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Kösemen DS, Çetin S, Demirci D, Babaoğlu K. Evaluation of the Left Ventricular Myocardium Using Layer-Specific Strain Analysis in Adolescent Athletes Performing High-Intensity Interval Training. Pediatr Cardiol 2024; 45:770-779. [PMID: 38347232 DOI: 10.1007/s00246-024-03411-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/05/2024] [Indexed: 03/24/2024]
Abstract
High-intensity interval training (HIIT) has been demonstrated to be an efficient way of improving physical performance in adolescent athletes compared to conventional training modalities. The objective of this study was to evaluate the impact of HIIT on the myocardial function of adolescent athletes, specifically focusing on left ventricular (LV) function, using conventional echocardiography and layer-specific strain (LSS) analysis. A total of 19 male adolescent athletes (with mean age of 16.83 ± 1.29 years) participating in various football clubs were recruited for this study. During the course of 8 weeks, these adolescent male athletes engaged in HIIT program centered around running. Upon completion of HIIT program, a treadmill exercise test was conducted. Subsequently, conventional and LSS echocardiography were conducted to acquire the evaluation of LV myocardial function. Interventricular septum thickness and ventricular mass index were significantly increased post high-intensity interval training (p < 0.005). After the HIIT, the treadmill exercise test demonstrated a significant increase in test duration and metabolic equivalent compared to the pre-training values (p < 0.005). Post high-intensity interval training, LSS analysis revealed significantly improved LV circumferential strain values in the basal and mid-segments of the left ventricle when compared to the pre-training measurements (p < 0.005). The implementation of high-intensity interval training led to an enhancement of circumferential LSS in the LV, indicating a favorable physiological adaptation and improved efficiency of the myocardium.
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Affiliation(s)
| | - Süha Çetin
- Department of Cardiology, Okan University Hospital, Icmeler Mah. Aydinli Yolu Cad. Nr 2, Icmeler, 34947, Tuzla, Istanbul, Turkey.
| | - Deniz Demirci
- Department of Health Sciences, Uskudar University, Uskudar, Istanbul, Turkey
| | - Kadir Babaoğlu
- Department of Pediatric Cardiology, Kocaeli University, Kocaeli, Turkey
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Conti V, Migliorini F, Pilone M, Barriopedro MI, Ramos-Álvarez JJ, Montero FJC, Maffulli N. Right heart exercise-training-adaptation and remodelling in endurance athletes. Sci Rep 2021; 11:22532. [PMID: 34795399 PMCID: PMC8602371 DOI: 10.1038/s41598-021-02028-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/01/2021] [Indexed: 01/11/2023] Open
Abstract
Long-term sports training leads to myocardial adaptations, with remodelling of the heart chambers. However, while myocardial adaptations of the left heart are well described, remodelling of the right heart and its impact on the development of arrhythmias is still debated. To conduct a systematic review on right ventricle (RV) and right atrium (RA) structural and functional changes in athletes who participate in long-term endurance training. Systematic review. A systematic literature search was conducted. All the articles reporting right heart echocardiographic (ECHO) and cardiac magnetic resonance (CMR) parameters evaluated in endurance athletes and sedentary subjects were considered eligible. A multivariate analysis was conducted to investigate whether age, sex, body surface area (BSA), intensity of training are associated with RV ECHO, CMR parameters and RA ECHO parameters. A positive association between age and right atrium area (RAA) (P = 0.01) was found. This is a negative association to RV E/A (P = 0.004), and RV end diastolic diameter (RVED) longitudinal (P = 0.01). A positive association between BSA and RVED middle (P = 0.001), as well between BSA and RAA (P = 0.05) was found, along with a negative association with RV E/A (P = 0.002). A positive association between intensity of training and RV end systolic area (RVESA) (P = 0.03), RV end diastolic volume indexed (RVEDVI) (P = 0.01), RV end systolic volume indexed (RVESVI) (P = 0.01) was found, along with a negative association with ejection fraction (EF %) (P = 0.01). Endurance athletes demonstrated an association between RV remodelling and age, BSA and intensity of training.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Recontructive Surgery, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Marco Pilone
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - María I Barriopedro
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Juan José Ramos-Álvarez
- Escuela de Medicina Deportiva. Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Javer Calderon Montero
