Abstract

To determine the effect of plasma volume change with short-term training and diuresis on left ventricular diastolic filling and exercise oxygen uptake (VO(2)) in older versus younger men. Eleven older (68 +/- 5 y) physically active (maximal oxygen uptake [VO(2max)] = 25.9 +/- 3.6 mL. kg-1. min-1) and 10 younger sedentary males (24 +/- 5 y, VO(2max) 40.5 +/- 5.0 mL. kg-1. min-1) were randomly assigned to 5 consecutive days of (1) 1 h/d high intensity stationary cycling (EXER); (2) 100 mg/d spironolactone (DIUR); and (3) exercise and diuretic (EXDI). Each treatment was separated by a 21-day washout. Doppler echocardiographic indices of left ventricular diastolic filling including peak early and atrial transmitral flow velocity and isovolumic relaxation time; percent change in plasma volume; submaximal VO(2) kinetics; and VO(2max) were determined at baseline and 48 hours after each treatment. Plasma volume was increased more in the young following EXER (8.92 +/- 7.6 vs. 6.2%, P = 0.038) and decreased more in the older group following DIUR (-11.5% vs. -3.54 +/- 9.0, P < 0.001). There was no significant difference between groups after EXDI. Significant changes in peak early flow velocity with EXER in older subjects were not reflected in any other changes in left ventricular diastolic filling across conditions. No changes in left ventricular diastolic filling were observed in the young group with any condition. VO(2max) and VO(2) kinetics were unchanged under all conditions from baseline in both groups. These results suggest that exercise VO(2) responses either at maximal or submaximal workrates are not limited by alterations in left ventricular pump function in physically fit older adults.

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