Hemodynamic Response to Rapid Saline Infusion Compared with Exercise in Healthy Participants Aged 20–80 Years

M. J. Andersen, E. Wolsk, R. Bakkestrøm, J. H. Thomsen, L. Balling, J. S. Dahl, F. Gustafsson, J. E. Møller, C. Hassager*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND AND OBJECTIVE: Rapid saline infusion and exercise has been proposed as methods to unmask cardiovascular disease. However, the normal hemodynamic response to rapid saline infusion has not been compared to exercise nor is it known whether the responses are age-dependent.We assessed the hemodynamic response to rapid saline infusion in healthy participants over a wide age-range and compared it to exercise in the same participants.

METHODS AND RESULTS: Fifty healthy participants (young <40 years, n = 16, middle-aged 40-59 years, n = 15, elderly 60-80 years, n = 19) underwent right heart catheterization at rest, during semisupine ergometer exercise at three exercise levels (25%, 50%, and 75% of peak VO 2) and after rapid saline infusion (10 ml/kg at a rate of 150 ml/min). Rapid saline infusion significantly increased pulmonary capillary wedge pressure (PCWP) similarly across all age groups (∆PCWP 6 ± 2; 7 ± 2; 6 ± 4 mmHg for the young, middle-aged and elderly respectively) with no correlation between age and ∆PCWP (r = 0.05; p = 0.74). However, there was a negative correlation between age and ∆stroke volume (SV) as elderly participants had a lower increase in SV following rapid saline infusion (r = 0.44; p = 0.002). On the contrary, exercise-induced significantly larger and age-dependent increases in PCWP (r = 0.58; p < 0.0001). Exercise also caused a larger increase in SV compared with rapid fluid loading (p = 0.0003) CONCLUSION: Unlike exercise, rapid saline infusion caused an age-independent increase in PCWP in healthy adults. Suggesting that age-related impairments beyond passive stiffness have a greater impact on exercise-induced increase in PCWP.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01974557.

Original languageEnglish
JournalJournal of Cardiac Failure
Volume25
Issue number11
Pages (from-to)902-910
ISSN1071-9164
DOIs
Publication statusPublished - Nov 2019

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Pulmonary Wedge Pressure
Exercise
Age Groups
Clinical Trials

Keywords

  • Exercise
  • Healthy
  • Hemodynamics
  • Saline infusion

Cite this

Andersen, M. J. ; Wolsk, E. ; Bakkestrøm, R. ; Thomsen, J. H. ; Balling, L. ; Dahl, J. S. ; Gustafsson, F. ; Møller, J. E. ; Hassager, C. / Hemodynamic Response to Rapid Saline Infusion Compared with Exercise in Healthy Participants Aged 20–80 Years. In: Journal of Cardiac Failure. 2019 ; Vol. 25, No. 11. pp. 902-910.
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title = "Hemodynamic Response to Rapid Saline Infusion Compared with Exercise in Healthy Participants Aged 20–80 Years",
abstract = "BACKGROUND AND OBJECTIVE: Rapid saline infusion and exercise has been proposed as methods to unmask cardiovascular disease. However, the normal hemodynamic response to rapid saline infusion has not been compared to exercise nor is it known whether the responses are age-dependent.We assessed the hemodynamic response to rapid saline infusion in healthy participants over a wide age-range and compared it to exercise in the same participants.METHODS AND RESULTS: Fifty healthy participants (young <40 years, n = 16, middle-aged 40-59 years, n = 15, elderly 60-80 years, n = 19) underwent right heart catheterization at rest, during semisupine ergometer exercise at three exercise levels (25{\%}, 50{\%}, and 75{\%} of peak VO 2) and after rapid saline infusion (10 ml/kg at a rate of 150 ml/min). Rapid saline infusion significantly increased pulmonary capillary wedge pressure (PCWP) similarly across all age groups (∆PCWP 6 ± 2; 7 ± 2; 6 ± 4 mmHg for the young, middle-aged and elderly respectively) with no correlation between age and ∆PCWP (r = 0.05; p = 0.74). However, there was a negative correlation between age and ∆stroke volume (SV) as elderly participants had a lower increase in SV following rapid saline infusion (r = 0.44; p = 0.002). On the contrary, exercise-induced significantly larger and age-dependent increases in PCWP (r = 0.58; p < 0.0001). Exercise also caused a larger increase in SV compared with rapid fluid loading (p = 0.0003) CONCLUSION: Unlike exercise, rapid saline infusion caused an age-independent increase in PCWP in healthy adults. Suggesting that age-related impairments beyond passive stiffness have a greater impact on exercise-induced increase in PCWP. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01974557.",
keywords = "Exercise, Healthy, Hemodynamics, Saline infusion",
author = "Andersen, {M. J.} and E. Wolsk and R. Bakkestr{\o}m and Thomsen, {J. H.} and L. Balling and Dahl, {J. S.} and F. Gustafsson and M{\o}ller, {J. E.} and C. Hassager",
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Hemodynamic Response to Rapid Saline Infusion Compared with Exercise in Healthy Participants Aged 20–80 Years. / Andersen, M. J.; Wolsk, E.; Bakkestrøm, R.; Thomsen, J. H.; Balling, L.; Dahl, J. S.; Gustafsson, F.; Møller, J. E.; Hassager, C.