- Escuela de Medicina Deportiva. Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London, E1 4DG, England, UK
- Department of Musculoskeletal Disorders, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Kumar V, Manduca A, Rao C, Ryu AJ, Gibbons RJ, Gersh BJ, Chandrasekaran K, Asirvatham SJ, Araoz PA, Oh JK, Egbe AC, Behfar A, Borlaug BA, Anavekar NS. An under-recognized phenomenon: Myocardial volume change during the cardiac cycle. Echocardiography 2021; 38:1235-1244. [PMID: 34085722 DOI: 10.1111/echo.15093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Myocardial volume is assumed to be constant over the cardiac cycle in the echocardiographic models used by professional guidelines, despite evidence that suggests otherwise. The aim of this paper is to use literature-derived myocardial strain values from healthy patients to determine if myocardial volume changes during the cardiac cycle. METHODS A systematic review for studies with longitudinal, radial, and circumferential strain from echocardiography in healthy volunteers ultimately yielded 16 studies, corresponding to 2917 patients. Myocardial volume in systole (MVs) and diastole (MVd) was used to calculate MVs/MVd for each study by applying this published strain data to three models: the standard ellipsoid geometric model, a thin-apex geometric model, and a strain-volume ratio. RESULTS MVs/MVd<1 in 14 of the 16 studies, when computed using these three models. A sensitivity analysis of the two geometric models was performed by varying the dimensions of the ellipsoid and calculating MVs/MVd. This demonstrated little variability in MVs/MVd, suggesting that strain values were the primary determinant of MVs/MVd rather than the geometric model used. Another sensitivity analysis using the 97.5th percentile of each orthogonal strain demonstrated that even with extreme values, in the largest two studies of healthy populations, the calculated MVs/MVd was <1. CONCLUSIONS Healthy human myocardium appears to decrease in volume during systole. This is seen in MRI studies and is clinically relevant, but this study demonstrates that this characteristic was also present but unrecognized in the existing echocardiography literature.
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Affiliation(s)
- Vinayak Kumar
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Armando Manduca
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Chaitanya Rao
- Electrical Engineer, self-employed, Melbourne, Australia
| | - Alexander J Ryu
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Philip A Araoz
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jae K Oh
- Department of Cardiology, Mayo Clinic, Rochester, MN, USA
| | | | - Atta Behfar
- Department of Cardiology, Mayo Clinic, Rochester, MN, USA
| | | | - Nandan S Anavekar
- Department of Cardiology, Mayo Clinic, Rochester, MN, USA.,Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Huang YC, Tsai HH, Fu TC, Hsu CC, Wang JS. High-Intensity Interval Training Improves Left Ventricular Contractile Function. Med Sci Sports Exerc 2020; 51:1420-1428. [PMID: 30829901 DOI: 10.1249/mss.0000000000001931] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Improved myocardial contractility is a critical circulatory adaptation to exercise training. However, the types of exercise that enhance left ventricular (LV) contractile and diastolic functions have not yet been established. This study investigated how high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) influence LV mechanics during exercise. METHODS Fifty-four healthy sedentary men were randomized to engage in either HIIT (3-min intervals at 40% and 80% of V˙O2max, n = 18) or MICT (sustained 60% of V˙O2max, n = 18) for 30 min·d, 5 d·wk for 6 wk or to a control group (n = 18) that did not engage in exercise intervention. LV mechanics during semiupright bicycle exercise tests were measured by two-dimensional speckle-tracking echocardiography. RESULTS Before the interventions, acute bicycle exercise increased (i) peak basal/apical radial and circumferential and peak longitudinal strains and strain rates, (ii) peak basal/apical rotations and torsion, and (iii) peak systolic twisting and early diastolic untwisting velocities in the LV. After the interventions, the HIIT group exhibited greater LV mass and diastolic internal diameter as well as higher ratio of E wave to A wave and early diastolic propagation velocity than did the MICT group. Despite decreased peak apical rotation and torsion, HIIT enhanced peak apical radial strain and strain rate as well as shortened the time to reach peak untwisting velocity in the LV during exercise. However, the LV mechanics during exercise were unchanged in the control group. CONCLUSION HIIT but not MICT induces eccentric myocardial hypertrophy. Moreover, HIIT effectively improves the LV mechanics during exercise by increasing contractile and diastolic functions.
