4)	175 (4)	176 (4)	0.154
Weight [kg]	70.3 (8.1)	72.8 (5.6)	75.1 (4.4)	71.1 (5.9)	0.243
BMI [kg∙m^− 2]	22.2 (1.7)^#	22.7 (1.8)	24.6 (1.6)	23.1 (1.6)	0.009

BMI, body mass index. Values are mean (SD) unless stated otherwise.

^§P for one-way ANOVA.

^†P for young sedentary vs young athlete and senior sedentary vs senior athlete (Wilcoxon signed rank tests).

^#Young sedentary vs senior sedentary, P = 0.002 (Holm-corrected).

Table II. VO₂peak, maximal workload, resting blood pressure, and heart rate.

	Young		Senior		P-value
	Sedentary (n = 12)	Athlete (n = 10)	Sedentary (n = 11)	Athlete (n = 17)	Age	Athlete
VO2peak [mL∙min^− 1]	3131 (452)	4341 (243)	2237 (345)	3323 (458)	< 0.001	< 0.001
VO2peak [mL∙kg^− 1∙min^− 1]	44.6 (4.3)	59.8 (3.5)	29.6 (3.1)	46.9 (7.0)	< 0.001	< 0.001
Peak workload [W], (median, range)	275 (200;325)	350 (350;375)	175 (150;225)	275 (200;325)	< 0.001	< 0.001
Resting systolic blood pressure [mmHg]	120 (16)	120 (7)	127 (10)	138 (18)	0.003	0.159
Resting diastolic blood pressure [mmHg]	65 (10)	62 (6)	78 (5)	76 (14)	< 0.001	0.321
Resting HR [min^− 1]	64 (6)	51 (9)	63 (7)	54 (8)	0.615	< 0.001

HR, heart rate. Values are mean (SD) unless stated otherwise. P-values of two-way ANOVA. No significant age*athlete interactions.

Figure 1. (A–H) Mitral inflow, tissue Doppler velocities, and heart rate during supine exercise echocardiography. Values are mean (SEM). P-values < 0.1 of mixed model repeated measures ANOVA are given. A, atrial-phase mitral inflow velocity; a’, atrial-phase mitral annular tissue Doppler velocity; E, early mitral inflow velocity; e’, early mitral annular tissue Doppler velocity; E/A, ratio of early and atrial-phase mitral inflow velocities; E/e’, ratio of early mitral inflow and early mitral annular tissue Doppler velocities; HR, heart rate; s’, systolic mitral annular tissue Doppler velocity.

Table III. Resting mitral inflow and mitral annular tissue Doppler velocities.

	Young		Senior		P-value
	Sedentary	Athlete	Sedentary	Athlete	Two-way ANOVA		Multiple linear regression
	(n = 12)	(n = 10)	(n = 11)	(n = 17)	Age	Athlete	Age	Athlete	Resting HR
E [cm∙s^− 1]	81 (18)	93 (12)	56 (8)	63 (15)	<0.001	0.024	<0.001	0.207	0.239
A [cm∙s^− 1]	46 (9)	48 (4)	63 (12)	59 (15)	<0.001	0.581	<0.001	0.308	0.008
E/A	1.7 (0.4)	2.0 (0.3)	0.9 (0.2)	1.1 (0.3)	<0.001	0.018	<0.001	0.861	<0.001
e’ [cm∙s^− 1]	13.4 (2.0)	13.8 (1.7)	7.8 (1.7)	8.3 (2.5)	<0.001	0.387	<0.001	0.528	0.884
E/e’	6.1 (1.4)	6.9 (1.4)	7.5 (1.4)	8.1 (2.8)	0.014	0.235	0.014	0.502	0.575
a’ [cm∙s^− 1]	7.1 (2.1)	6.8 (2.1)	11.2 (1.0)	10.1 (1.4)	<0.001	0.150	<0.001	0.881	0.013
s’ [cm∙s^− 1]	9.7 (1.4)	9.5 (1.2)	9.4 (1.2)	8.2 (1.5)	0.040	0.051	0.027	0.582	0.042

Values are mean (SD). No significant age*training interactions. A, atrial-phase mitral inflow velocity; a’, atrial-phase mitral annular tissue Doppler velocity; E, early mitral inflow velocity; e’, early mitral annular tissue Doppler velocity; E/A, ratio of early and atrial-phase mitral inflow velocities; E/e’, ratio of early mitral inflow and early mitral annular tissue Doppler velocities; s’, systolic mitral annular tissue Doppler velocity.

Table IV. Echocardiographic dimensions.

