Echocardiographic findings in 104 professional cyclists with follow-up study

Miki, Takahiko; Yokota, Yoshiyuki; Seo, Toshihiko; Yokoyama, Mitsuhiro

doi:10.1016/0002-8703(94)90559-2

Cited by 34 publications

(21 citation statements)

References 30 publications

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“…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.…”

Section: Diastolic Functioncontrasting

confidence: 79%

“…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.…”

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confidence: 99%

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

et al. 1998

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Background-The question of whether training-induced left ventricular hypertrophy in athletes is a physiological rather than a pathophysiological phenomenon remains unresolved. The purpose of the present study was to detect any abnormalities in cardiac function in hypertrophic hearts of elite cyclists and to examine the response of myocardial high-energy phosphate metabolism to high workloads induced by atropine-dobutamine stress. Methods and Results-We studied 21 elite cyclists and 12 healthy control subjects. Left ventricular mass, volume, and function were determined by cine MRI. Myocardial high-energy phosphates were examined by 31 P magnetic resonance spectroscopy. There were no significant differences between cyclists and control subjects for left ventricular ejection fraction (59Ϯ5% versus 61Ϯ4%), left ventricular cardiac index (3.4Ϯ0.4 versus 3.4Ϯ0.4 L ⅐ min Ϫ1 ⅐ m Ϫ2 ), peak early filling rate (562Ϯ93 versus 535Ϯ81 mL/s), peak atrial filling rate (315Ϯ93 versus 333Ϯ65 mL/s), ratio of early and atrial filling volumes (3.0Ϯ1.0 versus 2.6Ϯ0.6), mean acceleration gradient of early filling (5.2Ϯ1.4 versus 5.8Ϯ1.9 L/s 2 ), mean deceleration gradient of early filling(Ϫ3.1Ϯ0.9 versus Ϫ3.2Ϯ0.7 L/s

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Section: Diastolic Functioncontrasting

confidence: 79%

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confidence: 99%

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

et al. 1998

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“…1,2) To date, conflicting data have been reported concerning the nature (physiologic versus pathologic) of left ventricular hypertrophy (LVH) in master athletes and veterans. [3][4][5][6] Exaggerated blood pressure response (EBPR) during exercise is associated with increased risk of worsening hypertension in normotensives, as well as in subjects with high normal blood pressure (BP). 7,8) Moreover, EBPR might be related to adverse cardiovascular outcomes, partially due to its association with indices of target-organ damage such as LVH, abnormal geometry, or carotid atherosclerosis.…”

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confidence: 99%

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

et al. 2013

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SummaryThis study was conducted to study left ventricular hypertrophy (LVH), diastolic dysfunction, pulse pressure (PP), and plasma endothelin (ET)-1 level in amateur marathon runners with an exaggerated blood pressure response (EBPR) to exercise. The study participants included normotensive marathon runners (NM, n = 15), EBPR marathon runners (EBPR, n = 17), normotensive sedentary individuals (CON, n = 13), and hypertensive patients (HTN, n = 14). An integrated M-mode/2-dimensional echocardiographic analysis was performed. Plasma ET-1 levels at resting were measured using a commercial ELISA kit. LV wall thickness and end-diastolic dimensions as well as LV mass index (LVMI) were higher in EBPR than in CON. There were no differences in systolic function among the groups. Analysis of diastolic function, such as lower Em and higher E/Em ratio on TDI, showed a worse relaxation pattern in EBPR. Despite LVH, NM subjects showed no abnormality of LV diastolic dysfunction. HTN subjects in the early stage of their disease showed a slightly modified LV structural and diastolic function, but there was no statistical difference compared with CON. The E/Em ratio was significantly correlated with PP and LVMI. LVMI was significantly correlated with PP. There was a significant difference in plasma ET-1 concentration between marathon runners and hypertensive subjects. We demonstrated that marathon runners with EBPR showed an increase in LVMI and diastolic dysfunction more than HTN subjects in the early stage. PP was significantly related to these two variables. Caution should be exercised when connecting LVH and diastolic dysfunction with plasma ET-1 concentration in all marathon runners. (Int Heart J 2013; 54: 82-87)Key words: Endothelin-1, Marathon A thlete's heart is a well known condition characterized by structural, electrical, and functional adaptations of the myocardium consequent to regular physical training and consistent with the intensity, duration, and type of activity.1,2) To date, conflicting data have been reported concerning the nature (physiologic versus pathologic) of left ventricular hypertrophy (LVH) in master athletes and veterans. [3][4][5][6] Exaggerated blood pressure response (EBPR) during exercise is associated with increased risk of worsening hypertension in normotensives, as well as in subjects with high normal blood pressure (BP). 7,8) Moreover, EBPR might be related to adverse cardiovascular outcomes, partially due to its association with indices of target-organ damage such as LVH, abnormal geometry, or carotid atherosclerosis. [9][10][11] In addition, diastolic dysfunction of the LV frequently accompanies EBPR. 12)However, we do not know whether EBPR in athletes would show the same features associated with abnormal LV remodeling and diastolic dysfunction. Recently, we have unofficially found numerous cases of EBPR to exercise in Korean nonathletic marathon runners. Marathons have become a popular leisure activity in Korea during the last 2 decades and rank first in popularity as a public sport. We t...