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Affiliation(s)
- Yu-Chieh Huang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN
| | - Hsing-Hua Tsai
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN
| | - Tieh-Cheng Fu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
| | - Jong-Shyan Wang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
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Żebrowska A, Mikołajczyk R, Waśkiewicz Z, Gąsior Z, Mizia-Stec K, Kawecki D, Rosemann T, Nikolaidis PT, Knechtle B. Left Ventricular Systolic Function Assessed by Speckle Tracking Echocardiography in Athletes with and without Left Ventricle Hypertrophy. J Clin Med 2019; 8:jcm8050687. [PMID: 31096682 PMCID: PMC6571655 DOI: 10.3390/jcm8050687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to evaluate selected parameters of strain and rotation of the left ventricle (the basal rotation (BR) index, the basal circumferential strain (BCS) index, and the global longitudinal strain (GLS) of the left ventricle) in male athletes with physiological cardiac hypertrophy (LVH group), and athletes (non-LVH group) and non-athletes without hypertrophy (control group, CG). They were evaluated using transthoracic echocardiography and speckle tracking echocardiography before and after an incremental exercise test. The LVH group demonstrated lower BR at rest than the non-LVH group (p < 0.05) and the CG (p < 0.05). Physical effort had no effect on BR, nor was this effect different between groups (p > 0.05). There was a combined influence of LVH and physical effort on BR (F = 5.70; p < 0.05) and BCS (F = 4.97; p < 0.05), but no significant differences in BCS and GLS at rest between the groups. A higher BCS and lower GLS after exercise in the LVH group were demonstrated in comparison with the CG (p < 0.05). Left ventricular basal rotation as well as longitudinal and circumferential strains showed less of a difference between rest and after physical effort in subjects with significant myocardial hypertrophy. In conclusion, the obtained results may suggest that echocardiographic assessment of basal rotation and circumferential strain of the left ventricular can be important in predicting cardiac disorders caused by physical effort in individuals with physiological and pathological heart hypertrophy.
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Affiliation(s)
- Aleksandra Żebrowska
- Department of Physiological and Medical Sciences, Academy of Physical Education, Mikołowska Street 72a, 40-065 Katowice, Poland.
| | - Rafał Mikołajczyk
- Department of Physiological and Medical Sciences, Academy of Physical Education, Mikołowska Street 72a, 40-065 Katowice, Poland.
| | - Zbigniew Waśkiewicz
- Department of Team Sports Games, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065 Katowice, Poland.
- Department of Sports Medicine and Medical Rehabilitation, Sechenov University, Moscow 119991, Russia.
| | - Zbigniew Gąsior
- Department of Cardiology, School of Health Science, Medical University of Silesia, Katowice, Poland Ziołowa Street 47, 40-635 Katowice, Poland.
| | - Katarzyna Mizia-Stec
- 1st Department of Cardiology, School of Medicine Medical University of Silesia, Katowice, Poland Ziołowa Street 47, 40-635 Katowice, Poland.
| | - Damian Kawecki
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Skłodowskiej, Curie 10 Street, 41-800 Zabrze, Poland.
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.
- Medbase St. Gallen Am Vadianplatz, 9001 St. Gallen, Switzerland.
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Cardiac deformation parameters and rotational mechanics by cardiac magnetic resonance feature tracking in pre-adolescent male soccer players. Cardiol Young 2018; 28:882-884. [PMID: 29559027 DOI: 10.1017/s1047951118000343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of the study was to analyse whether prolonged and regular physical training in children leads to changes in myocardial systolic deformation and rotational mechanics. For that purpose, cardiac MRI feature tracking was performed retrospectively in 35 pre-adolescent male soccer players and 20 matched controls. There were no changes in global strain, but left ventricular twist and apical rotation were greater in soccer players, which adds to the features of paediatric athlete's heart.
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