1
|
Wolff S, Picco JM, Díaz-González L, Valenzuela PL, Gonzalez-Dávila E, Santos-Lozano A, Matile P, Wolff D, Boraita A, Lucia A. Exercise-Induced Cardiac Fatigue in Recreational Ultramarathon Runners at Moderate Altitude: Insights From Myocardial Deformation Analysis. Front Cardiovasc Med 2022; 8:744393. [PMID: 35141287 PMCID: PMC8818846 DOI: 10.3389/fcvm.2021.744393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background Controversy exists on the actual occurrence of exercise-induced cardiac fatigue (EICF) with ultraendurance exercise, as well as on whether factors such as age or training status might predispose to this condition. The present study aimed to assess the occurrence of EICF among recreational ultramarathon runners, as well as to determine potential predictive factors. Methods Nineteen male recreational runners (42 ± 12yrs) participated in a 55-km trial race at moderate altitude (1,800–2,500 m). Participants were evaluated before and after the race using Doppler echocardiography and myocardial deformation analysis. EICF was determined as a reduction >5% of either left ventricular global longitudinal strain (LVGLS) or right ventricular free wall strain (RVFWS). Demographical (age, body mass index), training (training experience, volume and intensity), competition (finishing time, relative intensity) and biochemical variables (blood lactate, creatine kinase [CK] and CK-MB) were assessed as predictors of EICF. Results A significant reduction in LVGLS (20.1 ± 2.1% at baseline vs. 18.8 ± 2.4% at post-race, p = 0.026), but not in RVFWS (27.4 ± 7.0 vs. 24.6 ± 5.3%, p = 0.187), was observed after the race. EICF was present in 47 and 71% of the participants attending to the decrease in LVGLS and RVFWS, respectively. No associations were found between any of the analyzed variables and EICF except for age, which was associated with the magnitude of decrement of RVFWS (r = 0.58, p = 0.030). Conclusions Ultramarathon running at moderate altitude seems to induce EICF in a considerable proportion of recreational athletes.
Collapse
Affiliation(s)
- Sebastián Wolff
- Wolff Cardiology and Sport Medicine Institute, Mendoza, Argentina
| | - José M. Picco
- Wolff Cardiology and Sport Medicine Institute, Mendoza, Argentina
| | - Leonel Díaz-González
- Cardiology Department, CEMTRO Clinic, Madrid, Spain
- Cardiology Department, La Paz Hospital, Madrid, Spain
| | - Pedro L. Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Physical Activity and Health Research Group (“PaHerg”), Research Institute of the Hospital 12 de Octubre (“Imas12”), Madrid, Spain
| | | | - Alejandro Santos-Lozano
- I+HeALTH, European University Miguel de Cervantes, Valladolid, Spain
- Physical Activity and Health Research Group (“PaHerg”), Research Institute of the Hospital 12 de Octubre (“Imas12”), Madrid, Spain
| | | | - David Wolff
- Wolff Cardiology and Sport Medicine Institute, Mendoza, Argentina
| | - Araceli Boraita
- Department of Cardiology, Sports Medicine Center, Spanish Sports Health Protection Agency, Consejo Superior de Deportes, Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Physical Activity and Health Research Group (“PaHerg”), Research Institute of the Hospital 12 de Octubre (“Imas12”), Madrid, Spain
- *Correspondence: Alejandro Lucia
| |
Collapse
|
2
|
Chen H, Warncke ML, Muellerleile K, Saering D, Beitzen-Heineke A, Kisters A, Swiderska M, Cavus E, Jahnke CM, Adam G, Lund GK, Tahir E. Acute impact of an endurance race on biventricular and biatrial myocardial strain in competitive male and female triathletes evaluated by feature-tracking CMR. Eur Radiol 2021; 32:3423-3435. [PMID: 34902061 PMCID: PMC9038901 DOI: 10.1007/s00330-021-08401-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/02/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022]
Abstract
