Echocardiographic evaluation of long-term effects of exercise on left ventricular hypertrophy and function in professional bicyclists.

Abstract

SUMMARY Echocardiographic examinations were performed in 60 professional bicyclists and control subjects to determine the effects of exercise on left ventricular hypertrophy and function. The athletes were separated by age into three groups: group I (n = 14), 20-29 years; group 2 (n = 17), 30-39 years; and group 3 (n = 29), 40-49 years.Echocardiograms showed enlargement of the left ventricular end-diastolic dimensions in all three groups compared with age-matched control groups (p < 0.001). Thickness of the interventricular septum and the left ventricular posterior wall was more prominent in group 3 of the athletes than groups I and 2 of the athletes and control group (p < 0.001). Resting left ventricular function evaluated with fractional shortening, ejection fraction and mean velocity of circumferential fiber shortening was significantly depressed in group 3 compared with the other groups. Moreover, 14% of group 3 subjects showed enlargement of left atrial dimension and T-wave inversion in the left precordial leads of the ECG. We conclude that left ventricular hypertrophy is an important ventricular adaptation in relatively young athletes. However, middle-aged athletes may be more susceptible to electrocardiographic abnormalities and prominent hypertrophy, and some may have slightly depressed left ventricular function.TRAINED ATHLETES often have bradycardia, systolic murmurs, radiographic evidence of cardiac enlargement, and a variety of electrocardiographic alterations.'-3 However, there has been controversy as to whether the athlete's heart is diseased, because the athletes usually do not have symptoms and remain active. Echocardiography provides a noninvasive and sensitive means of assessing cardiac dimension and function,4-7 and studies in relatively younger athletes have been reported.8 '3 However, few reports have noted the long-term effects of exercise on left ventricular hypertrophy and function in both young and middle-aged athletes. We used echocardiography to determine a pattern of hypertrophy and left ventricular function in professional bicyclists who had been under continuous training from youth to middle age.

Functional and Metabolic Evaluation of the Athlete’s Heart By Magnetic Resonance Imaging and Dobutamine Stress Magnetic Resonance Spectroscopy

“…These data indicate that LV hypertrophy in cyclists is not associated with significant changes in systolic or diastolic LV function. We could not confirm the findings of Nishimura at al, 9 who found significantly depressed resting systolic LV function in 40-to 49-year-old cyclists, or the findings of Miki et al, 10 who demonstrated a decreased ratio of early to atrial filling velocities in 40-to 60-year-old cyclists. Our findings are, however, in agreement with other previous Doppler echocardiographic studies in cylists [47][48][49][50] and other athletes 43,49,[51][52][53][54][55][56][57][58] that demonstrated normal or enhanced LV function parameters.…”

“…7,8 Echocardiographic studies have demonstrated reduced diastolic properties in several older elite cyclists, suggesting that in the long run, extreme physical training may have a negative effect on the heart, manifested by partly irreversible LV hypertrophy and impaired LV filling. 9,10 Previous studies of the morphological and functional aspects of the athlete's heart used echocardiography. 2,[11][12][13] In recent years, magnetic resonance techniques with the capability of assessing cardiac mass, function, and metabolism ( 31 P magnetic resonance spectroscopy) became available.…”

Effect of moderate physical training on left ventricular mass in mild hypertensive persons.

“…The lack of changes in left ventricular systolic function, estimated through the echocardiographic LVSF, is an effect of prolonged physical training described by some investigators. One investigator, 13 however, has shown a mild deterioration of LVSF in bicyclists over 40 years old and, also, after nontraining periods.…”

Physiological Society Symposium – the Athlete's Heart

“…For the purposes of clarification, a highly trained athlete is defined in this paper as an individual who engages in regular organised physical training within a particular sporting discipline and competes at county or national level. To date there have been several echocardiographic studies involving over 4000 highly trained athletes (Morganroth et al 1975;Roeske et al 1975;Nishimura et al 1980;Longhurst et al 1980;Fagard et al 1983;Maron, 1986;Douglas et al 1986;Pelliccia et al 1991Pelliccia et al , 1996Rodriguez et al 1995 (Foale et al 1986) making it difficult to ascertain from cross-sectional studies whether an increase in right ventricular dimensions in a highly trained athlete is related to exercise or not.…”