Alterations in Cardiac Mechanics Following Ultra-Endurance Exercise: Insights from Left and Right Ventricular Area-Deformation Loops.

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Lord, R ; George, KP ; Somauroo, J ; Stembridge, M ; Jain, N ; Hoffman, MD ; Shave, R ; Haddad, F ; Ashley, E ; Jones, H ; Oxborough, D

BACKGROUND: The aim of this study was to use novel area-deformation (ε) loops to interrogate the interaction between the right ventricular (RV) and left ventricular (LV) mechanics following a 100-mile endurance run. METHODS: Fifteen participants (mean body mass, 70.1 ± 8.8 kg; mean age, 40 ± 8 years) were recruited for the study. Echocardiography was performed before the race, after the race, and 6 hours into recovery. RV and LV area and longitudinal ε were assessed using standard and speckle-tracking echocardiography. Following cubic spline interpolation, these variables were obtained across the same cardiac cycle and used to derive area-ε loops. RESULTS: The RV area-ε loop demonstrated a rightward shift after the race, with increased RV area (from 26.0 to 27.1 cm(2)) and reduced peak RV ε (from -28.6% to -25.8%). The recovery RV area-ε loop was similar to the postrace loop. A leftward shift was observed in the LV area-ε loop after the race, secondary to reduced LV area (from 35.8 to 32.5 cm(2)) and reduced peak ε (from -18.3% to -16.6%). In recovery, LV ε values returned toward baseline. CONCLUSIONS: A 100-mile ultramarathon resulted in a rightward shift in the RV area-ε loop as a result of RV dilatation. There was a concomitant leftward shift in the LV area-ε loop as a result of underfilling of the left ventricle. At 6 hours after exercise, there was a partial recovery of the left ventricle, while RV function remained depressed. It appears that changes in RV function do not have a serial impact on the left ventricle during recovery from ultra-endurance activity.
  • References (23)
    23 references, page 1 of 3

    1. Lord R, Oxborough D, Somauroo J, George K. Echocardiographic Evidence of the Cardiac Stress of Competing in Ultra-endurance exercise. Deutsche Zeitschrift für Sportmedizin. 2014;65(4):93-101.

    2. Dawson EA, Shave R, George K, Whyte G, Ball D, Gaze D, et al. Cardiac drift during prolonged exercise with echocardiographic evidence of reduced diastolic function of the heart. Eur J Appl Physiol. 2005;94(3):305-9.

    3. La Gerche A, Heidbuchel H, Burns AT, Mooney DJ, Taylor AJ, Pfluger HB, et al. Disproportionate Exercise Load and Remodeling of the Athlete's Right Ventricle. Med Sci Spor Exerc. 2011;43(6):974-81.

    4. George K, Shave R, Oxborough D, Cable T, Dawson E, Artis N, et al. Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking. Eur J Echocardiogr. 2009;10(2):238-43.

    5. Oxborough D, Shave R, Warburton D, Williams K, Oxborough A, Charlesworth S, et al. Dilatation and Dysfunction of the Right Ventricle Immediately After Ultraendurance Exercise: Exploratory Insights From Conventional Two-Dimensional and Speckle Tracking Echocardiography. Circ: Cardiovasc Imag. 2011;4(3):253-63.

    6. Oxborough D, Whyte G, Wilson M, O'Hanlon R, Birch K, Shave R, et al. A Depression in Left Ventricular Diastolic Filling following Prolonged Strenuous Exercise is Associated with Changes in Left Atrial Mechanics. J Am Soc Echocardiogr. 2010;23(9):968-76.

    7. La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, et al. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J. 2012;33(8):998-1006.

    8. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography: Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685-713.

    9. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.

    10. Burns AT, Gerche AL, Prior DL, MacIsaac AI. Left Ventricular Torsion Parameters are Affected by Acute Changes in Load. Echocardiogr. 2010;27(4):407-14.

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