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Right ventricular adaptations and arrhythmias in amateur ultra-endurance athletes
  1. Caroline Rimensberger1,
  2. Frederik Carlen2,
  3. Nicolas Brugger2,
  4. Christian Seiler2,
  5. Matthias Wilhelm1
  1. 1Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland
  2. 2Division of Echocardiography, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland
  1. Correspondence to Dr Matthias Wilhelm, Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Swiss Cardiovascular Centre Bern, Inselspital, University Hospital and University of Bern, Switzerland; matthias.wilhelm{at}insel.ch

Abstract

Objective Ultra-endurance sports are becoming increasingly popular in middle-aged amateur athletes. Right ventricular (RV) arrhythmogenic remodelling has been described in high-level endurance athletes, like professional cyclists. The clinical relevance for amateurs is unknown.

Design We investigated male amateur runners of the 2011 Grand Prix of Bern, a popular 10-mile race in Switzerland. Participants were stratified according to their former participations in long-distance competitions: active controls (leisure-time runners), marathon runners and ultra-endurance athletes (78 and 100 km runners, long-distance triathletes). RV function and morphology were assessed by echocardiography, including two-dimensional speckle tracking. Primary endpoint was RV global strain. Ventricular ectopy was assessed by 24 h ambulatory Holter monitoring. Results were adjusted for lifetime training hours.

Results 97 normotensive athletes were included in the final analysis. The mean age was 42±8 years. Compared with active controls and marathon runners, ultra-endurance athletes had significantly more lifetime training hours and participated more often in competitions. Groups showed no differences with regard to RV global strain (–21.8±2.9 vs −23.3±2.8 vs −21.7±2.3%; p=0.973) and RV end-diastolic area (22.1±2.9 vs 22.9±4.2 vs 23.2±3.5 cm2; p=0.694). The number of premature ventricular contractions (PVCs) was weakly associated with the RV size (r=0.208; p=0.042). Overall ventricular ectopy was low (0–486 PVCs/24 h) and equally distributed between the groups.

Conclusions In our small sample of amateur athletes, long-term ultra-endurance sport practice was not associated with RV dysfunction or complex ventricular arrhythmias.

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