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Hu S, Zhang H, Ma H, Yang C, Hu P, Gao F. Assessment of right ventricular structure and systolic function in amateur marathon runners using three-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 2023; 39:1473-1482. [PMID: 37178419 PMCID: PMC10427556 DOI: 10.1007/s10554-023-02869-z] [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: 11/14/2022] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Prolonged high-intensity endurance exercise has been reported to have adverse effects on the heart, which are further correlated with exercise dose. However, its effect on the right ventricle (RV) of amateur runners is unknown. This study aimed was to evaluate the early right ventricular structure and systolic function of amateur marathon runners by three-dimensional speckle tracking echocardiography (3D-STE), and to further analyze the correlation between relevant parameters and the amount of training. A total of 30 amateur marathon runners (marathon group) and 27 healthy volunteers (control group) were enrolled. Conventional echocardiography combined with 3D-STE was performed in all subjects, and the marathon group was screened by echocardiography a week before a marathon (V1), within 1 h post-marathon (V2), and 4 days post-marathon (V3). RV global longitudinal strain (GLS) and RV end-diastolic volume (EDV) increased significantly in the marathon group compared to the control group (P < 0.05). RV GLS was significantly decreased in the marathon group within 1 h post-marathon (V1: - 26.2 ± 2.5% vs V2: - 23.0 ± 1.6% vs V3: - 25.6 ± 2.6%, P < 0.001). However, there was no significant difference in RV ejection fraction (RVEF) (P > 0.05). The results of the correlation analysis showed that RV EDV and RV end-systolic volume (ESV) were positively correlated with the average training volume (P < 0.001). Multivariate linear regression analysis showed that average training volume was an independent predictor of RV EDV in amateur marathoners (β = 0.642, P < 0.001). The systolic function of the RV was enhanced in amateur marathon runners in the early stage, manifested by an increase in RV EDV. After a long period of high-intensity endurance exercise, RV systolic function will temporarily be reduced. 3D-STE can identify this subclinical change with high sensitivity and provide valuable information to assess the structure and function of RV in amateur marathon runners.
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Affiliation(s)
- Shanting Hu
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Hebin Zhang
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- Hangzhou Institute of Sports Medicine for Marathon, Hangzhou, China
| | - Hui Ma
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Cunxin Yang
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
| | - Peipei Hu
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China
| | - Feng Gao
- Department of Ultrasonography, Affiliate Hospital of Hangzhou Normal University, Hangzhou, China.
- School of Medicine, Hangzhou Normal University, Hangzhou, China.
- Hangzhou Institute of Sports Medicine for Marathon, Hangzhou, China.
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Zimmermann P, Eckstein ML, Moser O, Schöffl I, Zimmermann L, Schöffl V. Left Ventricular, Left Atrial and Right Ventricular Strain Modifications after Maximal Exercise in Elite Ski-Mountaineering Athletes: A Feasibility Speckle Tracking Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13153. [PMID: 36293734 PMCID: PMC9603167 DOI: 10.3390/ijerph192013153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Eleven world elite ski-mountaineering (Ski-Mo) athletes were evaluated for pronounced echocardiographic physiological remodeling as the primary aim of our feasibility speckle tracking study. In this context, sports-related cardiac remodeling was analyzed by performing two-dimensional echocardiography, including speckle tracking analysis of the left atrium (LA), right ventricle (RV) and left ventricular (LV) global longitudinal strain (LV-GLS) at rest and post-peak performance. The feasibility echocardiographic speckle tracking analysis was performed on eleven elite Ski-Mo athletes, which were obtained in 2022 during the annual medical examination. The obtained data of the professional Ski-Mo athletes (11 athletes, age: 18-26 years) were compared for different echocardiographic parameters at rest and post-exercise. Significant differences were found for LV-GLS mean (p = 0.0036) and phasic LA conduit strain pattern at rest and post-exercise (p = 0.0033). Furthermore, negative correlation between LV mass and LV-GLS (p = 0.0195, r = -0.69) and LV mass Index and LV-GLS (p = 0.0253, r = -0.66) at rest were elucidated. This descriptive reporting provided, for the first time, a sport-specific dynamic remodeling of an entire elite national team of the Ski-Mo athlete's left heart and elucidated differences in the dynamic deformation pattern of the left heart.
