The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

Emil Wolsk*, Rine Bakkestrøm, Jacob H. Thomsen, Louise Balling, Mads J. Andersen, Jordi S. Dahl, Christian Hassager, Jakob E. Møller, Finn Gustafsson

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objectives In this study, the authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. Background At present, the influence of age on hemodynamic function is largely unknown. Because many diseases with proposed cardiac impact are more prevalent in the older population, it is pivotal to know how hemodynamic parameters are affected by age itself to discern the influence of disease from that of physiological aging. Methods Sixty-two healthy participants, evenly distributed with respect to age (20 to 80 years) and sex (32 women/30 men), were prospectively enrolled in the study. Participants were all deemed healthy by medical history, echocardiography, exercise test, spirometry, blood tests, and electrocardiogram. Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. Results During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise, there was augmented filling pressure (p < 0.0001) and diminished cardiac output (p = 0.001) and hence a higher pressure:flow ratio (pulmonary artery pressure/capillary wedge pressure to cardiac output) with progressive age, evident from the earliest ages. All indexed hemodynamic measures were similar between sexes. The diagnostic threshold (pulmonary capillary wedge pressure ≥25 mm Hg) currently used during exercise testing to diagnose abnormal left ventricular filling pressure was measured in 30% of our healthy elderly participants. Conclusions Cardiac aging was progressive without sex differences in healthy participants. The hemodynamic reference values obtained suggest that the diagnostic threshold for abnormal filling pressure should be individually determined according to age of the patient.

Original languageEnglish
JournalJACC: Heart Failure
Volume5
Issue number5
Pages (from-to)337-346
ISSN2213-1779
DOIs
Publication statusPublished - 1. May 2017

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Exercise
Leg
Pulmonary Wedge Pressure
Ventricular Pressure
Exercise Test
Pulmonary Hypertension
Sex Characteristics
Pulmonary Artery
Echocardiography
Electrocardiography
Reference Values
Age Groups
Guidelines
Lung
Population

Keywords

  • aging
  • catheterization
  • exercise
  • healthy
  • hemodynamics
  • sex

Cite this

Wolsk, E., Bakkestrøm, R., Thomsen, J. H., Balling, L., Andersen, M. J., Dahl, J. S., ... Gustafsson, F. (2017). The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals. JACC: Heart Failure, 5(5), 337-346. https://doi.org/10.1016/j.jchf.2016.10.012
Wolsk, Emil ; Bakkestrøm, Rine ; Thomsen, Jacob H. ; Balling, Louise ; Andersen, Mads J. ; Dahl, Jordi S. ; Hassager, Christian ; Møller, Jakob E. ; Gustafsson, Finn. / The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals. In: JACC: Heart Failure. 2017 ; Vol. 5, No. 5. pp. 337-346.
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abstract = "Objectives In this study, the authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. Background At present, the influence of age on hemodynamic function is largely unknown. Because many diseases with proposed cardiac impact are more prevalent in the older population, it is pivotal to know how hemodynamic parameters are affected by age itself to discern the influence of disease from that of physiological aging. Methods Sixty-two healthy participants, evenly distributed with respect to age (20 to 80 years) and sex (32 women/30 men), were prospectively enrolled in the study. Participants were all deemed healthy by medical history, echocardiography, exercise test, spirometry, blood tests, and electrocardiogram. Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. Results During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise, there was augmented filling pressure (p < 0.0001) and diminished cardiac output (p = 0.001) and hence a higher pressure:flow ratio (pulmonary artery pressure/capillary wedge pressure to cardiac output) with progressive age, evident from the earliest ages. All indexed hemodynamic measures were similar between sexes. The diagnostic threshold (pulmonary capillary wedge pressure ≥25 mm Hg) currently used during exercise testing to diagnose abnormal left ventricular filling pressure was measured in 30{\%} of our healthy elderly participants. Conclusions Cardiac aging was progressive without sex differences in healthy participants. The hemodynamic reference values obtained suggest that the diagnostic threshold for abnormal filling pressure should be individually determined according to age of the patient.",
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The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals. / Wolsk, Emil; Bakkestrøm, Rine; Thomsen, Jacob H.; Balling, Louise; Andersen, Mads J.; Dahl, Jordi S.; Hassager, Christian; Møller, Jakob E.; Gustafsson, Finn.

In: JACC: Heart Failure, Vol. 5, No. 5, 01.05.2017, p. 337-346.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

AU - Wolsk, Emil

AU - Bakkestrøm, Rine

AU - Thomsen, Jacob H.

AU - Balling, Louise

AU - Andersen, Mads J.

AU - Dahl, Jordi S.

AU - Hassager, Christian

AU - Møller, Jakob E.

AU - Gustafsson, Finn

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objectives In this study, the authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. Background At present, the influence of age on hemodynamic function is largely unknown. Because many diseases with proposed cardiac impact are more prevalent in the older population, it is pivotal to know how hemodynamic parameters are affected by age itself to discern the influence of disease from that of physiological aging. Methods Sixty-two healthy participants, evenly distributed with respect to age (20 to 80 years) and sex (32 women/30 men), were prospectively enrolled in the study. Participants were all deemed healthy by medical history, echocardiography, exercise test, spirometry, blood tests, and electrocardiogram. Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. Results During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise, there was augmented filling pressure (p < 0.0001) and diminished cardiac output (p = 0.001) and hence a higher pressure:flow ratio (pulmonary artery pressure/capillary wedge pressure to cardiac output) with progressive age, evident from the earliest ages. All indexed hemodynamic measures were similar between sexes. The diagnostic threshold (pulmonary capillary wedge pressure ≥25 mm Hg) currently used during exercise testing to diagnose abnormal left ventricular filling pressure was measured in 30% of our healthy elderly participants. Conclusions Cardiac aging was progressive without sex differences in healthy participants. The hemodynamic reference values obtained suggest that the diagnostic threshold for abnormal filling pressure should be individually determined according to age of the patient.

AB - Objectives In this study, the authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. Background At present, the influence of age on hemodynamic function is largely unknown. Because many diseases with proposed cardiac impact are more prevalent in the older population, it is pivotal to know how hemodynamic parameters are affected by age itself to discern the influence of disease from that of physiological aging. Methods Sixty-two healthy participants, evenly distributed with respect to age (20 to 80 years) and sex (32 women/30 men), were prospectively enrolled in the study. Participants were all deemed healthy by medical history, echocardiography, exercise test, spirometry, blood tests, and electrocardiogram. Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. Results During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise, there was augmented filling pressure (p < 0.0001) and diminished cardiac output (p = 0.001) and hence a higher pressure:flow ratio (pulmonary artery pressure/capillary wedge pressure to cardiac output) with progressive age, evident from the earliest ages. All indexed hemodynamic measures were similar between sexes. The diagnostic threshold (pulmonary capillary wedge pressure ≥25 mm Hg) currently used during exercise testing to diagnose abnormal left ventricular filling pressure was measured in 30% of our healthy elderly participants. Conclusions Cardiac aging was progressive without sex differences in healthy participants. The hemodynamic reference values obtained suggest that the diagnostic threshold for abnormal filling pressure should be individually determined according to age of the patient.

KW - aging

KW - catheterization

KW - exercise

KW - healthy

KW - hemodynamics

KW - sex

U2 - 10.1016/j.jchf.2016.10.012

DO - 10.1016/j.jchf.2016.10.012

M3 - Journal article

C2 - 28017352

AN - SCOPUS:85010696864

VL - 5

SP - 337

EP - 346

JO - J A C C: Heart Failure

JF - J A C C: Heart Failure

SN - 2213-1779

IS - 5

ER -