Importance of the athlete's heart has been arisen in the last decades.
Consequences of the sedentary way of life are the most threatening through the impairments of the cardiovascular system. Endurance performance is mostly limited by the characteristics of the athlete's heart. Sudden death of the athletes is always associated with cardiac disorders.
Main characteristics of the athlete's heart can be divided into morphologic, functional and regulatory ones.
The main morphologic characteristics are the physiologic left ventricular (LV) hypertrophy and a richer coronary capillary network. The functional adaptation contains a better systolic and diastolic function, modified metabolism and electric characteristics. The most easily detected modification is the better LV diastolic function. Adaptation of the cardiac regulation is manifested mostly by a lower heart rate (HR).
Summarizing: the athlete's heart is an enlarged but otherwise normal heart characterized by a low heart rate, an increased pumping capacity, and a greater ability to deliver oxygen to skeletal muscle.
In our previous review characteristics of the athlete's heart were divided into three groups: morphologic (left ventricular (LV) hypertrophy, improved coronary circulation), functional (better diastolic function) and regulatory (lower heart rate (HR)) features. In the present review, the influences of the types of sports and the age on the athlete's heart are discussed. Studies using echocardiographic, Doppler-echocardiographic, tissue Doppler imaging (TDI) and magnetic resonance imaging (MRI) results are mostly involved. The coronary circulation was investigated overwhelmingly in animal experiments. In the LV hypertrophy a major contributor is the increase of the LV wall thickness (WT) than that of the LV internal diameter (ID). A right ventricular (RV) hypertrophy can also be seen in athletes. Athletic features are induced mostly by endurance training. Approximately two years regular physical training is needed to develop characteristics of the athlete's heart, hence, in the young children they are less marked. LV hypertrophy and lower HR are characteristic in young and adult athletes, but they are less marked in older ones. A richer coronary capillary network can develop mostly at a young age.
Characteristics of the athlete's heart have been investigated mostly in the left ventricle (LV); reports referring to the right ventricle (RV) have only appeared recently. The aim of the present study was to compare the training effects on RV and LV in elite male endurance athletes. To this end, echocardiography was conducted in 52 elite endurance athletes (A) and in 25 non-athletes (NA). Differences between A and NA in the morphology was more marked in the RV (body-size-matched (rel.)) long axis diastolic diameter (RVLADd): 63.4 ± 6.3 vs. 56.4 ± 6.3; rel. short axis diastolic diameter (RVSADd): 27.3 ± 3.6 vs. 23.6 ± 2.7 mm/m, RV diastolic area 28 ± 5.0 vs. 21.3 ± 4.3 cm 2 in all cases, p < 0.001) than in the LV (rel. LVLADd: 63.8 mm/m ± 5.6 vs. 60.7 mm/m ± 6.6, p < 0.05, rel.LVSADd 37.8 ± 3.1 vs. 35.3 ± 2.4, no difference). In the athletes ratios of peak early to late diastolic filling velocity (2.07 ± 0.51 vs. 1.75 ± 0.36, p < 0.01), the TDI-determined E'/A' ratio in the septal (1.89 ± 0.55 vs. 1.62 ± 0.55, p < 0.05) and lateral (2.62 ± 0.72, vs. 2.18 ± 0.87, p < 0.001) walls were significantly higher than in NA only in the LV. Results indicate that in male endurance athletes morphologic adaptation is similar or slightly stronger in the RV than in the LV, functional adaptation seems to be stronger in the LV.
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