Abnormalities in arterial-ventricular coupling in older healthy persons are attenuated by sodium nitroprusside

Author:

Chantler Paul D.12,Nussbacher Amit3,Gerstenblith Gary4,Schulman Steven P.4,Becker Lewis C.4,Ferrucci Luigi5,Fleg Jerome L.1,Lakatta Edward G.1,Najjar Samer S.1

Affiliation:

1. Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland;

2. Department of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, West Virginia;

3. Division of Geriatric Cardiology, Heart Institute, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil;

4. Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland; and

5. Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

Abstract

The coupling between arterial elastance ( EA; net afterload) and left ventricular elastance ( ELV; pump performance), known as EA/ ELV, is a key determinant of cardiovascular performance and shifts during exercise due to a greater increase in ELV versus EA. This normal exercise-induced reduction in EA/ ELV decreases with advancing age. We hypothesized that sodium nitroprusside (SNP) can acutely ameliorate the age-associated deficits in EA/ ELV. At rest and during graded exercise to exhaustion, EA was characterized as end-systolic pressure/stroke volume and ELV as end-systolic pressure/end-systolic volume. Resting EA/ ELV did not differ between old (70 ± 8 yr, n = 15) and young (30 ± 5 yr, n = 17) subjects because of a tandem increase in EA and ELV in older subjects. During peak exercise, a blunted increase in ELV in old (7.8 ± 3.1 mmHg/ml) versus young (11.4 ± 6.5 mmHg/ml) subjects blunted the normal exercise-induced decline in EA/ ELV in old (0.25 ± 0.11) versus young (0.16 ± 0.05) subjects. SNP administration to older subjects lowered resting EA/ ELV by 31% via a reduction in EA (10%) and an increase in ELV (47%) and lowered peak exercise EA/ ELV (36%) via an increase in ELV (68%) without a change in EA. Importantly, SNP attenuated the age-associated deficits in EA/ ELV and ELV during exercise, and at peak exercise EA/ ELV in older subjects on drug administration did not differ from young subjects without drug administration. In conclusion, some age-associated deficiencies in EA/ ELV, EA, and ELV, in older subjects can be acutely abolished by SNP infusion. This is relevant to common conditions in older subjects associated with a significant impairment of exercise performance such as frailty or heart failure with preserved ejection fraction.

Publisher

American Physiological Society

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

Cited by 12 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Ventricular–Vascular Interaction;Encyclopedia of Gerontology and Population Aging;2021

2. Ventricular–Vascular Interaction;Encyclopedia of Gerontology and Population Aging;2020

3. Arterial Ventricular Uncoupling With Age and Disease and Recoupling With Exercise;Exercise and Sport Sciences Reviews;2017-04

4. Age-associated pro-inflammatory remodeling and functional phenotype in the heart and large arteries;Journal of Molecular and Cellular Cardiology;2015-06

5. Mechanism of decreased sensitivity of dobutamine associated left ventricular wall motion analyses for appreciating inducible ischemia in older adults;Journal of Cardiovascular Magnetic Resonance;2015-04-08

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