Proper Exercise Can Reverse Damage From Heart Aging
Released: 4-Jan-2018 12:45 PM EST
Source Newsroom: UT Southwestern Medical Center
https://www.newswise.com/articles/proper-exercise-can-reverse-damage-from-heart-aging
Newswise — DALLAS – Jan. 8, 2018 – Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure – if it’s enough exercise, and if it’s begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources.
The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down: - One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 percent of peak rate for 4 minutes, with 3 minutes of recovery, repeated four times (a so-called “4 x 4”).
- Each interval session was followed by a recovery session performed at relatively low intensity.
- One day’s session lasted an hour and was of moderate intensity. (As a “prescription for life,” Levine said this longer session could be a fun activity such as tennis, aerobic dancing, walking, or biking.)
- One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation -- the “talk test.” In the study, exercise sessions were individually prescribed based on exercise tests and heart rate monitoring.
- One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.
Study
Reversing the Cardiac Effects of Sedentary Aging in Middle Age—A Randomized Controlled Trial
Implications For Heart Failure Prevention
Circulation. 2018;137:00–00.
DOI: 10.1161/CIRCULATIONAHA.117.030617
BACKGROUND: Poor tness in middle age is a risk factor for heart failure, particularly heart failure with a preserved ejection fraction. The development of heart failure with a preserved ejection fraction is likely mediated through increased left ventricular (LV) stiffness, a consequence of sedentary aging. In a prospective, parallel group, randomized controlled trial, we examined the effect of 2 years of supervised high- intensity exercise training on LV stiffness.
METHODS: Sixty-one (48% male) healthy, sedentary, middle-aged participants (53±5 years) were randomly assigned to either 2 years of exercise training (n=34) or attention control (control; n=27). Right heart catheterization and 3-dimensional echocardiography were performed with preload manipulations to de ne LV end-diastolic pressure-volume relationships and Frank-Starling curves. LV stiffness was calculated by curve t of the diastolic pressure-volume curve. Maximal oxygen uptake. (Vo2max) was measured to quantify changes in tness.
RESULTS: Fifty-three participants completed the study. Adherence to prescribed exercise sessions was 88±11%. Vo2max increased by 18% (exercise training: pre 29.0±4.8 to post 34.4±6.4; control: pre 29.5±5.3 to post 28.7±5.4, group×time P<0.001) and LV stiffness was reduced (right/downward shift in the end-diastolic pressure-volume relationships; preexercise training stiffness constant 0.072±0.037 to postexercise training 0.051±0.0268, P=0.0018), whereas there was no change in controls (group×time P<0.001; pre stiffness constant 0.0635±0.026 to post 0.062±0.031, P=0.83). Exercise increased LV end-diastolic volume (group×time P<0.001), whereas pulmonary capillary wedge pressure was unchanged, providing greater stroke volume for any given lling pressure (loading×group×time P=0.007).
CONCLUSIONS: In previously sedentary healthy middle-aged adults, 2 years of exercise training improved maximal oxygen uptake and decreased cardiac stiffness. Regular exercise training may provide protection against the future risk of heart failure with a preserved ejection fraction by preventing the increase in cardiac stiffness attributable to sedentary aging.