Characterizing the spectrum of right ventricular remodelling in response to chronic training

Abstract

The significance and spectrum of reduced right ventricular (RV) deformation, reported in endurance athletes, is unclear. To comprehensively analyze the cardiac performance at rest of athletes, especially focusing on integrating RV size and deformation to unravel the underlying triggers of this ventricular remodelling. Hundred professional male athletes and 50 sedentary healthy males of similar age were prospectively studied. Conventional echocardiographic parameters of all four chambers were obtained, as well as 2D echo-derived strain (2DSE) in the left (LV) and in the RV free wall with separate additional analysis of the RV basal and apical segments. Left and right-sided dimensions were larger in athletes than in controls, but with a disproportionate RA enlargement. RV global strain was lower in sportsmen (-26.8 ± 2.8% vs -28.5 ± 3.4%, p < 0.001) due to a decrease in the basal segment (-22.8 ± 3.5% vs -25.8 ± 4.0%, p < 0.001) resulting in a marked gradient of deformation from the RV inlet towards the apex. By integrating size, deformation and stroke volume, we observed that the LV working conditions were similar in all sportsmen while a wider variability existed in the RV. Cardiac remodelling in athletes is more pronounced in the right heart cavities with specific regional differences within the right ventricle, but with a wide variability among individuals. The large inter-individual differences, as well as its acute and chronic relevance warrant further investigation.

Adolescent Finswimmers: Early Myocardial Adaptations in Different Swimming Styles

“…The said differences are explained by the different intrathoracic pressure developed during the swimming trails, as well as the systematic changes in the breathing pattern, which are necessary in order to optimize muscle strength and increase endurance [ 6 ]. Moreover, it has been proposed that the physiological characteristics of finswimming athletes [ 21 ] and cardiac adaptation to exercise training depend on the different muscle groups activated during the workout [ 22 ], while the cardiac remodeling in athletes is more pronounced in the heart cavities with specific regional differences [ 23 ]. During the training and the race, finswimmers develop periods of apnea that may be used to cover short distances underwater.…”

Cardiovascular imaging 2017 in the International Journal of Cardiovascular Imaging

“…Sitges et al [44] studied 100 professional male athletes and 50 sedentary healthy males of similar age. Conventional echocardiographic parameters of all four chambers were obtained, as well as two dimensional echo-derived strain in the left and in the right ventricular free wall with separate additional analysis of the right ventricular basal and apical segments.…”

Exercise-induced cardio-pulmonary remodelling in endurance athletes: Not only the heart adapts

“…The mechanisms underlying these differential responses have been scarcely explored, but differential pulmonary vasculature adaptation may be involved. 11,12…”