G Bernardino1,2, M Sanz de la Garza3,4, B Domenech-Ximenos3,5, S Prat-Gonzàlez3,4, R J Perea6, I Blanco7,8, F Burgos7,8, A Sepulveda-Martinez9,10,11, M Rodriguez-Lopez9,10,12, F Crispi9,10, C Butakoff13, M A González Ballester14,15, M De Craene16, M Sitges3,4, B Bijnens14,15. 1. BCN Medtech, DTIC Universitat Pompeu Fabra, Barcelona, Spain. gabriel.bernardino@upf.edu. 2. Medisys, Philips, Paris, France. gabriel.bernardino@upf.edu. 3. Cardiovascular Institute, Hospital Clínic, IDIBAPS, Barcelona, Spain. 4. CIBERCV, Barcelona, Spain. 5. Radiology Department, Hospital Universitari Dr. Josep Trueta, Girona, Spain. 6. Radiology Department, IDIBAPS, Hospital Clinic, Barcelona, Spain. 7. ICR, IDIBAPS, University of Barcelona, Barcelona, Spain. 8. Biomedical Research Networking Center on Respiratory Diseases, Madrid, Spain. 9. BCNatal, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. 10. CIBER-ER, Barcelona, Spain. 11. Fetal Medicine Unit, Department of Obstetrics and Gynecology Hospital Clínico de la Universidad de Chile, Santiago de Chile, Chile. 12. Pontificia Universidad Javeriana Cali, Cali, Colombia. 13. BSC, Barcelona, Spain. 14. BCN Medtech, DTIC Universitat Pompeu Fabra, Barcelona, Spain. 15. ICREA, Barcelona, Spain. 16. Medisys, Philips, Paris, France.
Abstract
AIMS: Endurance athletes develop cardiac remodeling to cope with increased cardiac output during exercise. This remodeling is both anatomical and functional and shows large interindividual variability. In this study, we quantify local geometric ventricular remodeling related to long-standing endurance training and assess its relationship with cardiovascular performance during exercise. METHODS: We extracted 3D models of the biventricular shape from end-diastolic cine magnetic resonance images acquired from a cohort of 89 triathlon athletes and 77 healthy sedentary subjects. Additionally, the athletes underwent cardio-pulmonary exercise testing, together with an echocardiographic study at baseline and few minutes after maximal exercise. We used statistical shape analysis to identify regional bi-ventricular shape differences between athletes and non-athletes. RESULTS: The ventricular shape was significantly different between athletes and controls (p < 1e-6). The observed regional remodeling in the right heart was mainly a shift of the right ventricle (RV) volume distribution towards the right ventricular infundibulum, increasing the overall right ventricular volume. In the left heart, there was an increment of left ventricular mass and a dilation of the left ventricle. Within athletes, the amount of such remodeling was independently associated to higher peak oxygen pulse (p < 0.001) and weakly with greater post-exercise RV free wall longitudinal strain (p = 0.03). CONCLUSIONS: We were able to identify specific bi-ventricular regional remodeling induced by long-lasting endurance training. The amount of remodeling was associated with better cardiopulmonary performance during an exercise test.
AIMS: Endurance athletes develop cardiac remodeling to cope with increased cardiac output during exercise. This remodeling is both anatomical and functional and shows large interindividual variability. In this study, we quantify local geometric ventricular remodeling related to long-standing endurance training and assess its relationship with cardiovascular performance during exercise. METHODS: We extracted 3D models of the biventricular shape from end-diastolic cine magnetic resonance images acquired from a cohort of 89 triathlon athletes and 77 healthy sedentary subjects. Additionally, the athletes underwent cardio-pulmonary exercise testing, together with an echocardiographic study at baseline and few minutes after maximal exercise. We used statistical shape analysis to identify regional bi-ventricular shape differences between athletes and non-athletes. RESULTS: The ventricular shape was significantly different between athletes and controls (p < 1e-6). The observed regional remodeling in the right heart was mainly a shift of the right ventricle (RV) volume distribution towards the right ventricular infundibulum, increasing the overall right ventricular volume. In the left heart, there was an increment of left ventricular mass and a dilation of the left ventricle. Within athletes, the amount of such remodeling was independently associated to higher peak oxygen pulse (p < 0.001) and weakly with greater post-exercise RV free wall longitudinal strain (p = 0.03). CONCLUSIONS: We were able to identify specific bi-ventricular regional remodeling induced by long-lasting endurance training. The amount of remodeling was associated with better cardiopulmonary performance during an exercise test.
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