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“…It is notable that this reduction was mainly due to reduction of posterior wall thickness. In contrast, Miki et al [39] found no reduction of wall thickness in veteran cyclists who performed a big amount of training. Reduction of left ventricular mass has been found in several detraining studies in athletes [25, 46, 47].…”

Section: Discussionmentioning

confidence: 97%

“…Unchanged heart rate also was found by Sivertssen et al [26] on 25 years’ follow-up of Norwegian previous elite cross country skiers who also maintained some training. In rowers [25] and cyclists [39] who stopped their training the heart rate increased, while bradycardia was maintained in those who continued training [39]. …”

Section: Discussionmentioning

confidence: 99%

Long-Term Assessment of Electrocardiographic and Echocardiographic Findings in Norwegian Elite Endurance Athletes

Bjørnstad¹,

Bjørnstad²,

Urheim³

et al. 2008

Cardiology

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Objectives: The long-term outcome and clinical significance of athlete’s heart has been debated and more longitudinal data are needed. We present a prospective 15 years’ follow-up study of ECG and echo findings in elite endurance athletes following the end of their competitive career. Methods: Clinical evaluation, ECG, ambulatory Holter recording and echocardiography were performed in 30 top-level endurance athletes with a mean age of 24 years with follow-up 15 years later. All had then ended their competitive career, but still performed recreational sports activities. Results: No clinical events were reported. Average resting heart rate was unchanged (53.5 ± 10 at baseline and 55.4 ± 11 at follow-up, p = n.s.), complex ventricular arrhythmias did not occur and the number of ventricular premature beats (VPBs) were 0.4 ± 0.8/h at baseline and 3.8 ± 10/h at follow-up (p = n.s.). In a subgroup of 4 subjects with >100 VPBs per hour at follow-up left ventricular mass was increased compared to the others (p < 0.03). Furthermore, regression of sino-atrial (SA) and atrioventricular (AV) blocks was shown. There were no cases of atrial flutter or fibrillation. There was a slight reduction in mean left ventricular wall thickness (9.9 ± 1.2 vs. 9.5 ± 1.4 mm, p < 0.05) and a highly significant reduction of relative wall thickness (0.38 vs. 0.35, p < 0.001). Left ventricular end-diastolic volume (68 ± 6 vs. 70 ± 7 ml ml/m², p = n.s.) and left ventricular mass (109 ± 19 vs. 107 ± 19 g/m², p = n.s.) were unchanged when corrected for body surface area and ejection fraction (EF) increased (60 ± 7 vs. 67 ± 6%, p < 0.01). Parameters of left ventricular diastolic function were normal both at baseline and follow-up. Conclusions: There was no evidence of deleterious cardiac effects of previous top-level endurance athletic activity at 15 years’ follow-up.

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Echocardiographic findings in 104 professional cyclists with follow-up study

Cited by 34 publications

References 30 publications

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

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

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

Long-Term Assessment of Electrocardiographic and Echocardiographic Findings in Norwegian Elite Endurance Athletes

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