Persistent and reversible cardiac dysfunction among amateur marathon runners

Neilan, Tomas G.; Yoerger, Danita M.; Douglas, Pamela S.; Marshall, Jane E.; Halpern, Elkan F.; Lawlor, David; Picard, Michael H.; Wood, Malissa J.

doi:10.1093/eurheartj/ehi813

Cited by 175 publications

(162 citation statements)

References 28 publications

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“…Normal values and measurement variability data for this imaging modality have recently been published (18,42). Several recent studies have characterized resting LV strain and the impact of a single exercise session on LV strain in trained athletes (32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

The impact of endurance exercise training on left ventricular systolic mechanics

Baggish¹,

Yared²,

Wang³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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118

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Although exercise training-induced changes in left ventricular (LV) structure are well characterized, adaptive functional changes are incompletely understood. Detailed echocardiographic assessment of LV systolic function was performed on 20 competitive rowers (10 males and 10 females) before and after endurance exercise training (EET; 90 days, 10.7 Ϯ 1.1 h/wk). Structural changes included LV dilation (end-diastolic volume ϭ 128 Ϯ 25 vs. 144 Ϯ 28 ml, P Ͻ 0.001), right ventricular (RV) dilation (end-diastolic area ϭ 2,850 Ϯ 550 vs. 3,260 Ϯ 530 mm 2 , P Ͻ 0.001), and LV hypertrophy (mass ϭ 227 Ϯ 51 vs. 256 Ϯ 56 g, P Ͻ 0.001). Although LV ejection fraction was unchanged (62 Ϯ 3% vs. 60 Ϯ 3%, P ϭ not significant), all direct measures of LV systolic function were altered. Peak systolic tissue velocities increased significantly (basal lateral SЈ⌬ ϭ 0.9 Ϯ 0.6 cm/s, P ϭ 0.004; and basal septal SЈ⌬ ϭ 0.8 Ϯ 0.4 cm/s, P ϭ 0.008). Radial strain increased similarly in all segments, whereas longitudinal strain increased with a base-to-apex gradient. In contrast, circumferential strain (CS) increased in the LV free wall but decreased in regions adjacent to the RV. Reductions in septal CS correlated strongly with changes in RV structure (⌬RV end-diastolic area vs. ⌬LV septal CS; r 2 ϭ 0.898, P Ͻ 0.001) and function (⌬peak RV systolic velocity vs. ⌬LV septal CS, r 2 ϭ 0.697, P Ͻ 0.001). EET leads to significant changes in LV systolic function with regional heterogeneity that may be secondary to concomitant RV adaptation. These changes are not detected by conventional measurements such as ejection fraction.athlete's heart; left ventricle; strain; ventricular interdependence LEFT VENTRICULAR (LV) structural adaptation in response to aerobic endurance exercise training (EET) has been well characterized. Increases in LV chamber dimensions, wall thickness, and mass have been documented among individuals who participate in EET, and it is these structural attributes that underlie the concept of the "athlete's heart" (8,38,41). At the present time, the impact of EET on LV functional mechanics is less clear.Several reports demonstrate that EET results in enhanced LV diastolic function (3,23,31). In contrast, existing data suggest that LV systolic function is unchanged by EET (9,15,39). Previous studies examining the impact of EET on LV systolic function have relied on indexes such as ejection fraction or fractional area change that may lack the sensitivity to detect regional changes in myocardial function. Novel imaging techniques such as two-dimensional strain and tissueDoppler echocardiography are direct, more sensitive methods of assessing myocardial systolic function (13,14). To date, a prospective and longitudinal assessment of the impact of EET on LV systolic function using these techniques has not been conducted.We hypothesized that EET would result in enhanced resting LV contractility but that this adaptation would be underrepresented by conventional indexes of systolic function. To address this hypothesis, we performed a focused ...

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Section: Discussionmentioning

confidence: 99%

The impact of endurance exercise training on left ventricular systolic mechanics

Baggish¹,

Yared²,

Wang³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

Self Cite

118

View full text Add to dashboard Cite

show abstract

“…Cardiac function has also been assessed using echocardiography and a global decrease in both systolic and diastolic RV (Neilan et al, 2006;Poh et al, 2008) and LV (Banks et al, 2011;George et al, 2009) function in recovery from prolonged endurance exercise reported in conjunction with the acute structural adaptations. The right-sided ECG changes evident in the current study may represent an electrical adaptation linked to these structural and functional changes and provide further insight into the acute electrical adaptations in response to a bout of ultra-endurance exercise.…”

Section: Standard 12 Lead Ecgmentioning

confidence: 99%

Exploratory insights from the right‐sided electrocardiogram following prolonged endurance exercise

Lord

George

Somauroo

et al. 2016

European Journal of Sport Science

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“…Understanding ethnic differences and similarities is important for understanding cardiovascular disease experiences among Indigenous populations. Longitudinal strain is a correlate of LV contractility and indicates regional myocardial dysfunction and longitudinal and circumferential strains are prognostic of cardiovascular events and survival [43–45]. Further, elastance and arterial–ventricular coupling provide insight into the interaction between the arterial system and the LV, evaluating stroke work and energetic efficiency and providing indications of atherosclerotic heart disease [46].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular dynamics of Canadian Indigenous peoples

Foulds

Bredin

2018

International Journal of Circumpolar Health

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Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min−1∙L−1 vs. 15.36 ± 2.97 mmHg∙min−1∙L−1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL−1·m−2 vs. 0.55 ± 0.17 mmHg·mL−1·m−2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min−1∙L−1 vs. 13.93 ± 2.61 mmHg∙min−1∙L−1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

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Persistent and reversible cardiac dysfunction among amateur marathon runners

Abstract: Marathon running leads to transient systolic and more persistent diastolic dysfunction of both the LV and the RV.

Cited by 175 publications

References 28 publications

The impact of endurance exercise training on left ventricular systolic mechanics

The impact of endurance exercise training on left ventricular systolic mechanics

Exploratory insights from the right‐sided electrocardiogram following prolonged endurance exercise

Cardiovascular dynamics of Canadian Indigenous peoples

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