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

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/m²], 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.​clini​caltr​ials.​gov; Unique identifier: NCT01024634.