Document Detail


The pulmonary circulation and exercise responses in the elderly.
MedLine Citation:
PMID:  20941654     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aging is associated with a progressive deterioration in the structure and function of the pulmonary circulation. Remodeling of the pulmonary vasculature occurs from maturity to senescence that is characterized by an increase in pulmonary vascular stiffness, pulmonary vascular pressures, and pulmonary vascular resistance along with increased heterogeneity of alveolar ventilation and pulmonary perfusion and decreased pulmonary capillary blood volume and membrane diffusing capacity that is consistent with a reduction in alveolar-capillary surface area. In theory, the aforementioned age-related changes in the pulmonary circulation may conspire to make elderly individuals more susceptible to gas exchange abnormalities during exercise. However, despite the erosion in ventilatory reserve with aging, the healthy older adult appears able to maintain alveolar ventilation at a level that allows maintenance of arterial blood gases within normal limits, even during heavy exercise. This ability to maintain adequate gas exchange likely occurs because age-related reductions in the maximal metabolic demand of exercise occur at a rate equal to or greater than the rate of deterioration in ventilatory reserve. A more prominent aspect of aging is the loss of lung elastic recoil that is associated with a modest reduction in the expiratory boundary of the maximal flow-volume envelope. This in turn increases the severity of expiratory airflow limitation and induces dynamic lung hyperinflation during exercise. The consequences of this age-associated decrease in elastic recoil on the pulmonary circulation are speculative, but an age-associated decline in elastic recoil may influence pulmonary vascular resistance and cardiac output, in addition to its impact on the work and oxygen cost of breathing.
Authors:
Bryan J Taylor; Bruce D Johnson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2010-10-12
Journal Detail:
Title:  Seminars in respiratory and critical care medicine     Volume:  31     ISSN:  1098-9048     ISO Abbreviation:  Semin Respir Crit Care Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-13     Completed Date:  2011-02-14     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  9431858     Medline TA:  Semin Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  528-38     Citation Subset:  IM    
Copyright Information:
© Thieme Medical Publishers.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aging / physiology
Exercise / physiology*
Exercise Tolerance / physiology
Heart Failure / etiology
Humans
Lung / physiology*
Pulmonary Circulation / physiology*
Pulmonary Gas Exchange / physiology
Pulmonary Ventilation / physiology
Grant Support
ID/Acronym/Agency:
HL71478/HL/NHLBI NIH HHS; R01 HL071478/HL/NHLBI NIH HHS
Comments/Corrections

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