Right ventricular myocardial performance index and exercise capacity in athletes

Kaşıkçıoğlu, Erdem; Oflaz, Hüseyin; Akhan, Hulya; Kayserilioğlu, Abidin

doi:10.1007/s00380-005-0824-x

Cited by 30 publications

(24 citation statements)

References 32 publications

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“…Observational studies of young male endurance athletes have shown a balanced physiologic hypertrophy of the RV and LV in response to high levels of training (2)(3)(4)(5)(6). The two studies that used MRI included 44 athletes and 31 control subjects (mean age, 25 yr) and found a 22 to 37% increase in RV mass and a 3 to 25% increase in RVEDV in athletes compared with control subjects (3,4).…”

Section: Discussionmentioning

confidence: 99%

“…The small number of studies performed have shown significant effects of intense exercise on RV mass and volumes (3)(4)(5)(6). However, because RV structure and function are difficult to measure with standard transthoracic echocardiography, little is known about the relationship between physical activity and RV structure and function in large cohorts of adults who are not elite athletes.…”

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confidence: 99%

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Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

Aaron¹,

Tandri²,

Barr³

et al. 2009

C27. Right Ventricular Function and Exercise

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Rationale: Intense exercise in elite athletes is associated with increased left ventricular (LV) and right ventricular (RV) mass and volumes. However, the effect of physical activity on the RV in an older community-based population is unknown. Objectives: We studied the association between levels of physical activity in adults and RV mass and volumes. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac magnetic resonance imaging on community-based participants without clinical cardiovascular disease. RV volumes were determined from manually contoured endocardial margins. RV mass was determined from the difference between epicardial and endocardial volumes multiplied by the specific gravity of myocardium. Metabolic equivalent-minutes/day were calculated from the selfreported frequency, duration, and intensity of physical activity. Measurements and Main Results: The study sample (n 5 1,867) was aged 61.8 6 10 years, 48% male, 44% white, 27% African American, 20% Hispanic, and 9% Chinese. Higher levels of moderate and vigorous physical activity were linearly associated with higher RV mass (P 5 0.02) after adjusting for demographics, anthropometrics, smoking, cholesterol, diabetes mellitus, hypertension, and LV mass. Higher levels of intentional exercise (physical activity done for the sole purpose of conditioning or fitness) were nonlinearly associated with RV mass independent of LV mass (P 5 0.03). There were similar associations between higher levels of physical activity and larger RV volumes. Conclusions: Higher levels of physical activity in adults were associated with greater RV mass independent of the associations with LV mass; similar results were found for RV volumes. Exercise-associated RV remodeling may have important clinical implications.Keywords: exercise; pulmonary heart disease; pulmonary hypertension; magnetic resonance imaging Physical activity has many physiologic effects on the cardiovascular system, both acutely and chronically. Exercise acutely raises cardiac output through tachycardia, augmented stroke volume, and increased ejection fraction (1). Systemic and pulmonary arterial pressures increase and vascular resistances decrease. Long-term high-intensity physical activity is associated with increased left ventricle (LV) mass, volume, and wall thickness (2-6), a constellation of changes known as the ''athlete's heart.'' Most studies of the cardiac effects of physical activity focus on LV morphology in small cohorts of young male endurance athletes.The substantial differences in embryology, morphology, perfusion, workload, and downstream vascular beds (and the diseases which affect them) make extrapolation of findings from the LV to the right ventricle (RV) difficult. The small number of studies performed have shown significant effects of intense exercise on RV mass and volumes (3-6). However, because RV structure and function are difficult to measure with standard transthoracic echocardiography, little is known about the relationship between physical activity and RV str...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

Aaron¹,

Tandri²,

Barr³

et al. 2009

C27. Right Ventricular Function and Exercise

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“…The athlete's right ventricle. A number of echocardiographic studies have assessed right ventricular geometry and function in both male and female athletes (7)(8)(9)(10). The definition of the RV's complex structure is far superior using CMR.…”

Section: Figure 1 Important Domains Of Study In Athlete's Heartmentioning

confidence: 99%

“…D'Andrea et al (64) reported supra-normal RV free wall myocardial systolic velocities and Kasikcioglu et al (10) reported enhanced RV myocardial performance index values in athletes when compared with control patients. It may be concluded, therefore, that although athletes may have impaired RV function immediately after intense endurance exercise and in the context of ventricular arrhythmias, healthy athletes, at rest, should have RV functional measures that are at least as good as the nonathletic population.…”

Section: A Young Athlete With Hypertrophic Cardiomyopathymentioning

confidence: 99%

Athlete's Heart: The Potential for Multimodality Imaging to Address the Critical Remaining Questions

Gerche

Taylor

Prior

2009

JACC: Cardiovascular Imaging

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Moderate exercise is a powerful therapy in the treatment and prevention of cardiac disease, but intense habitual exercise leads to cardiac adaptations for which the prognostic benefits are less clear. The athlete's heart syndrome refers to the morphological and electrical remodeling which occurs to varying extents dependent upon the sporting discipline. Its accurate differentiation from pathological entities is critical. This review describes the role multi-modality imaging serves in determining the limitations and consequences of intense exercise. Tissue characterization and imaging studies during exercise are emphasized as important future directions of inquiry with the potential to address remaining controversies.

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“…We therefore did not investigate the effect of strength training or high intensity training, both of which have been advocated as alternatives for dynamic aerobic training in acquired heart disease. 24,25 We measured the echocardiographic parameters at rest. Ideally, we would have presented echocardiographic parameters before and after the intervention measured during exercise.…”

Section: Limitationsmentioning

confidence: 99%

Regional Ventricular Performance and Exercise Training in Children and Young Adults After Repair of Tetralogy of Fallot

Duppen

Geerdink

Kuipers

et al. 2015

Circ: Cardiovascular Imaging

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Background-Public-health guidelines recommend patients with congenital heart disease to exercise. Studies have shown that patients with congenital heart disease can improve physical exercise capacity. The effect of training on regional ventricular performance has hardly been studied. We performed a pilot study to assess whether an exercise training program would result in adverse changes of regional ventricular performance in patients with corrected tetralogy of Fallot. Methods and Results-Multicenter prospective randomized controlled pilot study in patients with tetralogy of Fallot aged 10 to 25 years. A 12-week standardized aerobic dynamic exercise training program (3 one-hour sessions per week) was used. Pre-and post-training cardiopulmonary exercise tests, MRI, and echocardiography, including tissue-Doppler imaging, were performed. Patients were randomized to the exercise group (n=28) or control group (n=20). One patient in the exercise group dropped out. Change in tissue-Doppler imaging parameters was similar in the exercise group and control group (change in right ventricle free wall peak velocity E′ exercise group, 0.8±2.6 cm/s; control group, 0.9±4.1; peak velocity A′ exercise group, 0.4±2.4 m/s; control group 4.6±18.1 cm/s). Conclusions-This randomized controlled pilot study provides preliminary data suggesting that regional ventricular performance is well maintained during 3-month aerobic dynamic exercise training in children and young adults with repaired tetralogy of Fallot. This information might help patients adhere to current public-health guidelines. Clinical Trial Registration-URL: http//:www.trialregister.nl. Unique identifier: NTR2731.

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Right ventricular myocardial performance index and exercise capacity in athletes

Cited by 30 publications

References 32 publications

Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

Athlete's Heart: The Potential for Multimodality Imaging to Address the Critical Remaining Questions

Regional Ventricular Performance and Exercise Training in Children and Young Adults After Repair of Tetralogy of Fallot

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