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Affiliation(s)
- Paul Zimmermann
- Department of Cardiology, Klinikum Bamberg, 96049 Bamberg, Germany
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Max L. Eckstein
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Isabelle Schöffl
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nurnberg, 91054 Erlangen, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Lukas Zimmermann
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
| | - Volker Schöffl
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
- Department of Orthopedic and Trauma Surgery, Friedrich-Alexander-University Erlangen-Nurnberg, 91054 Erlangen, Germany
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, 96049 Bamberg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine at the University of Colorado School of Medicine, Denver, CO 80045, USA
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Mrakic-Sposta S, Gussoni M, Vezzoli A, Dellanoce C, Comassi M, Giardini G, Bruno RM, Montorsi M, Corciu A, Greco F, Pratali L. Acute Effects of Triathlon Race on Oxidative Stress Biomarkers. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:3062807. [PMID: 32256948 PMCID: PMC7109587 DOI: 10.1155/2020/3062807] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/12/2019] [Indexed: 01/01/2023]
Abstract
The response to strenuous exercise was investigated by reactive oxygen species (ROS) production, oxidative damage, thiol redox status, and inflammation assessments in 32 enrolled triathlon athletes (41.9 ± 7.9 yrs) during Ironman® (IR), or half Ironman® (HIR) competition. In biological samples, inflammatory cytokines, aminothiols (glutathione (GSH), homocysteine (Hcy), cysteine (Cys), and cysteinylglycine (CysGly)), creatinine and neopterin, oxidative stress (OxS) biomarkers (protein carbonyl (PC), thiobarbituric acid-reactive substances (TBARS)), and ROS were assessed. Thirteen HIR and fourteen IR athletes finished the race. Postrace, ROS (HIR +20%; IR +28%; p < 0.0001), TBARS (HIR +57%; IR +101%), PC (HIR +101%; IR +130%) and urinary neopterin (HIR +19%, IR +27%) significantly (range p < 0.05-0.0001) increased. Moreover, HIR showed an increase in total Cys +28%, while IR showed total aminothiols, Cys, Hcy, CysGly, and GSH increase by +48, +30, +58, and +158%, respectively (range p < 0.05-0.0001). ROS production was significantly correlated with TBARS and PC (R 2 = 0.38 and R 2 = 0.40; p < 0.0001) and aminothiols levels (range R 2 = 0.17-0.47; range p < 0.01-0.0001). In particular, ROS was directly correlated with the athletes' age (R 2 = 0.19; p < 0.05), with ultraendurance years of training (R 2 = 0.18; p < 0.05) and the days/week training activity (R 2 = 0.16; p < 0.05). Finally, the days/week training activity (hours/in the last 2 weeks) was found inversely correlated with the IL-6 postrace (R 2 = -0.21; p < 0.01). A strenuous performance, the Ironman® distance triathlon competition, alters the oxidant/antioxidant balance through a great OxS response that is directly correlated to the inflammatory parameters; furthermore, the obtained data suggest that an appropriate training time has to be selected in order to achieve the lowest ROS production and IL-6 concentration at the same time.