Objectives Cardiac adaptation in endurance athletes is a well-known phenomenon, but the acute impact of strenuous exercise is rarely reported on. The aim of this study was to analyze the alterations in biventricular and biatrial function in triathletes after an endurance race using novel feature-tracking cardiac magnetic resonance (FT-CMR). Methods Fifty consecutive triathletes (45 ± 10 years; 80% men) and twenty-eight controls were prospectively recruited, and underwent 1.5-T CMR. Biventricular and biatrial volumes, left ventricular ejection fraction (LVEF), FT-CMR analysis, and late gadolinium imaging (LGE) were performed. Global systolic longitudinal (GLS), circumferential (GCS), and radial strain (GRS) were assessed. CMR was performed at baseline and following an endurance race. High-sensitive troponin T and NT-proBNP were determined. The time interval between race completion and CMR was 2.3 ± 1.1 h (range 1–5 h). Results Post-race troponin T (p < 0.0001) and NT-proBNP (p < 0.0001) were elevated. LVEF remained constant (62 ± 6 vs. 63 ± 7%, p = 0.607). Post-race LV GLS decreased by tendency (− 18 ± 2 vs. − 17 ± 2%, p = 0.054), whereas GCS (− 16 ± 4 vs. − 18 ± 4%, p < 0.05) and GRS increased (39 ± 11 vs. 44 ± 11%, p < 0.01). Post-race right ventricular GLS (− 19 ± 3 vs. − 19 ± 3%, p = 0.668) remained constant and GCS increased (− 7 ± 2 vs. − 8 ± 3%, p < 0.001). Post-race left atrial GLS (30 ± 8 vs. 24 ± 6%, p < 0.0001) decreased while right atrial GLS remained constant (25 ± 6 vs. 24 ± 6%, p = 0.519). Conclusions The different alterations of post-race biventricular and biatrial strain might constitute an intrinsic compensatory mechanism following an acute bout of endurance exercise. The combined use of strain parameters may allow a better characterization of ventricular and atrial function in endurance athletes. Key Points • Triathletes demonstrate a decrease of LV global longitudinal strain by tendency and constant RV global longitudinal strain following an endurance race. • Post-race LV and RV global circumferential and radial strains increase, possibly indicating a compensatory mechanism after an acute endurance exercise bout. • Subgroup analyses of male triathletes with focal myocardial fibrosis did not demonstrate alterations in biventricular and biatrial strain after an endurance race. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08401-y.
Collapse
Affiliation(s)
- Hang Chen
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Malte L Warncke
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Kai Muellerleile
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Dennis Saering
- Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany
| | - Antonia Beitzen-Heineke
- Department of Oncology, Hematology, BMT With Department of Pneumology, University Medical Center Hamburg, Hamburg, Germany
| | - Anna Kisters
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Monika Swiderska
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ersin Cavus
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Charlotte M Jahnke
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Gunnar K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| |
Collapse
|
3
|
Marathon-Induced Cardiac Fatigue: A Review over the Last Decade for the Preservation of the Athletes' Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168676. [PMID: 34444424 PMCID: PMC8391217 DOI: 10.3390/ijerph18168676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
AIM To provide a state-of-the-art review of the last 10 years focusing on cardiac fatigue following a marathon. METHODS The PubMed, Bookshelf and Medline databases were queried during a time span of 10 years to identify studies that met the inclusion criteria. Twenty-four studies focusing only on the impact of marathons on the cardiac function and factors involved in cardiac fatigue were included in this review. RESULTS Sixteen studies focused on the impact of marathons on several biomarkers (e.g., C-reactive protein, cardiac troponin T). Seven studies focused on the left (LV) or right (RV) ventricular function following a marathon and employed cardiac magnetic resonance, echocardiography, myocardial speckle tracking and heart rate variability to analyze global and regional LV or RV mechanics and the impact of the autonomic nervous system on cardiac function. One study focused on serum profiling and its association with cardiac changes after a marathon. CONCLUSIONS This review reported a negligible impact of marathons on LV and RV systolic and contractile function but a negative impact on LV diastolic function in recreational runners. These impairments are often associated with acute damage to the myocardium. Thus, the advice of the present review to athletes is to adapt their training and have a regular medical monitoring to continue to run marathons while preserving their cardiac health.
