Left and right ventricular morphology and function in athletes with elevated pulmonary systolic arterial pressure

Mirea, Oana; Corîci, Oana Maria; Istrătoaie, Octavian; Donoiu, I; Iancău, Maria; Militaru, Constantin

doi:10.1111/echo.14016

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…2C), suggesting that the greater relative heart mass is a basis for the difference in left ventricle stroke volume between the groups. Stroke volume is correlated with cardiac mass in birds (Grubb, 1983;Seymour and Blaylock, 2000) and trained human athletes (Mirea et al, 2018). If increased cardiac mass in the hypoxicincubated alligators in this study translates to a relatively larger ventricle lumen volume, then this could account for the increased baseline stroke volume in the hypoxic group.…”

Section: Response To Dobutaminementioning

confidence: 67%

Embryonic developmental oxygen preconditions cardiovascular function response to acute hypoxic exposure and maximal β-adrenergic stimulation of anesthetized juvenile American alligators (Alligator mississippiensis)

Smith

Crossley

Elsey

et al. 2019

Journal of Experimental Biology

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The effects of the embryonic environment on juvenile phenotypes are widely recognized. We investigated the effect of embryonic hypoxia on the cardiovascular phenotype of 4-year-old American alligators (Alligator mississippiensis). We hypothesized that embryonic 10% oxygen preconditions cardiac function, decreasing the reduction in cardiac contractility associated with acute 5% oxygen exposure in juvenile alligators. Our findings indicate that dobutamine injections caused a 90% increase in systolic pressure in juveniles that were incubated in 21% and 10% O2 with the 10% O2 group responding with a greater rate of ventricular relaxation and greater left ventricle output compared the 21% O2 group. Further our findings indicate that juvenile alligators that experienced embryonic hypoxia have a faster rate of ventricular relaxation, greater left ventricle stroke volume, and greater cardiac power following beta-adrenergic stimulation, compared to juvenile alligators that did not experience embryonic hypoxia. When juveniles were exposed to 5% oxygen for 20 minutes, normoxic-incubated juveniles had a 50% decline in left ventricle maximal rate of pressure development and maximal pressure; however, these parameters were unaffected and decreased less in the hypoxic-incubated juveniles. These data indicate that embryonic hypoxia in crocodilians alters the cardiovascular phenotype, changing the juvenile response to acute hypoxia and beta-adrenergic stimulation.

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Section: Response To Dobutaminementioning

confidence: 67%

Embryonic developmental oxygen preconditions cardiovascular function response to acute hypoxic exposure and maximal β-adrenergic stimulation of anesthetized juvenile American alligators (Alligator mississippiensis)

Smith

Crossley

Elsey

et al. 2019

Journal of Experimental Biology

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“…In the multiple logistic regression model, the enhanced LV diastolic function in elite endurance athletes was due to a reduced resting heart rate, ( 29 ) and that in elite strength athletes might be related to an improved LV compliance. The reduced heart rate related to endurance exercise has been associated with an increase of parasympathetic tone ( 30 ). On the contrary, physically active Asian males regardless of endurance or strength exercise in the present study had a similar RVSP (25–29 mmHg) compared to non-Asian endurance athletes (26–27 mmHg), which was higher than that in sedentary controls in prior studies (16–22 mmHg) ( 25 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

Athlete's Heart in Asian Military Males: The CHIEF Heart Study

Liu

Tsai

Lima

et al. 2021

Front. Cardiovasc. Med.

