Depressed Systolic and Diastolic Cardiac Function after Prolonged Aerobic Exercise in Healthy Subjects

Ketelhut, Reinhard G.; Losem, C J; Messerli, F. H.

doi:10.1055/s-2007-1021269

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…In contrast with previous reports [1][2][3][20][21][22][23], our study did not show any significant change in systolic function after both competitions as well as in between the two races. Additionally, cardiac enzymes were within normal values after both races, confirming that no myocardial damage occurred in any athlete, as outlined by a previous study [24].…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies have shown that trained athletes may develop different degrees of systolic and diastolic dysfunction following strenuous exercise [1][2][3][20][21][22][23]. These studies, which employed two-dimensional Doppler echocardiography, have shown transient left ventricular systolic and diastolic dysfunctions soon after prolonged exercise.…”

Section: Discussionmentioning

confidence: 99%

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Transient cardiac left ventricular diastolic dysfunction following strenuous exercise

Fragasso

Palloshi

Roi³

et al. 2004

Sport Sci Health

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The long term clinical significance of exerciseinduced "cardiac fatigue" has not been clearly addressed. The aim of this study was to assess the effects of repetitive competitive high altitude running on left ventricular performance. Eleven athletes were studied before and after two high altitude races in two consecutive years. On both occasions 12-lead elettrocardiography (ECG) as well as Doppler echocardiography were performed 24 hours before, shortly after (within 30 min) and 24 hours after the end of the race. Measurements included ejection fraction, early (E) and late (A) transmitral inflow velocities, their ratio (E/A) and percent atrial contribution (AC). Similar studies were performed in 11 age-and sex-matched control subjects at baseline and following a maximal exercise test. Ejection fraction remained stable in both. Conversely, Doppler E/A ratio significantly decreased in atletes early after the race from 1.9±0.1 to 1.3±0.1 (p<0.05) for the first race and from 1.7±0.1 to 1.4±0.1 (p<0.05) for the second race. The decrease was mainly due to a reduction in E (p<0.05), since A was not modified. AC increased from 20%±3% to 28%±5% (p<0.05) and from 21%±3% to 26%±6% (p<0.05), respectively. All parameters returned to baseline at a 24-hour control. Compared to controls, all athletes had significantly higher resting E and A velocities and lower E/A ratio and AC to ventricular filling shortly after exercising. All parameters returned to baseline at the 24-hour controls. These findings are consistent with previous studies reporting transient cardiac fatigue following strenuous exercise. However, the functional effects of these changes do not seem to interfere with cardiac function and athletic performance in both the short term and mediumlong term.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transient cardiac left ventricular diastolic dysfunction following strenuous exercise

Fragasso

Palloshi

Roi³

et al. 2004

Sport Sci Health

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“…Distance/duration Measurement technique Timing of measurement Position/recovery or exercise data Observations Douglas et al [11] Ironman Triathlon 2D echo 3-19 min post-exercise Supine/recovery EF, FS (segmental) Douglas et al [12] Ironman Triathlon Doppler echo 20 min post-exercise Supine/recovery EDD Douglas et al [10] Ironman Triathlon Doppler echo 3-23 min post-exercise Supine/recovery EDD, FS, Ketelhut et al [13,17] 60 min cycling M-mode echo Immediately after 5 min and 60 min of exercise Supine/exercise SV, Q, EF, FS ; ESD Lucı! a et al [21] Marathon (42 km) M-mode and Doppler echo Immediately before and after exercise, and after 24-36 h of recovery Supine/recovery EF, mV CF during recovery (vs. preexercise) ; E/A ratio Niemela$ et al [8] 24 h run M-mode echo Immediately to 25 min postexercise Supine/recovery EDD, ESD, FS, mV CF Niemela$ et al [9] 24 h run M-mode echo Immediately post-exercise Supine/recovery FS, DFR, EDD, Palatini et al [20] 50 min cycling M-mode echo During exercise at 10 min intervals [4][5][6].…”

Section: Studymentioning

confidence: 99%

“…It remains unclear if LV dysfunction during such activity contributes to the decrease in stroke volume. Some investigations have described an impairment of LV function following exercise of a prolonged nature [8][9][10][11][12][13][14][15]. It is possible that a decline in ventricular output involves a depression in the contractile state ; however, despite reports of a transient decline in systolic function [8][9][10][11][12][13][14]16,17] and diastolic filling characteristics [9,13,16], several studies have failed to report a decline in LV performance [18][19][20][21].…”

Section: Studymentioning

confidence: 99%

Left ventricular performance during prolonged exercise: absence of systolic dysfunction

