Endurance Exercise and the Right Ventricle

Wasfy, Meagan M.; Baggish, Aaron L.

doi:10.1161/circulationaha.116.022418

Cited by 3 publications

(2 citation statements)

References 15 publications

(12 reference statements)

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“…In addition, the fact that participants with a higher right systolic function at rest showed a greater exercise training response in MICT is interesting. This is consistent with previous data indicating the critical role of the right ventricle in the responsiveness to endurance training (Sharma et al 2015 ; Bohm et al 2016 ; Wasfy and Baggish 2016a , b ; Rundqvist et al 2016 ; Heiskanen et al 2016 )—the cardiac pumping capacity is considered to be a biological factor influencing cardiorespiratory fitness (Moreira et al 2020 ). Left ventricular mass (i.e., LV-Mass) showed opposite associations in HIIT and MICT.…”

Section: Discussionsupporting

confidence: 91%

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains

et al. 2021

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Purpose We investigated the cardiovascular individual response to 6 weeks (3×/week) of work-matched within the severe-intensity domain (high-intensity interval training, HIIT) or moderate-intensity domain (moderate-intensity continuous training, MICT). In addition, we analyzed the cardiovascular factors at baseline underlying the response variability. Methods 42 healthy sedentary participants were randomly assigned to HIIT or MICT. We applied the region of practical equivalence-method for identifying the levels of responders to the maximal oxygen uptake (V̇O2max) response. For investigating the influence of cardiovascular markers, we trained a Bayesian machine learning model on cardiovascular markers. Results Despite that HIIT and MICT induced significant increases in V̇O2max, HIIT had greater improvements than MICT (p < 0.001). Greater variability was observed in MICT, with approximately 50% classified as “non-responder” and “undecided”. 20 “responders”, one “undecided” and no “non-responders” were observed in HIIT. The variability in the ∆V̇O2max was associated with initial cardiorespiratory fitness, arterial stiffness, and left-ventricular (LV) mass and LV end-diastolic diameter in HIIT; whereas, microvascular responsiveness and right-ventricular (RV) excursion velocity showed a significant association in MICT. Conclusion Our findings highlight the critical influence of exercise-intensity domains and biological variability on the individual V̇O2max response. The incidence of “non-responders” in MICT was one third of the group; whereas, no “non-responders” were observed in HIIT. The incidence of “responders” was 11 out of 21 participants in MICT, and 20 out of 21 participants in HIIT. The response in HIIT showed associations with baseline fitness, arterial stiffness, and LV-morphology; whereas, it was associated with RV systolic function in MICT.

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Section: Discussionsupporting

confidence: 91%

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains

et al. 2021

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“…In patients with a single-ventricle circulation, the absence of a sub-pulmonary pump results in profound exercise intolerance and premature heart failure (19). While the importance of a biventricular pump in effective cardiac performance seems evident from these results, the exact role of the RV during exercise and in particular its impact on LV function and cardiac output (CO) remain unclear (38).…”

Section: Introductionmentioning

confidence: 99%

Synergy in the heart: RV systolic function plays a key role in optimizing LV performance during exercise

Ruijsink

Forte

Duong

et al. 2020

American Journal of Physiology-Heart and Circulatory Physiology

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The right ventricle (RV) is often overlooked in the evaluation of cardiac performance and treatment of left ventricular (LV) heart diseases. However, recent evidence suggests the RV may play an important role in maintaining systemic cardiac function and delivering stroke volume (SV). We used exercise cardiac magnetic resonance and biomechanical modeling to investigate the role of the RV in LV stroke volume regulation. We studied SV augmentation during exercise by pharmacologically inducing negative chronotropy (sHRi) in healthy volunteers and investigating training-induced SV augmentation in endurance athletes. SV augmentation during exercise after sHRi is achieved differently in the two ventricles. In the RV, the larger SV is driven by increasing contraction down to lower end-systolic volume (ESV; p<.001). In the LV, SV augmentation is achieved through an increase in end-diastolic volume (EDV; p<.001), avoiding contraction to a lower ESV. The same mechanism is underlies the enhanced SV response observed in athletes. Changes in atrial area during SV augmentation suggest that the improved LV EDV response is sustained by the larger RV contractions. Using our biomechanical model, we explain this behavior and show that the RV systolic function driven regulation of LV SV optimizes the energetic cost of LV contraction, and leads to minimization of the total costs of biventricular contraction. In conclusion, this work provides mechanistic understanding of the pivotal role of the RV in optimizing LV SV during exercise. It demonstrates why optimizing RV function needs to become a key part of therapeutic strategies in patients and training for athletes.

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Response by Bohm et al to Letter Regarding Article, “Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast-Enhanced Cardiovascular Magnetic Resonance Study”

et al. 2016

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Endurance Exercise and the Right Ventricle

Cited by 3 publications

References 15 publications

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains

Synergy in the heart: RV systolic function plays a key role in optimizing LV performance during exercise

Response by Bohm et al to Letter Regarding Article, “Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast-Enhanced Cardiovascular Magnetic Resonance Study”

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