Aerobic training protects cardiac function during advancing age

a meta-analysis of four decades of controlled studies

Alexander J. Beaumont, Fergal M. Grace, Joanna C. Richards, Amy K. Campbell, Nicholas F. Sculthorpe*

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background
In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny.

Objectives
We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age.

Methods
Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic.

Results
Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age.

Conclusions
Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing.
Original languageEnglish
Pages (from-to)199-219
Number of pages21
JournalSports Medicine
Volume49
Issue number2
Early online date29 Oct 2018
DOIs
Publication statusPublished - 28 Feb 2019

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Meta-Analysis
Confidence Intervals
Athletes
Left Ventricular Function
Stroke Volume
Echocardiography
Databases

Keywords

  • ageing
  • cardiovascular health
  • Echocardiography
  • cardiac function
  • masters athletes

Cite this

@article{fe44fb3e7fcd44f5aee76af8c73298af,
title = "Aerobic training protects cardiac function during advancing age: a meta-analysis of four decades of controlled studies",
abstract = "BackgroundIn contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny.ObjectivesWe conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age.MethodsElectronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95{\%} confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic.ResultsOverall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95{\%} CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95{\%} CI 0.85–1.60), posterior wall thickness (1.20 mm, 95{\%} CI 0.83–1.56), LV mass (72 g, 95{\%} CI 46–98), LV mass index (28.17 g·m2, 95{\%} CI 19.84–36.49) and stroke volume (13.59 mL, 95{\%} CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95{\%} CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95{\%} CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95{\%} CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95{\%} CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95{\%} CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age.ConclusionsAthletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing.",
keywords = "ageing, cardiovascular health, Echocardiography, cardiac function, masters athletes",
author = "Beaumont, {Alexander J.} and Grace, {Fergal M.} and Richards, {Joanna C.} and Campbell, {Amy K.} and Sculthorpe, {Nicholas F.}",
year = "2019",
month = "2",
day = "28",
doi = "10.1007/s40279-018-1004-3",
language = "English",
volume = "49",
pages = "199--219",
journal = "Sports Medicine",
issn = "0112-1642",
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}

Aerobic training protects cardiac function during advancing age : a meta-analysis of four decades of controlled studies. / Beaumont, Alexander J.; Grace, Fergal M.; Richards, Joanna C.; Campbell, Amy K.; Sculthorpe, Nicholas F.

In: Sports Medicine, Vol. 49, No. 2, 28.02.2019, p. 199-219.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Aerobic training protects cardiac function during advancing age

T2 - a meta-analysis of four decades of controlled studies

AU - Beaumont, Alexander J.

AU - Grace, Fergal M.

AU - Richards, Joanna C.

AU - Campbell, Amy K.

AU - Sculthorpe, Nicholas F.

PY - 2019/2/28

Y1 - 2019/2/28

N2 - BackgroundIn contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny.ObjectivesWe conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age.MethodsElectronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic.ResultsOverall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age.ConclusionsAthletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing.

AB - BackgroundIn contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny.ObjectivesWe conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age.MethodsElectronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic.ResultsOverall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age.ConclusionsAthletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing.

KW - ageing

KW - cardiovascular health

KW - Echocardiography

KW - cardiac function

KW - masters athletes

U2 - 10.1007/s40279-018-1004-3

DO - 10.1007/s40279-018-1004-3

M3 - Article

VL - 49

SP - 199

EP - 219

JO - Sports Medicine

JF - Sports Medicine

SN - 0112-1642

IS - 2

ER -