TY - JOUR
T1 - Verapamil acutely reduces ventricular-vascular stiffening and improves aerobic exercise performance in elderly individuals
AU - Chen, Chen Huan
AU - Nakayama, Masaru
AU - Talbot, Maurice
AU - Nevo, Erez
AU - Fetics, Barry
AU - Gerstenblith, Gary
AU - Becker, Lewis C.
AU - Kass, David A.
N1 - Funding Information:
This study was supported by NIA grant AG:12249 (DAK), Colin Research Fellowship Award (BF) and Fogarty Foundation Grant (EN).
PY - 1999/5
Y1 - 1999/5
N2 - OBJECTIVES: We tested the hypothesis that acute intravenous verapamil acutely enhances aerobic exercise performance in healthy older individuals in association with a combined reduction of ventricular systolic and arterial vascular stiffnesses. BACKGROUND: Age-related vascular stiffening coupled with systolic ventricular stiffening may limit cardiovascular reserve and, thus, exercise performance in aged individuals. METHODS: Nineteen healthy volunteers with mean age 70 ± 10 years underwent maximal-effort upright ergometry tests on two separate days after receiving either 0.15 mg/kg i.v. verapamil or 0.5 N saline in a double-blind, randomized, crossover study. RESULTS: Baseline vascular stiffness, indexed by arterial pulse-wave velocity (Doppler) and augmentation index (carotid tonometry) declined with verapamil (-5.9 ± 2.1% and -31.7 ± 12.8%, respectively, both p < 0.05). Preload- adjusted maximal ventricular power, a surrogate for ventricular end-systolic stiffness, also declined by -9.5 ± 3.6%. Peripheral resistance and peak filling rate were unchanged. With verapamil, exercise duration prior to the anaerobic threshold (AT) increased by nearly 50% (260 ± 129 to 387 ± 176 s) with a corresponding 13.4 ± 4.7% rise in oxygen consumption (V̇O2) at that time (both p < 0.01). Total exercise duration prolonged by +6 ± 2.7% (p < 0.05) with no change in maximal V̇O2. Baseline cardiodepression from verapamil reversed by peak exercise with net increases in stroke volume and Cardiac output (p < 0.05). CONCLUSIONS: Acute intravenous verapamil reduces ventriculovascular stiffening and improves aerobic exercise performance in healthy aged individuals. This highlights a role for heart-arterial coupling in modulating exertional capacity in the elderly, suggesting a potentially therapeutic target for aged individuals with exertional limitations.
AB - OBJECTIVES: We tested the hypothesis that acute intravenous verapamil acutely enhances aerobic exercise performance in healthy older individuals in association with a combined reduction of ventricular systolic and arterial vascular stiffnesses. BACKGROUND: Age-related vascular stiffening coupled with systolic ventricular stiffening may limit cardiovascular reserve and, thus, exercise performance in aged individuals. METHODS: Nineteen healthy volunteers with mean age 70 ± 10 years underwent maximal-effort upright ergometry tests on two separate days after receiving either 0.15 mg/kg i.v. verapamil or 0.5 N saline in a double-blind, randomized, crossover study. RESULTS: Baseline vascular stiffness, indexed by arterial pulse-wave velocity (Doppler) and augmentation index (carotid tonometry) declined with verapamil (-5.9 ± 2.1% and -31.7 ± 12.8%, respectively, both p < 0.05). Preload- adjusted maximal ventricular power, a surrogate for ventricular end-systolic stiffness, also declined by -9.5 ± 3.6%. Peripheral resistance and peak filling rate were unchanged. With verapamil, exercise duration prior to the anaerobic threshold (AT) increased by nearly 50% (260 ± 129 to 387 ± 176 s) with a corresponding 13.4 ± 4.7% rise in oxygen consumption (V̇O2) at that time (both p < 0.01). Total exercise duration prolonged by +6 ± 2.7% (p < 0.05) with no change in maximal V̇O2. Baseline cardiodepression from verapamil reversed by peak exercise with net increases in stroke volume and Cardiac output (p < 0.05). CONCLUSIONS: Acute intravenous verapamil reduces ventriculovascular stiffening and improves aerobic exercise performance in healthy aged individuals. This highlights a role for heart-arterial coupling in modulating exertional capacity in the elderly, suggesting a potentially therapeutic target for aged individuals with exertional limitations.
UR - http://www.scopus.com/inward/record.url?scp=0033133505&partnerID=8YFLogxK
U2 - 10.1016/S0735-1097(99)00052-2
DO - 10.1016/S0735-1097(99)00052-2
M3 - Article
C2 - 10334431
AN - SCOPUS:0033133505
SN - 0735-1097
VL - 33
SP - 1602
EP - 1609
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 6
ER -