Central hemodynamics in ultra-endurance athletes.

Central hemodynamics such as ascending aortic blood pressure (BP), wave reflection and myocardial perfusion are clinically important in the context of cardiovascular health. Ultra-endurance athletes may be at greater risk of cardiovascular abnormalities due to chronically increased physiological stress placed on the cardiovascular system. This study was a cross-sectional investigation that compared central hemodynamics in ultra-endurance athletes and matched controls. Forty-four athletes (36 males; aged mean+/-S.D., 34+/-8 years) undergoing ultra-endurance training (16.3+/-3.7 h/week) were compared to 44 matched recreationally active (1.2+/-0.9 h/week) controls (36 males; aged 34+/-8 years). Brachial BP was measured using an oscillometric device while central hemodynamics including ascending aortic BP, wave reflection (augmentation index, AIx), ejection duration, sub-endocardial perfusion (SEVR) and timing of the reflected wave (T(R)) were determined by applanation tonometry and pulse wave analysis. There were no significant (P>0.05) differences between groups in AIx (athletes and controls; 6+/-12% versus 6+/-13%, respectively), T(R) (athletes and controls; 165+/-22 ms versus 165+/-19 ms, respectively), brachial (athletes and controls; 51+/-9 mmHg versus 48+/-12 mmHg, respectively) or central pulse pressure (33+/-5 mmHg versus 31+/-7 mmHg). However, athletes had significantly increased SEVR (226+/-42% versus 198+/-46%; P<0.001) despite having a longer ejection duration (348+/-19 ms versus 339+/-18 ms; P<0.05). Furthermore, the amount of exercise training volume was significantly related to central (r=-0.46; P=0.002), but not brachial pulse pressure (r=-0.28; P>0.05). Ultra-endurance athletes had increased sub-endocardial perfusion capacity and the quantity of exercise training was associated with central rather than peripheral hemodynamics.