Collapse
|
4
|
Pinto MM, Dubouchaud H, Jouve C, Rigaudière JP, Patrac V, Bouvier D, Hininger-Favier I, Walrand S, Demaison L. A chronic low-dose magnesium L-lactate administration has a beneficial effect on the myocardium and the skeletal muscles. J Physiol Biochem 2021; 78:501-516. [PMID: 34292519 DOI: 10.1007/s13105-021-00827-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/08/2021] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to determine whether magnesium L-lactate is responsible for having a beneficial effect on the myocardium and the skeletal muscles and how this substrate acts at the molecular level. Twenty seven young male Wistar rats were supplied with a magnesium L-lactate (L) solution, a magnesium chloride (M) solution and/or water (W) as a vehicle for 10 weeks. The treated animals absorbed the L and M solutions as they wished since they also had free access to water. After 9 weeks of treatment, in vivo cardiac function was determined ultrasonically. The animals were sacrificed at the end of the tenth week of treatment and the heart was perfused according to the Langendorff method by using a technique allowing the determination of cardiomyocyte activity (same coronary flow in the two groups). Blood was collected and skeletal muscles of the hind legs were weighed. The myocardial expressions of the sodium/proton exchange 1 (NHE1) and sodium/calcium exchange 1 (NCX1), intracellular calcium accumulation, myocardial magnesium content, as well as systemic and tissue oxidative stress, were determined. Animals of the L group absorbed systematically a low dose of L-lactate (31.5 ± 4.3 µg/100 g of body weight/day) which was approximately four times higher than that ingested in the W group through the diet supplied. Ex vivo cardiomyocyte contractility and the mass of some skeletal muscles (tibialis anterior) were increased by the L treatment. Myocardial calcium was decreased, as was evidenced by an increase in total CaMKII expression, without any change in the ratio between phosphorylated CaMKII and total CaMKII. Cardiac magnesium tended to be elevated. Our results suggest that the increased intracellular magnesium concentration was related to L-lactate-induced cytosolic acidosis and to the activation of the NHE1/NCX1 axis. Interestingly, systemic oxidative stress was reduced by the L treatment whereas the lipid profile of the animals was unaltered. Taken together, these results suggest that a chronic low-dose L-lactate intake has a beneficial health effect on some skeletal muscles and the myocardium through the activation of the NHE1/NCX1 axis, a decrease in cellular calcium and an increase in cellular magnesium. The treatment can be beneficial for the health of young rodents in relation to chronic oxidative stress-related diseases.
Collapse
Affiliation(s)
- Marlène Magalhaes Pinto
- INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Hervé Dubouchaud
- INSERM, U1055, Laboratory of Fundamental and Applied Bioenergetics, LBFA, Université Grenoble Alpes, 38000, Grenoble, France
| | - Chrystèle Jouve
- INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Jean-Paul Rigaudière
- INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Véronique Patrac
- INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Damien Bouvier
- Department of Medical Biochemistry and Molecular Biology, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Isabelle Hininger-Favier
- INSERM, U1055, Laboratory of Fundamental and Applied Bioenergetics, LBFA, Université Grenoble Alpes, 38000, Grenoble, France
| | - Stéphane Walrand
- CHU Clermont-Ferrand, INRAE, UNH, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Luc Demaison
- INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, 28 Place Henri Dunant, 63000, Clermont-Ferrand, France.