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Background: Elite athlete's heart is characterized by a greater left ventricular mass indexed by body surface area (LVMI) and diastolic function; however previous studies are mainly conducted in non-Asian athletes compared to sedentary controls.Methods: This study included 1,388 male adults, aged 18–34 years, enrolled in the same unified 6-month physical training program in Taiwan. During the midterm exams of 2020, all trainees completed a 3-km run (endurance) test, and 577 were randomly selected to attend a 2-min push-up (muscular strength) test. Elite athletes were defined as the performance of each exercise falling one standard deviation above the mean (16%). Cardiac structure and function were measured by echocardiography and compared between elite and non-elite athletes. Multiple logistic regression analysis was used to determine the independent predictors of elite athlete status at each exercise modality.Results: As compared to non-elite controls, elite endurance athletes had greater LVMI (84.4 ± 13.6 vs. 80.5 ± 12.9 g/m2, p < 0.001) and lateral mitral E'/A' ratio (2.37 ± 0.73 vs. 2.22 ± 0.76, p < 0.01) with lower late diastolic A' (7.77 ± 2.16 vs. 8.30 ± 3.69 cm/s, p = 0.03). Elite strength athletes had greater LVMI (81.8 ± 11.4 vs. 77.5 ± 12.1, p = 0.004) and lateral mitral E'/A' ratio (2.36 ± 0.70 vs. 2.11 ± 0.71, p < 0.01) with a greater early diastolic E' (19.30 ± 4.06 vs. 18.18 ± 4.05 cm/s, p = 0.02). Greater LVMI and lower heart rate were independent predictors of elite endurance athletes [odds ratio (OR) and 95% confidence intervals: 1.03 (1.02, 1.04) and 0.96 (0.95, 0.98), respectively]. Greater LVMI, lateral mitral E'/A' ratio and right ventricular systolic pressure were independent predictors of elite strength athletes [OR: 1.03 (1.01, 1.05), 1.50 (1.06, 2.12), and 1.12 (1.05, 1.19), respectively].Conclusions: Cardiac structural and functional characteristics differ between endurance and strength elite athletes. While greater LVMI predicts elite status in both groups of Asian athletes, consistent with findings from Western elite athletes, greater diastolic function, and right ventricular systolic pressure characterize strength elite athletes, while lower heart rate at rest predicts endurance elite athletic status.

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“…Elevated systolic pulmonary artery pressure (sPAP) may be induced by strenuous endurance exercise. Mirea et al [24] found that 12.9% of the athletes they studied exhibited higher sPAP, which was further enhanced by bicycle ergometric stress effort and correlated with significant RV enlargement. Despite this, both conventional methods and STE indicated preserved RV function in these athletes.…”

Section: Athlete's Heart Grey Zonementioning

confidence: 91%

Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges

Palermi,

Sperlongano,

Mandoli

et al. 2023

JCM

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This comprehensive review explores the role of exercise stress echocardiography (ESE) in assessing cardiovascular health in athletes. Athletes often exhibit cardiovascular adaptations because of rigorous physical training, making the differentiation between physiological changes and potential pathological conditions challenging. ESE is a crucial diagnostic tool, offering detailed insights into an athlete’s cardiac function, reserve, and possible arrhythmias. This review highlights the methodology of ESE, emphasizing its significance in detecting exercise-induced anomalies and its application in distinguishing between athlete’s heart and other cardiovascular diseases. Recent advancements, such as LV global longitudinal strain (GLS) and myocardial work (MW), are introduced as innovative tools for the early detection of latent cardiac dysfunctions. However, the use of ESE also subsumes limitations and possible pitfalls, particularly in interpretation and potential false results, as explained in this article.

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Left and right ventricular morphology and function in athletes with elevated pulmonary systolic arterial pressure

Abstract: Pulmonary arterial systolic pressure elevation in young athletes is associated with pronounced right ventricular enlargement, even when compared to matched athletes. Conventional and speckle tracking echocardiography showed preserved right ventricular function.

Cited by 8 publications

References 34 publications

Embryonic developmental oxygen preconditions cardiovascular function response to acute hypoxic exposure and maximal β-adrenergic stimulation of anesthetized juvenile American alligators (Alligator mississippiensis)

Embryonic developmental oxygen preconditions cardiovascular function response to acute hypoxic exposure and maximal β-adrenergic stimulation of anesthetized juvenile American alligators (Alligator mississippiensis)

Athlete's Heart in Asian Military Males: The CHIEF Heart Study

Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges

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