The effect of lifelong endurance exercise on cardiovascular structure and exercise function in women.
Level 4 - case-series / case-control
Cross-sectional comparative physiological study
PubMed 32347540 · doi:10.1113/JP278503
What was done
This retrospective, cross-sectional study evaluated 70 women across three groups: 35 older (>60 years) untrained women (OU), 13 older women who engaged in four or more endurance exercise sessions weekly for at least 25 years (OT), and 22 middle-aged (35–59 years) untrained women (MU) as an age-reference control. Investigators measured oxygen uptake (VO2) and cardiovascular function (cardiac output and stroke volume via acetylene rebreathing) at rest, submaximal exercise, and maximal exercise (VO2max). Blood volume (CO rebreathing), left ventricular (LV) mass (cardiac MRI), and invasive static and dynamic LV chamber compliance were also assessed.
What was found
Older trained women had higher VO2max (p < 0.001), maximal cardiac output (~17% higher vs. MU, ~40% higher vs. OU, all p < 0.001), and maximal stroke volume (~27% higher vs. MU, ~38% higher vs. OU, all p < 0.001). Blood volume (mL/kg) and LV mass index (g/m^2) were higher in OT versus OU (~11% and ~16%, respectively; both p <= 0.015). Static LV chamber compliance was greater in OT compared to both untrained groups (median [25–75%]: MU: 0.065 [0.049–0.080]; OU: 0.085 [0.061–0.138]; OT: 0.047 [0.031–0.054], p <= 0.053).
Why it matters
This study shows that lifelong committed endurance training preserves cardiac structure, LV compliance, and functional exercise capacity in aging women, mirroring patterns previously documented in men.
Limits
The study is constrained by a small sample size (n = 13 in the trained group) and a cross-sectional design that cannot determine causality or rule out healthy-survivor and self-selection biases. Historical exercise habits were assessed retrospectively.
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