| |
Collapse
|
5
|
Lakin R, Debi R, Yang S, Polidovitch N, Goodman JM, Backx PH. Differential negative effects of acute exhaustive swim exercise on the right ventricle are associated with disproportionate hemodynamic loading. Am J Physiol Heart Circ Physiol 2021; 320:H1261-H1275. [PMID: 33416456 DOI: 10.1152/ajpheart.00603.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acute exhaustive endurance exercise can differentially impact the right ventricle (RV) versus the left ventricle (LV). However, the hemodynamic basis for these differences and its impact on postexercise recovery remain unclear. Therefore, we assessed cardiac structure and function along with hemodynamic properties of mice subjected to single bouts (216 ± 8 min) of exhaustive swimming (ES). One-hour after ES, LVs displayed mild diastolic impairment compared with that in sedentary (SED) mice. Following dobutamine administration to assess functional reserve, diastolic and systolic function were slightly impaired. Twenty-four hours after ES, LV function was largely indistinguishable from that in SED. By contrast, 1-h post swim, RVs showed pronounced impairment of diastolic and systolic function with and without dobutamine, which persisted 24 h later. The degree of RV impairment correlated with the time-to-exhaustion. To identify hemodynamic factors mediating chamber-specific responses to ES, LV pressure was recorded during swimming. Swimming initiated immediate increases in heart rates (HRs), systolic pressure, dP/dtmax and -dP/dtmin, which remained stable for ∼45 min. LV end-diastolic pressures (LVEDP) increased to ≥45 mmHg during the first 10 min and subsequently declined. After 45 min, HR and -dP/dtmin declined, which correlated with gradual elevations in LVEDP (to ∼45 mmHg) as mice approached exhaustion. All parameters rapidly normalized postexercise. Consistent with human studies, our findings demonstrate a disproportionate negative impact of acute exhaustive exercise on RVs that persisted for at least 24 h. We speculate that the differential effects of exhaustive exercise on the ventricles arise from a ∼2-fold greater hemodynamic load in the RV than in LV originating from profound elevations in LVEDPs as mice approach exhaustion.NEW & NOTEWORTHY Acute exhaustive exercise differentially impacts the right ventricle (RV) versus left ventricle (LV), yet the underlying hemodynamic basis remains unclear. Using pressure-volume analyses and pressure-telemetry implantation in mice, we confirmed a marked disproportionate and persistent negative impact of exhaustive exercise on the RV. These differences in responses of the ventricles to exhaustive exercise are of clinical relevance, reflecting ∼2-fold greater hemodynamic RV loads versus LVs arising from massive (∼45 mmHg) increases in LV end-diastolic pressures at exhaustion.
Collapse
Affiliation(s)
- Robert Lakin
- Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Biology, York University, Toronto, Ontario, Canada.,Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Ryan Debi
- Department of Biology, York University, Toronto, Ontario, Canada
| | - Sibao Yang
- Department of Biology, York University, Toronto, Ontario, Canada.,Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Nazari Polidovitch
- Department of Biology, York University, Toronto, Ontario, Canada.,Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Jack M Goodman
- Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada.,Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| | - Peter H Backx
- Department of Biology, York University, Toronto, Ontario, Canada.,Division of Cardiology, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Balmain BN, Sabapathy S, Yamada A, Shiino K, Chan J, Haseler LJ, Kavanagh JJ, Morris NR, Stewart GM. Cardiac perturbations after high-intensity exercise are attenuated in middle-aged compared with young endurance athletes: diminished stress or depleted stimuli? Am J Physiol Heart Circ Physiol 2020; 320:H159-H168. [PMID: 33124881 DOI: 10.1152/ajpheart.00427.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Strenuous exercise elicits transient functional and biochemical cardiac imbalances. Yet, the extent to which these responses are altered owing to aging is unclear. Accordingly, echocardiograph-derived left ventricular (LV) and right ventricular (RV) global longitudinal strain (GLS) and high-sensitivity cardiac troponin I (hs-cTnI) were assessed before (pre) and after (post) a 60-min high-intensity cycling race intervention (CRIT60) in 11 young (18-30 yr) and 11 middle-aged (40-65 yr) highly trained male cyclists, matched for cardiorespiratory fitness. LV and RV GLS were measured at rest and during a semirecumbent exercise challenge performed at the same intensity (young: 93 ± 10; middle-aged: 85 ± 11 W, P = 0.60) pre- and post-CRIT60. Augmentation (change from rest-to-exercise challenge) of LV GLS (pre: -2.97 ± 0.65; post: -0.82 ± 0.48%, P = 0.02) and RV GLS (pre: -2.08 ± 1.28; post: 3.08 ± 2.02%, P = 0.01) was attenuated and completely abolished, in the young following CRIT60, while augmentation of LV GLS (pre: -3.21 ± 0.41; post: -3.99 ± 0.55%, P = 0.22) and RV GLS (pre: -3.47 ± 1.44; post: -1.26 ± 1.00%, P = 0.27) was preserved in middle-aged following CRIT60. While serum hs-cTnI concentration increased followingCRIT60 in the young (pre: 7.3 ± 1.6; post: 17.7 ± 1.6 ng/L, P < 0.01) and middle-aged (pre: 4.5 ± 0.6; post: 10.7 ± 2.0 ng/L, P < 0.01), serum hs-cTnI concentration increased to a greater extent in the young than in the middle-aged following CRIT60 (P < 0.01). These findings suggest that functional and biochemical cardiac perturbations induced by high-intensity exercise are attenuated in middle-aged relative to young individuals. Further study is warranted to determine whether acute exercise-induced cardiac perturbations alter the adaptive myocardial remodeling response.NEW & NOTEWORTHY High-intensity endurance exercise elicits acute cardiac imbalances that may be an important stimulus for adaptive cardiac remodeling. This study highlights that following a bout of high-intensity exercise that is typical of routine day-to-day cycling training, exercise-induced autonomic, biochemical, and functional cardiac imbalances are attenuated in middle-aged relative to young well-trained cyclists. These findings suggest that aging may alter exercise-induced stress stimulus response that initiates cardiac remodeling in athlete's heart.
Collapse
Affiliation(s)
- Bryce N Balmain
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, Texas.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | | | - Akira Yamada
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Kenji Shiino
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Jonathan Chan
- Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,Cardiology Division, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Luke J Haseler
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Justin J Kavanagh
- Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Norman R Morris
- Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Glenn M Stewart
- Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
7
|
Trachsel LD, David LP, Gayda M, Henri C, Hayami D, Thorin-Trescases N, Thorin É, Blain MA, Cossette M, Lalongé J, Juneau M, Nigam A. The impact of high-intensity interval training on ventricular remodeling in patients with a recent acute myocardial infarction-A randomized training intervention pilot study. Clin Cardiol 2019; 42:1222-1231. [PMID: 31599994 PMCID: PMC6906981 DOI: 10.1002/clc.23277] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High‐intensity interval training (HIIT) is a time‐efficient method to improve V˙O2peak in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI). Methods Nineteen post‐AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N‐terminal pro B‐type natriuretic peptide levels and G protein‐coupled receptor kinase 2 expression) were performed before and after a 12‐week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and V˙O2 at the first ventilatory threshold (V˙O2 VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed. Results V˙O2peak and OUES improved solely in the HIIT group (P < .05 for group/time, respectively). There was a significant training effect for the improvement of peak work load in both groups (P < .05). O2 pulse and V˙O2 at VT1 both improved only in the HIIT group (P < .05 for time, no interaction). HIIT improved radial strain and pulsed‐wave tissue Doppler imaging derived e′ (P < .05 for time, no interaction). Cardiac biomarkers did not change in either group. Conclusions In post‐AMI patients, HIIT lead to significant improvements in prognostic CPET parameters compared to usual care. HIIT was associated with favorable ventricular remodeling regarding certain echocardiographic parameters of LV function.
Collapse
Affiliation(s)
- Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Douglas Hayami
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Éric Thorin
- Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mélissa-Anne Blain
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
8
|
Abstract
Purpose Previous studies have noted consequences of ultra-distance trail running on health, but few studies are available regarding the temporal variations of renal biomarker injury during the running. The aim of this study was to assess the of kidney function parameters temporal variation during and on short-term after an ultra-distance race. Methods We performed an observational study with 47 subjects participating in an ultra-distance race (80 km). Urine (47 subjects) and blood (21 subjects) samples were serially collected before (baseline—km 0), during (21 and 53 km), on arrival (80 km), and 9 days after the race (d9). Results Mean serum creatinine increased during the race from 90±14 μmol/L (km0) to 136±32 μmol/L (km 80—p<0.0001) corresponding to a 52% increase. Mean creatininuria progressively increased from 4.7±4.5 mmol/L (km 0) to 22.8±12.0 mmol/L (km 80) (p<0.0001). Both urinary biomarkers (Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1) of acute kidney injury (AKI) progressively increased during the race (p<0.05 vs baseline). However, after adjustment to urine dilution by urine creatinine, no significant changes remained (p>0.05). On day 9, no significant difference remains in blood and urine biomarkers compared to their respective baseline levels. Conclusions During an ultra-distance race, despite an acute and transient increase in the serum creatinine levels, urinary biomarkers of AKI displayed only limited changes with a complete regression on day 9. These results suggest the absence of the short-term impact of an ultra-distance race kidney function.