	Young		Senior		P-value
	Sedentary (n = 12)	Athlete (n = 10)	Sedentary (n = 11)	Athlete (n = 17)	Age	Athlete
LVEF [%]	59 (2)	58 (4)	59 (3)	60 (4)	0.732	0.391
LVEDV [mL]	93 (23)	134 (27)	89 (18)	122 (15)	0.183	< 0.001
LVEDVI [mL∙m^− 2]	50 (13)	70 (14)	47 (9.2)	66 (8.6)	0.228	< 0.001
LVESV [mL]	38 (9.7)	56 (14)	37 (8.5)	49 (9.0)	0.151	< 0.001
LVESVI [mL∙m^− 2]	20 (5.2)	29 (6.9)	19 (4.4)	26 (5.0)	0.186	< 0.001
LVEDD [mm]	48 (5)	54 (4)	45 (2)	50 (4)	0.004	< 0.001
LVEDDI [mm∙m^− 2]	2.6 (0.3)	2.8 (0.2)	2.3 (0.1)	2.7 (0.2)	0.018	< 0.001
LVESD [mm]	32 (5)	35 (4)	29 (2)	32 (4)	0.004	0.019
LVESDI [mm∙m^− 2]	1.7 (0.2)	1.9 (0.2)	1.5 (0.1)	1.7 (0.2)	0.010	0.028
LVWT [mm]	7.7 (1.4)	8.2 (1.2)	8.9 (0.9)	10.1 (1.3)	< 0.001	0.019
LVWTI [mm∙m^− 2]	4.1 (0.8)	4.3 (0.5)	4.7 (0.5)	5.4 (0.7)	< 0.001	0.018
RWT	0.32 (0.09)	0.29 (0.05)	0.38 (0.04)	0.37 (0.06)	0.001	0.310
LVM [g]	122 (30)	159 (29)	129 (20)	188 (39)	0.042	< 0.001
LVMI [g∙m^− 2]	65 (16)	83 (12)	68 (11)	101 (20)	0.025	< 0.001
LVM∙height^− 2.7 [g∙m^− 2.7]	26 (6.7)	33 (5.3)	29 (5.1)	41 (8.9)	0.009	< 0.001
LVM/LVEDV [g∙mL^− 1]	1.38 (0.44)	1.21 (0.27)	1.49 (0.34)	1.55 (0.34)	0.038	0.695
LAV [mL]	32 (9)	49 (11)	39 (17)	63 (18)	0.021	< 0.001
LAVI [mL∙m^− 2]	17 (5)	26 (6)	21 (9)	34 (10)	0.035	< 0.001

Values are mean (SD). P-values of two-way ANOVA. No significant age*training interactions.

LAV(I), left atrial volume (indexed for body surface area); LVEDD(I), left ventricular end-diastolic dimension (indexed for body surface area); LVEF, left ventricular ejection fraction; LVEDV(I), left ventricular end-diastolic volume (indexed for body surface area); LVESD(I), left ventricular end-systolic dimension (indexed for body surface area); LVESV(I), left ventricular end-systolic volume (indexed for body surface area); LVM(I), left ventricular mass (indexed for body surface area); LVM∙height^{− 2.7}, left ventricular mass allometrically adjusted for height; LVWT(I), left ventricular wall thickness (indexed for body surface area); RWT, relative wall thickness.

Table V. Correlations between VO₂peak [mL∙kg^{− 1}∙min^{− 1}] and selected echocardiographic parameters.

	R	P-value
Erest	0.57	< 0.001
Arest	− 0.47	< 0.001
E/Arest	0.66	< 0.001
e'rest	0.57	< 0.001
a'rest	− 0.54	< 0.001
E30%	0.32	0.028
e’30%	0.30	0.040
E60%	0.44	0.002
e’60%	0.42	0.004
s’60%	0.33	0.023
Erecovery	0.60	< 0.001
E/Arecovery	0.62	< 0.001
e'recovery	0.53	< 0.001
a'recovery	− 0.48	< 0.001
LVEDVI	0.49	< 0.001

A, atrial-phase mitral inflow velocity; a’, atrial-phase mitral annular tissue Doppler velocity; E, early mitral inflow velocity; e’, early mitral annular tissue Doppler velocity; E/A, ratio of early and atrial-phase mitral inflow velocities; LVEDVI, left ventricular end-diastolic volume indexed for body surface area; r, Pearson correlation coefficient; s’, systolic mitral annular tissue Doppler velocity.

Only parameters for which P ≤ 0.1 are listed. Subscripts refer to stage of exercise echocardiography.

Table VI. Multiple linear regression with VO₂peak as outcome.

	SC	P-value
E/Arest	0.56	< 0.001
s’60%	0.27	0.009
LVEDVI	0.53	< 0.001

R^{2 =} 0.64. Subscripts refer to stage of exercise echocardiography.

E/A, ratio of early and atrial-phase mitral inflow velocities; s’, systolic mitral annular tissue Doppler velocity; SC, Standardized coefficient.