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Abstract

Background

The decline in maximal oxygen consumption (VO_2max) with age seems to be exacerbated in endurance-trained athletes (EA) relative to untrained healthy subjects. Whether maximal cardiac output (Q_max) parallels this group-specific decline with age remains uncertain. Therefore, we sought to systematically review the literature and determine whether Q_max is similarly enhanced in EA across all ages relative to age-matched untrained counterparts.

Design and methods

We conducted a systematic search of MEDLINE, Cochrane and Web of Science from their inceptions until June 2014 for articles evaluating Q_max in athletes. A meta-analysis was performed to determine the standardized mean difference (SMD) in Q_max between EA and age-matched untrained healthy subjects. Included studies had to (i) comprise EA and control groups matched for body size or (ii) present Q_max values normalized for body size. Subgroup and meta-regression analyses were used to study the influence of age and potential moderating factors.

Results

Eighteen studies were selected after systematic review, comprising 268 EA and 232 age-matched untrained subjects. Nine studies involved young EA (mean age ≤40 years) while nine studies involved master EA (mean age >55 years). After data pooling, young and master EA groups showed higher Q_max compared with control groups (SMD = 1.49 and SMD = 1.68, respectively; both p < 0.0001). The SMD in Q_max between EA and control groups was similar in studies in young EA compared with studies in master EA (p = 0.61). Moreover, the SMD in VO_2max between EA and control groups did not differ in studies in young EA compared with studies in master EA (p = 0.37). In meta-regression analyses, the difference in percentage of body fat between EA and control groups was inversely associated with the SMD in Q_max (B = − 0.17, p = 0.01) and the SMD in VO_2max (B = −0.20, p = 0.01). Mean age was not associated with the SMD in Q_max (B = −0.001, P = 0.90) nor with the SMD in VO_2max (B = 0.01, P = 0.58).

Conclusions

Based on current published studies, the enhanced Q_max observed in EA compared with untrained healthy subjects matched for body size is not affected by age but may be related, at least in part, to the improved body composition of EA.

Keywords

Endurance training ageing maximal cardiac output maximal oxygen consumption

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References

Mitchell

Sproule

Chapman

. The physiological meaning of the maximal oxygen intake test. J Clin Invest 1958; 37: 538–547.

Blair

Kampert

Kohl

3rd . Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276: 205–210.

Levine

. VO_2max: What do we know, and what do we still need to know? J Physiol 2008; 586: 25–34.

Astrand

. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl 1960; 49: 1–92.

Fleg

Morrell

Bos

. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation 2005; 112: 674–682.

Robinson

. Experimental studies of physical fitness in relation to age. Arbeitsphysiologie 1938; 10: 251–323.

Dehn

Bruce

. Longitudinal variations in maximal oxygen intake with age and activity. J Appl Physiol 1972; 33: 805–807.

Kasch

Boyer

Van Camp

. Cardiovascular changes with age and exercise. A 28-year longitudinal study. Scand J Med Sci Sports 1995; 5: 147–151.

Rogers

Hagberg

Martin

3rd . Decline in VO_2max with aging in master athletes and sedentary men. J Appl Physiol (1985) 1990; 68: 2195–2199.

10.

Ogawa

Spina

Martin

3rd . Effects of aging, sex, and physical training on cardiovascular responses to exercise. Circulation 1992; 86: 494–503.

11.

Wilson

Tanaka

. Meta-analysis of the age-associated decline in maximal aerobic capacity in men: Relation to training status. Am J Physiol Heart Circ Physiol 2000; 278: H829–834.

12.

Rosen

Sorkin

Goldberg

. Predictors of age-associated decline in maximal aerobic capacity: A comparison of four statistical models. J Appl Physiol (1985) 1998; 84: 2163–2170.

13.

Pimentel

Gentile

Tanaka

. Greater rate of decline in maximal aerobic capacity with age in endurance-trained than in sedentary men. J Appl Physiol (1985) 2003; 94: 2406–2413.

14.

Tanaka

Desouza

Jones

. Greater rate of decline in maximal aerobic capacity with age in physically active vs. sedentary healthy women. J Appl Physiol (1985) 1997; 83: 1947–1953.

15.

Fitzgerald

Tanaka

Tran

. Age-related declines in maximal aerobic capacity in regularly exercising vs. sedentary women: A meta-analysis. J Appl Physiol (1985) 1997; 83: 160–165.

16.

Eskurza

Donato

Moreau

. Changes in maximal aerobic capacity with age in endurance-trained women: 7-yr follow-up. J Appl Physiol (1985) 2002; 92: 2303–2308.

17.

Katzel

Sorkin

Fleg

. A comparison of longitudinal changes in aerobic fitness in older endurance athletes and sedentary men. J Am Geriatr Soc 2001; 49: 1657–1664.

18.

Marti

Howald

. Long-term effects of physical training on aerobic capacity: Controlled study of former elite athletes. J Appl Physiol (1985) 1990; 69: 1451–1459.

19.

Bassett

Jr. Howley

. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc 2000; 32: 70–84.

20.

Saltin

Calbet

. Point: In health and in a normoxic environment, VO_2max is limited primarily by cardiac output and locomotor muscle blood flow. J Appl Physiol (1985) 2006; 100: 744–745.

21.

Gonzalez-Alonso

Calbet

. Reductions in systemic and skeletal muscle blood flow and oxygen delivery limit maximal aerobic capacity in humans. Circulation 2003; 107: 824–830.