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Affiliation(s)
- Simona Mrakic-Sposta
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maristella Gussoni
- Institute of Science and Chemical Technology, National Council of Research (SCITEC-CNR), Milan, Italy
| | - Alessandra Vezzoli
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Cinzia Dellanoce
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Mario Comassi
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), Pisa, Italy
| | - Guido Giardini
- Neurology and Neurophysiology Department, Mountain Medicine Center Valle d' Aosta Regional Hospital Umberto Parini, Aosta, Italy
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Michela Montorsi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Milan, Italy
| | - Anca Corciu
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), Pisa, Italy
| | - Fulvia Greco
- Institute of Science and Chemical Technology, National Council of Research (SCITEC-CNR), Milan, Italy
| | - Lorenza Pratali
- Institute of Clinical Physiology, National Council of Research (IFC-CNR), Pisa, Italy
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Lakatos BK, Kiss O, Tokodi M, Tősér Z, Sydó N, Merkely G, Babity M, Szilágyi M, Komócsin Z, Bognár C, Kovács A, Merkely B. Exercise-induced shift in right ventricular contraction pattern: novel marker of athlete's heart? Am J Physiol Heart Circ Physiol 2018; 315:H1640-H1648. [PMID: 30216120 DOI: 10.1152/ajpheart.00304.2018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Data about the functional adaptation of the right ventricle (RV) to intense exercise are limited. Our aim was to characterize the RV mechanical pattern in top-level athletes using three-dimensional echocardiography. A total of 60 elite water polo athletes (19 ± 4 yr, 17 ± 6 h of training/wk, 50% women and 50% men) and 40 healthy sedentary control subjects were enrolled. We measured the RV end-diastolic volume index (RVEDVi) and ejection fraction (RVEF) using dedicated software. Furthermore, we determined RV global longitudinal (RV GLS) and circumferential strain (RV GCS) and the relative contribution of longitudinal ejection fraction (LEF) and radial ejection fraction (REF) to RVEF using the ReVISION method. Athletes also underwent cardiopulmonary exercise testing [O2 consumption (V̇o2)/kg]. Athletes had significantly higher RVEDVi compared with control subjects (athletes vs. control subjects, 88 ± 11 vs. 65 ± 10 ml/m2, P < 0.001); however, they also demonstrated lower RVEF (56 ± 4% vs. 61 ± 5%, P < 0.001). RV GLS was comparable between the two groups (-22 ± 5% vs. -23 ± 5%, P = 0.24), whereas RV GCS was significantly lower in athletes (-21 ± 4% vs. -26 ± 7%, P < 0.001). Athletes had higher LEF and lower REF contribution to RVEF (LEF/RVEF: 0.50 ± 0.07 vs. 0.42 ± 0.07, P < 0.001; REF/RVEF: 0.33 ± 0.08 vs. 0.45 ± 0.08, P < 0.001). Moreover, the pattern of RV functional shift correlated with V̇o2/kg (LEF/RVEF: r = 0.30, P < 0.05; REF/RVEF: r = -0.27, P < 0.05). RV mechanical adaptation to long-term intense exercise implies a functional shift; the relative contribution of longitudinal motion to global function was increased, whereas the radial shortening was significantly decreased, in athletes. Moreover, this functional pattern correlates with aerobic exercise performance, representing a potential new resting marker of an athlete's heart. NEW & NOTEWORTHY Intensive regular physical exercise results in significant changes of right ventricular morphology and function. By separate quantification of the right ventricular longitudinal and radial function, a relative dominance of longitudinal motion and a decrease in radial motion can be observed compared with sedentary controls. Moreover, this contraction pattern correlates with cardiopulmonary fitness. According to these results, this functional shift of the right ventricle may represent a novel marker of an athlete's heart.
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Affiliation(s)
| | - Orsolya Kiss
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | - Márton Tokodi
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | | | - Nóra Sydó
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | - Gergő Merkely
- Semmelweis University Heart and Vascular Center , Budapest , Hungary.,Department of Orthopaedics, Uzsoki Hospital , Budapest , Hungary
| | - Máté Babity
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | - Mónika Szilágyi
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | | | - Csaba Bognár
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | - Attila Kovács
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
| | - Béla Merkely
- Semmelweis University Heart and Vascular Center , Budapest , Hungary
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