Collapse
|
9
|
Lord RN, Utomi V, Oxborough DL, Curry BA, Brown M, George KP. Left ventricular function and mechanics following prolonged endurance exercise: an update and meta-analysis with insights from novel techniques. Eur J Appl Physiol 2018; 118:1291-1299. [PMID: 29869711 PMCID: PMC6028893 DOI: 10.1007/s00421-018-3906-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/26/2018] [Indexed: 11/24/2022]
Abstract
Background The cardiac consequences of undertaking endurance exercise are the topic of
recent debate. The purpose of this review is to provide an update on a growing
body of literature, focusing on left ventricular (LV) function following
prolonged endurance exercise over 2 h in duration which have employed novel
techniques, including myocardial speckle tracking, to provide a more
comprehensive global and regional assessment of LV mechanics. Methods Prospective studies were filtered independently following a pre-set criteria,
resulting in the inclusion of 27 studies in the analyses. A random-effects
meta-analysis was used to determine the weighted mean difference and 95%
confidence intervals (CI) of LV functional and mechanical data from
pre-to-post-exercise. Narrative commentary was also provided where volume of
available evidence precluded meta-analysis. Results A significant overall reduction in LV longitudinal strain (Ɛ) n = 22
(− 18 ± 1 to − 17 ± 1%; effect size (d) − 9:
− 1 to − 0.5%), strain rate n = 10 (SR;d − 0.9: − 0.1.3 to − 0.5 l/s) and twistn = 5 (11.9 ± 2.2 to 8.7 ± 2.2°,d − 1: − 1.6 to − 0.3°) was observed
following strenuous endurance exercise (range 120–1740 min) (P < 0.01). A smaller number of studies
(n = 4) also reported a non-significant
reduction in global circumferential and radial Ɛ (P > 0.05). Conclusion The meta-analysis and narrative commentary demonstrated that a reduction in LV
function and mechanics is evident following prolonged endurance exercise. The
mechanism(s) responsible for these changes are complex and likely
multi-factorial in nature and may be linked to right and left ventricular
interaction.
Collapse
Affiliation(s)
- Rachel N Lord
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University Cyncoed Campus, Cyncoed Road, Cardiff, CF236XD, UK.
| | - Victor Utomi
- Research Institure for Sport and Exercise Sciences, Tom Reilly Building, Liverpool John Moores University, Liverpool, UK
| | - David L Oxborough
- Research Institure for Sport and Exercise Sciences, Tom Reilly Building, Liverpool John Moores University, Liverpool, UK
| | - Bryony A Curry
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University Cyncoed Campus, Cyncoed Road, Cardiff, CF236XD, UK
| | - Megan Brown
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University Cyncoed Campus, Cyncoed Road, Cardiff, CF236XD, UK
| | - Keith P George
- Research Institure for Sport and Exercise Sciences, Tom Reilly Building, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
10
|
Changes of Cardiac Function During Ultradistance Trail Running. Am J Cardiol 2015; 116:1284-9. [PMID: 26294134 DOI: 10.1016/j.amjcard.2015.07.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/09/2015] [Accepted: 07/09/2015] [Indexed: 11/23/2022]
Abstract
Previous studies have noted reversible cardiac dysfunction during marathon races, but few data are available concerning ultradistance trail running. The aim of this study was to assess echocardiographic parameters during ultradistance trail running. We performed an observational study in 66 participants to the 80-km Ecotrail of Paris Ile de France. All subjects had echocardiographic examinations before the race and on arrival, and 28 of them underwent serial echocardiographic examinations during the race (21 and 53 km). A single experienced physician performed all echocardiographic examinations, and the same protocol was always used (conventional 2-dimensional and Doppler left ventricular parameters and longitudinal strain). All echocardiographic parameters of left ventricular (LV) systolic function were significantly decreased on arrival (p ≤0.002). A significant reduction of LV systolic function was observed in 48% of study subjects on arrival. No significant modification was observed at 21 or at 53 km, and only global longitudinal strain was significantly decreased (p = 0.0008). At arrival, mitral E/A ratio and average mitral tissue Doppler imaging e' wave were significantly decreased (p = 0.0001 and p = 0.0004, respectively), but these changes were observed from 21 km. In conclusion, ultradistance trail running can lead to abnormalities of LV systolic and diastolic functions in amateur runners. Diastolic dysfunction arises earlier than systolic dysfunction. Left ventricular systolic dysfunction occurred in 48% of the study subjects and was detected early by assessment of longitudinal strain.