2001

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We assessed left ventricular systolic and diastolic performance during and after prolonged exercise under controlled conditions in a group of healthy, trained men. Previous studies have examined the effects of prolonged effort on left ventricular function, yet it remains unclear whether or not left ventricular dysfunction (e.g. cardiac fatigue) can be produced under such conditions. We studied 15 healthy men, aged 27+/-1 years (mean+/-S.E.M.). Subjects exercised on bicycles at a constant work rate (60% of maximum oxygen uptake per min) for 150 min. Measurements of gas exchange, blood pressure and haematocrit were obtained, concurrent with the assessment of left ventricular function using equilibrium radionuclide angiography, at rest, during exercise (every 30 min) and after 30 min of recovery. Fluid replacement was provided and monitored during the exercise period. The baseline resting and exercise ejection fractions were 66+/-2% and 78+/-2% respectively. During exercise, subjects consumed 1816+/-136 ml of fluid, and the haematocrit had increased at 120 min of exercise (from 47.2%+/-0.6 to 49.9+/-0.8%; P<0.05). There was no change in either systolic or diastolic blood pressure throughout the exercise period, but heart rate drifted upwards from 141+/-2 beats/min after 30 min to 154+/-3 beats/min after 150 min (P<0.05). There was a small decline (8%; P<0.05) in end-diastolic volume at 150 min. No changes were observed in left ventricular ejection fraction, the pressure/volume ratio or end-systolic volume. After 30 min of sitting in recovery, heart rate was still higher than the pre-exercise value (84+/-3 compared with 69+/-2 beats/min; P<0.05), as were measures of peak filling rate and time to peak filling (P<0.05). The ejection fraction in the post-exercise recovery period was similar to the pre-exercise value. The results indicate that prolonged exercise of moderate duration may not induce abnormal left ventricular systolic function or cardiac fatigue during exercise.

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“…The EICF is found in both well trained (Douglas et al 1987;Whyte et al 2000) and untrained subjects (Seals et al 1988;Vanoverschelde et al 1991;Ketelhut et al 1992Ketelhut et al , 1994Palatini et al 1994), but subjects of disparate training background within the same experimental design have not been compared. This study evaluated whether the continued increase in HR during prolonged exercise becomes manifested in response to altered preload to the heart or to EICF and/or myocardial damage as indicated by serum cTnT in healthy young males encompassing a range of maximal oxygen uptake ( _ V O 2maz ).…”

Section: Introductionmentioning

confidence: 99%

Cardiac drift during prolonged exercise with echocardiographic evidence of reduced diastolic function of the heart

et al. 2005

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This study examined whether, in 16 male subjects, a continuous increase in heart rate (HR) during 4 h of ergometry cycling relates to cardiac fatigue or cardiomyocyte damage. Serum cardiac troponin T (cTnT) was determined and echocardiographic assessment was carried out prior to and after 2 h of exercise, within 15 min of completing exercise and after 24 h. Left ventricular contractile function (end-systolic blood pressure-volume relationship [SBP/ESV]) and diastolic filling (ratio of early to late peak left ventricular filling velocities [E:A]) were calculated. During exercise HR was 132+/-5 beats min(-1) after 2 h and increased to 141+/-5 beats min(-1) (mean +/- SD; P<0.05), but there was no evidence of altered LV contractile function (SBP/ESV 39.0+/-5.1 mmHg cm(-1) to 36.5+/-5.2 mmHg cm(-1) and SBP/ESV was not correlated to maximal oxygen uptake (r(2)=0.363). In contrast, E:A decreased (1.82+/-0.32 to 1.48+/-0.30; P<0.05) and returned towards baseline after 24 h (1.78+/-0.28), and individual changes were correlated to maximal oxygen uptake (r(2)=0.61; P<0.05). Low levels of cTnT were detected in two subjects after 4 h of exercise that had normalised by 24 h of recovery. During prolonged exercise cardiovascular drift occurred with echocardiographic signs of a reduced diastolic function of the heart, especially in those subjects with a high maximal oxygen uptake.

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Depressed Systolic and Diastolic Cardiac Function after Prolonged Aerobic Exercise in Healthy Subjects

Cited by 20 publications

References 11 publications

Transient cardiac left ventricular diastolic dysfunction following strenuous exercise

Transient cardiac left ventricular diastolic dysfunction following strenuous exercise

Left ventricular performance during prolonged exercise: absence of systolic dysfunction

Cardiac drift during prolonged exercise with echocardiographic evidence of reduced diastolic function of the heart

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