In: Journal of Cardiac Failure, Vol. 25, No. 11, 11.2019, p. 902-910.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Hemodynamic Response to Rapid Saline Infusion Compared with Exercise in Healthy Participants Aged 20–80 Years

AU - Andersen, M. J.

AU - Wolsk, E.

AU - Bakkestrøm, R.

AU - Thomsen, J. H.

AU - Balling, L.

AU - Dahl, J. S.

AU - Gustafsson, F.

AU - Møller, J. E.

AU - Hassager, C.

PY - 2019/11

Y1 - 2019/11

N2 - BACKGROUND AND OBJECTIVE: Rapid saline infusion and exercise has been proposed as methods to unmask cardiovascular disease. However, the normal hemodynamic response to rapid saline infusion has not been compared to exercise nor is it known whether the responses are age-dependent.We assessed the hemodynamic response to rapid saline infusion in healthy participants over a wide age-range and compared it to exercise in the same participants.METHODS AND RESULTS: Fifty healthy participants (young <40 years, n = 16, middle-aged 40-59 years, n = 15, elderly 60-80 years, n = 19) underwent right heart catheterization at rest, during semisupine ergometer exercise at three exercise levels (25%, 50%, and 75% of peak VO 2) and after rapid saline infusion (10 ml/kg at a rate of 150 ml/min). Rapid saline infusion significantly increased pulmonary capillary wedge pressure (PCWP) similarly across all age groups (∆PCWP 6 ± 2; 7 ± 2; 6 ± 4 mmHg for the young, middle-aged and elderly respectively) with no correlation between age and ∆PCWP (r = 0.05; p = 0.74). However, there was a negative correlation between age and ∆stroke volume (SV) as elderly participants had a lower increase in SV following rapid saline infusion (r = 0.44; p = 0.002). On the contrary, exercise-induced significantly larger and age-dependent increases in PCWP (r = 0.58; p < 0.0001). Exercise also caused a larger increase in SV compared with rapid fluid loading (p = 0.0003) CONCLUSION: Unlike exercise, rapid saline infusion caused an age-independent increase in PCWP in healthy adults. Suggesting that age-related impairments beyond passive stiffness have a greater impact on exercise-induced increase in PCWP. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01974557.

AB - BACKGROUND AND OBJECTIVE: Rapid saline infusion and exercise has been proposed as methods to unmask cardiovascular disease. However, the normal hemodynamic response to rapid saline infusion has not been compared to exercise nor is it known whether the responses are age-dependent.We assessed the hemodynamic response to rapid saline infusion in healthy participants over a wide age-range and compared it to exercise in the same participants.METHODS AND RESULTS: Fifty healthy participants (young <40 years, n = 16, middle-aged 40-59 years, n = 15, elderly 60-80 years, n = 19) underwent right heart catheterization at rest, during semisupine ergometer exercise at three exercise levels (25%, 50%, and 75% of peak VO 2) and after rapid saline infusion (10 ml/kg at a rate of 150 ml/min). Rapid saline infusion significantly increased pulmonary capillary wedge pressure (PCWP) similarly across all age groups (∆PCWP 6 ± 2; 7 ± 2; 6 ± 4 mmHg for the young, middle-aged and elderly respectively) with no correlation between age and ∆PCWP (r = 0.05; p = 0.74). However, there was a negative correlation between age and ∆stroke volume (SV) as elderly participants had a lower increase in SV following rapid saline infusion (r = 0.44; p = 0.002). On the contrary, exercise-induced significantly larger and age-dependent increases in PCWP (r = 0.58; p < 0.0001). Exercise also caused a larger increase in SV compared with rapid fluid loading (p = 0.0003) CONCLUSION: Unlike exercise, rapid saline infusion caused an age-independent increase in PCWP in healthy adults. Suggesting that age-related impairments beyond passive stiffness have a greater impact on exercise-induced increase in PCWP. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01974557.

KW - Exercise

KW - Healthy

KW - Hemodynamics

KW - Saline infusion

U2 - 10.1016/j.cardfail.2019.06.004

DO - 10.1016/j.cardfail.2019.06.004

M3 - Journal article

VL - 25

SP - 902

EP - 910

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 11

ER -