Collapse
|
11
|
Stewart GM, Yamada A, Haseler LJ, Kavanagh JJ, Koerbin G, Chan J, Sabapathy S. Altered ventricular mechanics after 60 min of high-intensity endurance exercise: insights from exercise speckle-tracking echocardiography. Am J Physiol Heart Circ Physiol 2015; 308:H875-83. [DOI: 10.1152/ajpheart.00917.2014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/29/2015] [Indexed: 11/22/2022]
Abstract
Transient reductions in myocardial strain coupled with cardiac-specific biomarker release have been reported after prolonged exercise (>180 min). However, it is unknown if 1) shorter-duration exercise (60 min) can perturb cardiac function or 2) if exercise-induced reductions in strain are masked by hemodynamic changes that are associated with passive recovery from exercise. Left ventricular (LV) and right ventricular global longitudinal strain (GLS), LV torsion, and high-sensitivity cardiac troponin T were measured in 15 competitive cyclists (age: 28 ± 3 yr, peak O2 uptake: 4.8 ± 0.6 l/min) before and after a 60-min high-intensity cycling race intervention (CRIT60). At both time points (pre- and post-CRIT60), strain and torsion were assessed at rest and during a standardized low-intensity exercise challenge (power output: 96 ± 8 W) in a semirecumbent position using echocardiography. During rest, hemodynamic conditions were different from pre- to post-CRIT60 (mean arterial pressure: 96 ± 1 vs. 86 ± 2 mmHg, P < 0.001), and there were no changes in strain or torsion. In contrast, during the standardized low-intensity exercise challenge, hemodynamic conditions were unchanged from pre- to post-CRIT60 (mean arterial pressure: 98 ± 1 vs. 97 ± 1 mmHg, not significant), but strain decreased (left ventricular GLS: −20.3 ± 0.5% vs. −18.5 ± 0.4%, P < 0.01; right ventricular GLS: −26.4 ± 1.6% vs. −22.4 ± 1.5%, P < 0.05), whereas LV torsion remained unchanged. Serum high-sensitivity cardiac troponin T increased by 345% after the CRIT60 (6.0 ± 0.6 vs. 20.7 ± 6.9 ng/l, P < 0.05). This study demonstrates that exercise-induced functional and biochemical cardiac perturbations are not confined to ultraendurance sporting events and transpire during exercise that is typical of day-to-day training undertaken by endurance athletes. The clinical significance of cumulative exposure to endurance exercise warrants further study.
Collapse
Affiliation(s)
- Glenn M. Stewart
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Akira Yamada
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Luke J. Haseler
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Justin J. Kavanagh
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Gus Koerbin
- ACT Pathology, The Canberra Hospital, Garran, Australian Capital Territory, Australia
- Faculty of Education, Science, Technology and Maths, University of Canberra, Bruce, Australian Capital Territory, Australia; and
| | - Jonathan Chan
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
- Cardiology Division, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Surendran Sabapathy
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|