22.

Krip

Gledhill

Jamnik

. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc 1997; 29: 1469–1476.

23.

Tanaka

Seals

. Invited review: Dynamic exercise performance in masters athletes: Insight into the effects of primary human aging on physiological functional capacity. J Appl Physiol (1985) 2003; 95: 2152–2162.

24.

Tanaka

Seals

. Endurance exercise performance in masters athletes: Age-associated changes and underlying physiological mechanisms. J Physiol 2008; 586: 55–63.

25.

Stroup

Berlin

Morton

. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283: 2008–2012.

26.

Ross

Grigoriadis

Mamisashvili

. Quality assessment of observational studies in psychiatry: An example from perinatal psychiatric research. Int J Methods Psychiatr Res 2011; 20: 224–234.

27.

Sprung

Atkinson

Cuthbertson

. Endothelial function measured using flow-mediated dilation in polycystic ovary syndrome: A meta-analysis of the observational studies. Clin Endocrinol 2013; 78: 438–446.

28.

Higgins JPT and Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane collaboration, 2011. Available from www.cochrane-handbook.org (accessed 25 August 2014).

29.

DerSimonian

Laird

. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177–188.

30.

Egger

Davey S mith

Schneider

. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.

31.

Roltsch

Brown

Hand

. No association between ACE I/D polymorphism and cardiovascular hemodynamics during exercise in young women. Int J Sports Med 2005; 26: 638–644.

32.

Carrick-Ranson

Hastings

Bhella

. The effect of lifelong exercise dose on cardiovascular function during exercise. J Appl Physiol 2014; 116: 736–745.

33.

Mollard

Woorons

Letournel

. Determinant factors of the decrease in aerobic performance in moderate acute hypoxia in women endurance athletes. Respir Physiol Neurobiol 2007; 159: 178–186.

34.

Mollard

Woorons

Letournel

. Determinants of maximal oxygen uptake in moderate acute hypoxia in endurance athletes. Eur J Appl Physiol 2007; 100: 663–673.

35.

Di Bello

Santoro

Talarico

. Left ventricular function during exercise in athletes and in sedentary men. Med Sci Sports Exerc 1996; 28: 190–196.

36.

Sagiv

Goldhammer

Ben-Sira

. What maintains energy supply at peak aerobic exercise in trained and untrained older men? Gerontology 2007; 53: 357–361.

37.

Hagberg

Goldberg

Lakatta

. Expanded blood volumes contribute to the increased cardiovascular performance of endurance-trained older men. J Appl Physiol 1998; 85: 484–489.

38.

Fleg

Schulman

O’Connor

. Cardiovascular responses to exhaustive upright cycle exercise in highly trained older men. J Appl Physiol 1994; 77: 1500–1506.

39.

Seals

Hagberg

Spina

. Enhanced left ventricular performance in endurance trained older men. Circulation 1994; 89: 198–205.

40.

Du Bois

. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 1989; 5: 303–311. discussion 312–313.

41.

Dogra

Spencer

Paterson

. Higher cardiorespiratory fitness in older trained women is due to preserved stroke volume. J Sports Sci Med 2012; 11: 745–750.

42.

McCole

Brown

Moore

. Enhanced cardiovascular hemodynamics in endurance-trained postmenopausal women athletes. Med Sci Sports Exerc 2000; 32: 1073–1079.

43.

La Gerche

Heidbuchel

Burns

. Disproportionate exercise load and remodeling of the athlete's right ventricle. Med Sci Sports Exerc 2011; 43: 974–981.

44.

Vinereanu

Florescu

Sculthorpe

. Left ventricular long-axis diastolic function is augmented in the hearts of endurance-trained compared with strength-trained athletes. Clin Sci 2002; 103: 249–257.

45.

Sprung

Atkinson

Cuthbertson

. Endothelial function measured using flow-mediated dilation in polycystic ovary syndrome: A meta-analysis of the observational studies. Clin Endocrinol (Oxf) 2013; 78: 438–446.

46.

Carrick-Ranson

Hastings

Bhella

. The effect of age-related differences in body size and composition on cardiovascular determinants of VO_2max. J Gerontol A Biol Sci Med Sci 2013; 68: 608–616.

47.

Klausen

Secher

Clausen

. Central and regional circulatory adaptations to one-leg training. J Appl Physiol Respir Environ Exerc Physiol 1982; 52: 976–983.

48.

Naylor

George

O’Driscoll

. The athlete’s heart: A contemporary appraisal of the ‘Morganroth hypothesis’. Sports Med 2008; 38: 69–90.

49.

Hunt

Davy

Jones

. Role of central circulatory factors in the fat-free mass-maximal aerobic capacity relation across age. Am J Physiol 1998; 275: H1178–1182.

50.

Turley

Stanforth

Rankinen

. Scaling submaximal exercise cardiac output and stroke volume: The heritage family study. Int J Sports Med 2006; 27: 993–999.

51.

Nytroen

Rustad

Gude

. Muscular exercise capacity and body fat predict VO(2peak) in heart transplant recipients. Eur J Prev Cardiol 2014; 21: 21–29.

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Maximal cardiac output in athletes: Influence of age

Abstract

Background

Design and methods

Results

Conclusions

Keywords

Get full access to this article

References

Supplementary Material