DOI: 10.1161/jaha.124.036107 ISSN: 2047-9980

Aerobic Training Attenuates Differences Between Black and White Adults in Left Ventricular–Vascular Coupling and Wasted Pressure Effort

João L. Marôco, Abbi D. Lane, Sushant M. Ranadive, Huimin Yan, Tracy Baynard, Bo Fernhall
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Background

Black compared with White adults have a higher risk for left‐ventricular hypertrophy and heart failure possibly due to the early onset of alterations in ventricular–vascular coupling (ie, arterial [ E a ] to ventricular elastance [ E es ] ratio) and wasted pressure effort ( E w ). Aerobic training preserves the coupling ratio ( E a / E es ) and attenuates E w , but whether this applies to Black adults is unknown. We hypothesized that Black rather than White adults would have greater training‐induced improvements in the E a / E es and E w .

Methods and Results

Fifty‐four young adults with normal blood pressure (Black=24 [58% female]; White=30 [47% female], mean=24 years; SD=5 years) completed an 8‐week aerobic training (3 times/week, 65%–85% peak oxygen uptake). E a / E es was estimated via echocardiography and scaled to body surface area, and the E w was estimated from pulse contour analysis. Black adults had lower E a / E es (difference ( d )=0.49 [95% CI, 0.14–0.84 mm Hg/mL], P =0.007) and higher E w ( d =1127 [95% CI, 104–2007 dyne cm −2  s], P =0.005). Both groups exhibited similar (race‐by‐training interaction, P =0.986) training‐induced reductions in scaled E a ( d =−0.11 [95% CI, −0.18 to −0.04 mm Hg/mL], P <0.001). Only in White adults, scaled E es increased ( d white =0.39 [95% CI, 0.11–0.32 mm Hg/mL], P =0.003) and E a / E es was reduced ( d white =−0.16 [95% CI, −0.33 to −0.18 mm Hg/mL/m 2 ], P <0.001). Conversely, only Black adults exhibited reductions in E w after training ( d black =−699 [95% CI, −1209 to −189 dyne cm −2  s], P =0.008).

Conclusions

Aerobic training‐induced differential effects on E a / E es and E w of White and Black young adults hold the potential to reduce racial disparities. This warrants confirmation in a larger sample.

Registration

URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01024634.

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