Left ventricular diastolic filling and cardiovascular functional capacity in older men

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Abstract
We investigated anaerobic threshold (thetaL) gas exchange kinetics and maximal oxygen uptake (V̇O2,max) among older men with reduced left ventricular end-diastolic filling (LVDF). Ten men (mean age, 73 years) with LVDF impairment and low fitness, but without other cardiovascular dysfunction were studied. Treatments compared to control included: 5 days, high intensity exercise training protocol; 5 days, calcium channel blockade (240 mg verapamil); 21 days, detraining/washout; and 5 days, combined treatments. Results indicated no changes in resting left ventricular systolic function with any treatment. Significant resting diastolic function changes included increased early:late flow velocity (control, 0.87; training, 1.28; verapamil, 1.32), and a decreased isovolumic relaxation time (control, 0.10 s; training, 0.08 s; verapamil, 0.08 s). The combined treatments were not additive. Sub-threshold oxygen uptake kinetics (tauVO2, s) were significantly faster following either training or verapamil (tauVO2,control, 62 ± 12; tauVO2,training, 44 ± 9; tauVO2,verapamil, 48 ± 10) and combined treatments (tauVO2, 41 ± 8). V̇O2,max (ml kg-1 min-1) was significantly increased (control, 21.8 ± 2.2; training, 27.3 ± 2.2; verapamil, 25.2 ± 3.4; combined treatments, 26.9 ± 2.3). Increasing ventricular preload with either exercise training or calcium channel blockade was coincident with faster tauVO2 and increased V̇O2,max.

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