Aortic compliance variation in long male distance triathletes: A new insight into the athlete’s artery?

Dupont, Anne-Charlotte; Poussel, Mathias; Hossu, Gabriela; Marie, Pierre-Yves; Chenuel, Bruno; Felblinger, Jacques; Mandry, Damien

doi:10.1016/j.jsams.2016.10.009

Cited by 13 publications

(14 citation statements)

References 28 publications

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“…As noted above, a meta-analysis showed a small but statistically significant difference in aortic size between young athletes and controls, and associations have been established between training duration and aortic size . In addition, there is evidence of differences in aortic function, specifically aortic stiffness and aortic distensibility, between trained and untrained individuals, and training interventions have been associated with improvements in distensibility and compliance . Our findings expand the evidence of aortic remodeling and suggest that the aorta responds to the hemodynamic stress of endurance sport with a temporal trajectory that is slower than that of the myocardium.…”

Section: Discussionsupporting

confidence: 79%

“…10 In addition, there is evidence of differences in aortic function, specifically aortic stiffness and aortic distensibility, between trained and untrained individuals, [33][34][35] and training interventions have been associated with improvements in distensibility and compliance. 36,37 Our findings expand the evidence of aortic remodeling and suggest that the aorta responds to the hemodynamic stress of endurance sport with a temporal trajectory that is slower than that of the myocardium. The physiology underlying endurance sport varies considerably across disciplines, and we therefore set an a priori hypothesis that aortic dimensions would differ among rowers and runners.…”

Section: Discussionsupporting

confidence: 72%

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Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

et al. 2020

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IMPORTANCE Aortic dilatation is frequently encountered in clinical practice among aging endurance athletes, but the distribution of aortic sizes in this population is unknown. It is additionally uncertain whether this may represent aortic adaptation to long-term exercise, similar to the well-established process of ventricular remodeling.OBJECTIVE To assess the prevalence of aortic dilatation among long-term masters-level male and female athletes with about 2 decades of exercise exposure. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study evaluated aortic size in veteran endurance athletes. Masters-level rowers and runners aged 50 to 75 years were enrolled from competitive athletic events across the United States from February to October 2018. Analysis began January 2019.EXPOSURES Long-term endurance exercise. MAIN OUTCOMES AND MEASURESThe primary outcome was aortic size at the sinuses of Valsalva and the ascending aorta, measured using transthoracic echocardiography in accordance with contemporary guidelines. Aortic dimensions were compared with age, sex, and body size-adjusted predictions from published nomograms, and z scores were calculated where applicable. RESULTS Among 442 athletes (mean [SD] age, 61 [6] years; 267 men [60%]; 228 rowers [52%]; 214 runners [48%]), clinically relevant aortic dilatation, defined by a diameter at sinuses of Valsalva or ascending aorta of 40 mm or larger, was found in 21% (n = 94) of all participants (83 men [31%] and 11 women [6%]). When compared with published nomograms, the distribution of measured aortic size displayed a rightward shift with a rightward tail (all P < .001). Overall, 105 individuals (24%) had at least 1 z score of 2 or more, indicating an aortic measurement greater than 2 SDs above the population mean. In multivariate models adjusting for age, sex, body size, hypertension, and statin use, both elite competitor status (rowing participation in world championships or Olympics or marathon time under 2 hours and 45 minutes) and sport type (rowing) were independently associated with aortic size. CONCLUSIONS AND RELEVANCEClinically relevant aortic dilatation is common among aging endurance athletes, raising the possibility of vascular remodeling in response to long-term exercise. Longitudinal follow-up is warranted to establish corollary clinical outcomes in this population.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 72%

