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ECHOCARDIOGRAPHIC STUDY OF RIGHT VENTRICULAR REMODELING IN TOP-LEVEL GEORGIAN ATHLETES
  1. L Maskhuliva1,2,
  2. V Akhalkatsi1,3,
  3. K Chelidze2,
  4. Z Kakhabrishvili1,2,4,
  5. M Matiashvili1,2,
  6. N Chabashvili2,
  7. T Chutkerashvili1
  1. 1Clinical Centre of Sports Medicine and Rehabilitation of Tbilisi State Medical University, Tbilisi, Georgia
  2. 2Tbilisi State Medical University, Tbilisi, Georgia
  3. 3Medical Service of Georgian Football Federation, Tbilisi, Georgia
  4. 4Medical Service of Georgian National Olympic Team, Tbilisi, Georgia

Abstract

Background There are a large number of studies which have focused on left ventricular (LV) structural and functional characteristics, however insufficient data exist concerning right heart response to exercise in elite athletes of different sporting disciplines.

Objective To investigate right ventricular (RV) dimensions and function in top-level athletes.

Design Retrospective study.

Setting Sports Medicine Clinical Centre.

Participants 124 top-level male athletes (18 cyclists, 62 football and 21 basketball players, 23 wrestlers) and 57 age-matched healthy sedentary controls were studied. All subjects were evaluated with 2D, spectral conventional, and tissue Doppler echocardiography. According to the guidelines of American Society of Echocardiography (ASE), RV subcostal wall thickness, RV diameters (RVD1, RVD2, RVD3, RVOT-Prox, RVOT-Distal) indexed by BSA, and functional parameters (TAPSE, FAC, TD MPI, E/A, E/E') were evaluated.

Main outcome measurements Athletes of various sport disciplines with respect to RV remodeling.

Results Morphologic parameters in most of the athletes and in all controls were within normal limits. Increased RV dimensions were found in 43(35%) athletes. RV wall thickness (3,82±0,71 vs. 3,51±0,32 mm) and RV diameters were significantly greater in athletes than in controls (P<.001). Most of the RV parameters in athletes were within the range of Mean and Upper Reference Values (URV), however RVD1 in 34 (27%) and RVD2 in 22 (18%) athletes exceeded URV by ASE criteria. By sporting disciplines RVD1 exceeded URV in 39% cyclists, 25% basketball players, 23% football players, 22% wrestlers. Interestingly, less than half of these athletes (47%) exhibited concomitant LV enlargement. RV functional parameters were in normal limits in athletes as in controls and did not differ (P>.20).

Conclusions In elite athletes long-term intensive training was associated with RV remodeling, particularly of RV base. RV function was not altered despite significant chamber dilatation. The extent of changes in RV morphology varied between sports: cyclists were more prone to exercise-induced RV structural remodeling.

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