P012 THE EFFECT OF AGE AND LONG-TERM BLOOD PRESSURE CONTROL ON DIASTOLIC CARDIAC FUNCTION IN MASTERS ATHELETES

Abstract

Background & Objectives: Arterial hypertension and age underlie the risk for diastolic dysfunction and heart failure with preserved ejection fraction. Blood pressure control and physical exercise are known to ameliorate age related cardiac adaptation. Therefore, we assessed diastolic function including left atrial (LA) strains in Masters Athletes as a model for healthy ageing. Methods: At the World Masters Athletics Championships 2022 in Tampere, Finland 108 Masters Athletes partook in this field-study. Baseline data included body measures, blood pressure, age, sex and sport disciplines. Transthoracic echocardiography was performed analogous to clinical standards. Additionally, LA reservoir strain (LA-Sr) and conduit strain (LA-Scd) were assessed by speckle tracking. Results: Complete data were acquired in 108 (42, 39% female) athletes with a mean age of 62±12 (35-91) years and a body-mass-index of 23,8±2,8 kg/m2. Mean systolic blood pressure was 125±16mmHg, one third (n=36) had values ≥130mmHg. 29 performed endurance, 79 resistance disciplines. LA strain was not influenced by sport discipline nor blood pressure, neither in dichotomization for clinical thresholds nor in linear correlation. Female athletes showed higher LA reservoir and conduit strain (LA-Sr: 29.1±5.3% versus 27±5.5%, p=0.046; LA-Scd: 16.6±6% versus 13.9±5.4%, p=0,018). With increasing age, body-mass-index and left-ventricular-mass-index, LA reservoir and conduit strains declined significantly, independent of blood pressure. In Masters Athletes that did not meet echocardiographic criteria of diastolic dysfunction we found significantly higher LA reservoir and conduit strains than in those with 2 criteria met (LA-Sr 29.8±5.2% versus 25.4±6.6%, p=0.007; LA-Scd -17.3±6% versus -13.4±6.5%, p=0.030). Conclusion: In the specialized cohort of Masters Athletes LA reservoir and conduit strain showed the same dependency from age, body-mass-index and left-ventricular-mass-index as other parameters of diastolic function with higher values in females. Furthermore, impaired diastolic function was associated with decreased LA strain. Therefore, assessment of LA strain seems beneficial beyond classical echocardiographic measurements in determining diastolic function in the elderly. Surprisingly, long-term blood pressure control by physical exercise had no effect on LA strains.