Original article
Myocardial Adaptation to Short-term High-intensity Exercise in Highly Trained Athletes

https://doi.org/10.1016/j.echo.2006.05.001Get rights and content

We aimed to clarify the myocardial adaptation to short-term high-intensity exercise among trained athletes. We screened 17 participants in the 2004 World Indoor Rowing Championships before and after a 2000-m sprint. Echocardiography included standard measurements and tissue Doppler–derived strain (ε), strain rate, and 2-dimensionally derived speckle-tracking imaging for left ventricular (LV) torsion. LV volumes and ejection fraction were unchanged after exercise. There was a reduction in early and an increase in late diastolic filling velocities and a decrease in the flow propagation velocity. Annular systolic velocities, slope of the systolic acceleration, septal and lateral ε, and speckle tracking–derived torsion were increased. The increased LV torsion was a result of increased basal and apical rotation. Right ventricular apical ε decreased. In conclusion, maximal intensity short-duration exercise was associated with attenuation of LV diastolic function, augmentation of LV systolic function, and a reduction in apical right ventricular contractility.

Section snippets

Screening and Approval Process

The protocol was approved by our human subjects review committee and the committee of the World Indoor Rowing Championships. Seventeen rowers scheduled to participate in the 2004 World Indoor Rowing Championship were recruited. Athletes rowed 2000 m using ergometers (Model C, Concept2 Inc, Morrisville, VT). These athletes volunteered for the study and provided written consent. Assessment included physical examination and a complete echocardiographic evaluation. Participants were screened not

Statistics

Data are presented as mean ± SD. Paired Student t test was used to compare changes in echocardiographic parameters before and after rowing. A Pearson correlation coefficient was calculated where appropriate using standard methods. Significance was set at P less than .05.

Standard Parameters

Seventeen volunteers were recruited for participation in the study. Complete pre- and postechocardiograms were obtained in all participants. Our study group included 12 men and 5 women with a mean age of 37 years (range 22-56). The mean finish time for men was 6 minutes 37 ± 27 seconds and for women it was 7 minutes 10 ± 9 seconds. Body weight did not change significantly (179 ± 30 vs 180 ± 28 lb, P = .93). Both systolic (120 ± 10 vs 126 ± 15 mm Hg, P = .24) and diastolic (72 ± 8 vs 68 ± 14 mm

Discussion

We sought to clarify the acute cardiac changes that occur with high-intensity exercise. These changes included a reversal in the LV diastolic filling pattern, augmentation of LV systolic function, and a reduction in RV apical ε.

During acute exercise, diastolic function must be augmented for LV filling to match the increased cardiac output. The shortened duration of diastole compromises LV filling, thereby potentially limiting the stroke volume. We found that the increased demands of exercise

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      2013, Journal of the American Society of Echocardiography
      Citation Excerpt :

      Our study, taking advantage of different groups of athletes (EAs and SAs, highly and moderately trained athletes, with or without RV dilatation), has shown that despite the existence of differences in RV and RA geometric measures, few meaningful differences in deformation exist, as RV and RA systolic and diastolic functions remain within normal ranges. There has been an ongoing controversy concerning longitudinal deformation of the RV free wall and especially its basic lateral segment,5,10-12 raising concern about potential myocardial damage due to endurance exercise, implying that exhausting training might lead to a type of RV cardiomyopathy.28-32 Our study, in concordance with findings by Oxborough et al.11 as well as D’Andrea et al.,10,33 has shown that even among highly trained athletes or athletes with dilated right ventricles performing endurance or strength exercise, global RV ε and SR, including basal deformation, are at least preserved if not increased.

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    Supported by an Irish Board for Training in Cardiovascular Medicine and Department of Health and Children Cardiovascular Health Strategy Travelling Fellowship and an American Society of Echocardiography Research Fellowship Award (Dr Neilan).

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