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

et al. 2020

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“…It is well-known that chronic endurance training induces the eccentric remodeling (e.g., increased chamber size) and superior compliance characteristics of the LV (Levine et al, 1991 ; Pluim et al, 2000 ; Scharhag et al, 2002 ; Caselli et al, 2011 ; Tomoto et al, 2015 ). Previously, these cardiac adaptations with superior aortic compliance in endurance athletes were reported (Dupont et al, 2017 ). As stroke volume (SV) increases in response to an increase in the end-diastolic volume which synchronized with the venous return (Guyton and Hall, 2011 ), such individuals exhibit a greater increase in SV after volume loading.…”

Section: Introductionmentioning

confidence: 62%

Relationship between Aortic Compliance and Impact of Cerebral Blood Flow Fluctuation to Dynamic Orthostatic Challenge in Endurance Athletes

et al. 2018

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Aorta effectively buffers cardiac pulsatile fluctuation generated from the left ventricular (LV) which could be a mechanical force to high blood flow and low-resistance end-organs such as the brain. A dynamic orthostatic challenge may evoke substantial cardiac pulsatile fluctuation via the transient increases in venous return and stroke volume (SV). Particularly, this response may be greater in endurance-trained athletes (ET) who exhibit LV eccentric remodeling. The aim of this study was to determine the contribution of aortic compliance to the response of cerebral blood flow fluctuation to dynamic orthostatic challenge in ET and age-matched sedentary (SED) young healthy men. ET (n = 10) and SED (n = 10) underwent lower body negative pressure (LBNP) (−30 mmHg for 4 min) stimulation and release the pressure that initiates a rapid regain of limited venous return and consequent increase in SV. The recovery responses of central and middle cerebral arterial (MCA) hemodynamics from the release of LBNP (~15 s) were evaluated. SV (via Modeflow method) and pulsatile and systolic MCA (via transcranial Doppler) normalized by mean MCA velocity (MCAv) significantly increased after the cessation of LBNP in both groups. ET exhibited the higher ratio of SV to aortic pulse pressure (SV/AoPP), an index of aortic compliance, at the baseline compared with SED (P < 0.01). Following the LBNP release, SV was significantly increased in SED by 14 ± 7% (mean ± SD) and more in ET by 30 ± 15%; nevertheless, normalized pulsatile, systolic, and diastolic MCAv remained constant in both groups. These results might be attributed to the concomitant with the increase in aortic compliance assessed by SV/AoPP. Importantly, the increase in SV/AoPP following the LBNP release was greater in ET than in SED (P < 0.01), and significantly correlated with the baseline SV/AoPP (r = 0.636, P < 0.01). These results suggest that the aortic compliance in the endurance athletes is able to accommodate the additional SV and buffer the potential increase in pulsatility at end-organs such as the brain.

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“…Iliac arteries show some pulsatility even in atherosclerotic patients [21], but this pulsatility is usually not sufficient to induce motion artifacts at non-gated CTA. Because of the increased left ventricular stroke volume and increased arterial compliance associated with endurance training [22][23][24][25], we hypothesized that motion artifacts may occur in our patients' iliac arteries at non-gated CTA images. Therefore, we planned an analysis of motion artifacts after inclusion of the first five patients who were imaged without ECG gating.…”

Section: Discussionmentioning

confidence: 99%

Arterial endofibrosis in endurance athletes: Prospective comparison of the diagnostic accuracy of intra-arterial digital subtraction angiography and computed tomography angiography

Perrier¹,

Feugier²,

Goutain-Majorel³

et al. 2020

Diagnostic and Interventional Imaging

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Aortic compliance variation in long male distance triathletes: A new insight into the athlete’s artery?

Abstract: Using CMR, we showed that vascular characteristics of the ascending aorta may vary along the sport season in endurance athletes. This remodelling could be considered as a physiological adaptation, but could eventually lead to an adverse vascular remodelling.

Cited by 13 publications

References 28 publications

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes

Relationship between Aortic Compliance and Impact of Cerebral Blood Flow Fluctuation to Dynamic Orthostatic Challenge in Endurance Athletes

Arterial endofibrosis in endurance athletes: Prospective comparison of the diagnostic accuracy of intra-arterial digital subtraction angiography and computed tomography angiography

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