Effect of Sex and Sporting Discipline on LV Adaptation to Exercise

Finocchiaro, Gherardo; Dhutia, Harshil; D’Silva, Andrew; Malhotra, Aneil; Steriotis, Alexandros; Millar, Lynne; Prakash, Keerthi; Narain, Rajay; Papadakis, Michael; Sharma, Rajan; Sharma, Sanjay

doi:10.1016/j.jcmg.2016.08.011

Cited by 146 publications

(130 citation statements)

References 27 publications

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“…Although like Utomi et al, 3 the majority of our EC cohort presented with normal LV geometry, a greater proportion of our cohort presented with eccentric hypertrophy (34% compared to 30%). These differences may be due to the sporting disciplines represented by the endurance‐trained cohort of Utomi et al, 3 as the influence of static (% maximal voluntary contraction) demands of highly dynamic sports on adaptation of LV geometry has previously been highlighted 2,36 . As previously demonstrated in other sporting disciplines, concentric hypertrophy was rare in EC (4%) 18 …”

Section: Discussionmentioning

confidence: 85%

Left ventricular remodeling in elite and sub‐elite road cyclists

Brown

Millar

Somauroo

et al. 2020

Scandinavian Med Sci Sports

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Marked adaptation of left ventricular (LV) structure in endurance athletes is well established. However, previous investigations of functional and mechanical adaptation have been contradictory. A lack of clarity in subjects’ athletic performance level may have contributed to these disparate findings. This study aimed to describe structural, functional, and mechanical characteristics of the cyclists’ LV, based on clearly defined performance levels. Male elite cyclists (EC) (n = 69), sub‐elite cyclists (SEC) (n = 30), and non‐athletes (NA) (n = 46) were comparatively studied using conventional and speckle tracking 2D echocardiography. Dilated eccentric hypertrophy was common in EC (34.7%), but not SEC (3.3%). Chamber concentricity was higher in EC compared to SEC (7.11 ± 1.08 vs 5.85 ± 0.98 g/(mL)2/3, P < .001). Ejection fraction (EF) was lower in EC compared to NA (57 ± 5% vs 59 ± 4%, P < .05), and reduced EF was observed in a greater proportion of EC (11.6%) compared to SEC (6.7%). Global circumferential strain (GCε) was greater in EC (−18.4 ± 2.4%) and SEC (−19.8 ± 2.7%) compared to NA (−17.2 ± 2.6%) (P < .05 and P < .001). Early diastolic filling was lower in EC compared with SEC (0.72 ± 0.14 vs 0.88 ± 0.12 cm/s, P < .001), as were septal E’ (12 ± 2 vs 15 ± 2 cm/s, P < .001) and lateral E’ (18 ± 4 vs 20 ± 4 cm/s, P < .05). The magnitude of LV structural adaptation was far greater in EC compared with SEC. Increased GCε may represent a compensatory mechanism to maintain stroke volume in the presence of increased chamber volume. Decreased E and E’ velocities may be indicative of a considerable functional reserve in EC.

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Section: Discussionmentioning

confidence: 85%

Left ventricular remodeling in elite and sub‐elite road cyclists

Brown

Millar

Somauroo

et al. 2020

Scandinavian Med Sci Sports

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“…Subsequently, many reports have emerged showing that females do indeed undergo exercise-induced growth, especially when adjusted for body mass (George et al, 1999; George et al, 1995; Maron, 2009). A recent echocardiographic analysis of over 1,000 elite athletes stratified male and female athletes by type of exercise (Finocchiaro et al, 2016). In this comprehensive assessment of cardiac adaptation, the study demonstrated increased chamber dimensions in female athletes compared to male counterparts, only when adjusted for body surface area.…”

Section: Sex Dimorphisms In Cardiac Adaptation To Exercisementioning

confidence: 99%

“…The suggestion is that a greater percentage of female athletes undergoing dynamic training exhibit eccentric cardiac growth compared to male athletes. Further, female athletes rarely demonstrate concentric cardiac growth (Finocchiaro et al, 2016). …”

Section: Sex Dimorphisms In Cardiac Adaptation To Exercisementioning

confidence: 99%

Molecular Mechanisms Underlying Cardiac Adaptation to Exercise

et al. 2017

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Exercise elicits coordinated multi-organ responses including skeletal muscle, vasculature, heart and lung. In the short term, the output of the heart increases to meet the demand of strenuous exercise. Long term exercise instigates remodeling of the heart including growth and adaptive molecular and cellular re-programming. Signaling pathways such as the insulin-like growth factor 1/PI3K/Akt pathway mediate many of these responses. Exercise-induced, or physiologic, cardiac growth contrasts with growth elicited by pathological stimuli such as hypertension. Comparing the molecular and cellular underpinnings of physiologic and pathologic cardiac growth has unveiled phenotype-specific signaling pathways and transcriptional regulatory programs. Studies suggest that exercise pathways likely antagonize pathological pathways, and exercise training is often recommended for patients with chronic stable heart failure or following myocardial infarction. Herein, we summarize the current understanding of the structural and functional cardiac responses to exercise as well as signaling pathways and downstream effector molecules responsible for these adaptations.

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“…36,37 Physiological myocardial adaptation induced by exercise training in athletes is dependent on genetics, family history of hypertension, gender, body composition and exercise volume as well as exercise blood pressure. 30,[38][39][40][41][42] However, the role of exercise blood pressure on myocardial adaptations has been less appreciated in athletes. 39,40 According to the currently presented and previously published data 1,3 this will have to be followed more closely and investigated in detail.…”

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confidence: 99%