Literature DB >> 23488623

Reduced right ventricular myocardial strain in the elite athlete may not be a consequence of myocardial damage. "Cream masquerades as skimmed milk".

Gerard King1, Ibrahim Almuntaser, Ross T Murphy, Andre La Gerche, Nick Mahoney, Kathleen Bennet, John Clarke, Angela Brown.   

Abstract

BACKGROUND: Latest research shows that the lower resting values of right ventricular (RV) myocardial % strain may represent a physiologic change rather than subclinical myocardial damage. Therefore, we assessed load-independent changes to the RV as a consequence of high intensity training by measuring the Isovolumic acceleration (IVA) of the free wall of the RV in conjunction with NT pro-BNP measured by an electrochemiluminescence assay.
METHODS: Seventeen controls (mean age 27 ± 4), 24 soccer footballers (mean age 24 ± 4), and 18 elite rowers (mean age 22 ± 4) were studied. Left ventricular (LV) and RV % strain were measured using two-dimensional (2D) speckle based automated functional imaging (AFI) software. RV free wall IVA was measured using pulsed-wave tissue Doppler at the lateral tricuspid annulus. Standard 2D echo were used to measured RV parameters including the Tei index (systolic and diastolic function) and the total annular plane systolic excursion (TAPSE) of the RV annulus. NT pro-BNP was measured by an electrochemiluminescence assay.
RESULTS: The RV diameter was increased in the footballers and elite rowers compared with controls (P < 0.001). RV wall size was greater in the elite rowers compared with controls and footballers (P = 0.002). The peak IVA of the RV was higher in the rowers, compared with the footballers and to controls (P < 0.001). The mean LV and RV % myocardial strain were lower in the elite athletes and the footballers compared with controls (P < 0.001). There was no difference in RV Tei index, levels of BNP, and TAPSE across all subjects.
CONCLUSIONS: This study showed a significant increase in IVA of the RV of athletes despite reduced myocardial % strain and normal levels in NT-proBNP. This suggests that the decrease in % strain is not a consequence of myocardial damage, but may represents a part of the physiological response to endurance exercise. Therefore, a reduced IVA in a remodeled RV could herald a pathological response.
© 2013, Wiley Periodicals, Inc.

Entities:  

Keywords:  athlete; isovolumic acceleration; right ventricle; strain; sub-clinical dysfunction

Mesh:

Year:  2013        PMID: 23488623     DOI: 10.1111/echo.12153

Source DB:  PubMed          Journal:  Echocardiography        ISSN: 0742-2822            Impact factor:   1.724


  9 in total

Review 1.  The heart of the endurance athlete assessed by echocardiography and its modalities: "embracing the delicate balance".

Authors:  Gerard King; Malissa J Wood
Journal:  Curr Cardiol Rep       Date:  2013-08       Impact factor: 2.931

Review 2.  Physiologic and pathophysiologic changes in the right heart in highly trained athletes.

Authors:  A D'Andrea; A La Gerche; E Golia; R Padalino; R Calabrò; M G Russo; E Bossone
Journal:  Herz       Date:  2015-05       Impact factor: 1.443

3.  The impact of chronic endurance and resistance training upon the right ventricular phenotype in male athletes.

Authors:  Victor Utomi; David Oxborough; Euan Ashley; Rachel Lord; Sarah Fletcher; Mike Stembridge; Rob Shave; Martin D Hoffman; Greg Whyte; John Somauroo; Sanjay Sharma; Keith George
Journal:  Eur J Appl Physiol       Date:  2015-03-17       Impact factor: 3.078

Review 4.  Mitochondrial DNA mutators.

Authors:  F Foury; J Hu; S Vanderstraeten
Journal:  Cell Mol Life Sci       Date:  2004-11       Impact factor: 9.261

5.  Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members.

Authors:  Jørg Saberniak; Nina E Hasselberg; Rasmus Borgquist; Pyotr G Platonov; Sebastian I Sarvari; Hans-Jørgen Smith; Margareth Ribe; Anders G Holst; Thor Edvardsen; Kristina H Haugaa
Journal:  Eur J Heart Fail       Date:  2014-10-16       Impact factor: 15.534

6.  Echocardiographic assessment of right ventricle adaptation to endurance training in young rowers - speckle tracking echocardiography.

Authors:  M Konopka; W Krol; K Burkhard-Jagodzinska; A Jakubiak; A Klusiewicz; J Chwalbinska; A Pokrywka; D Sitkowski; M Dluzniewski; W Braksator
Journal:  Biol Sport       Date:  2016-09-03       Impact factor: 2.806

7.  Right heart exercise-training-adaptation and remodelling in endurance athletes.

Authors:  Valeria Conti; Filippo Migliorini; Marco Pilone; María I Barriopedro; Juan José Ramos-Álvarez; Francisco Javer Calderon Montero; Nicola Maffulli
Journal:  Sci Rep       Date:  2021-11-18       Impact factor: 4.379

Review 8.  The role of new echocardiographic techniques in athlete's heart.

Authors:  Antonello D'Andrea; Eduardo Bossone; Juri Radmilovic; Pio Caso; Raffaele Calabrò; Maria Giovanna Russo; Maurizio Galderisi
Journal:  F1000Res       Date:  2015-07-20

9.  The influence of training status on right ventricular morphology and segmental strain in elite pre-adolescent soccer players.

Authors:  Viswanath B Unnithan; Alexander Beaumont; Thomas W Rowland; Nicholas Sculthorpe; Keith George; Rachel Lord; David Oxborough
Journal:  Eur J Appl Physiol       Date:  2021-02-22       Impact factor: 3.078

  9 in total

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