Moderate Physical Activity in Healthy Adults Is Associated With Cardiac Remodeling

Dawes, Timothy J W; Corden, Ben; Cotter, Sorcha; Marvao, Antonio de; Walsh, Roddy; Ware, James S.; Cook, Stuart A.; O’Regan, Declan P.

doi:10.1161/circimaging.116.004712

Cited by 44 publications

(36 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The atrial enlargement and low-normal function found in our population do not represent dysfunction but a physiologic aspect of the ''athlete's heart'': less contraction in a higher volume chamber can achieve the same stroke volume as a smaller one with more pronounced shortening. 4,21 The same applies to the LA as well; moreover, resting bradycardia in athletes shifts the diastolic filling of the LV even more toward the early period. 22,23 All these changes refer to a more effective LA-LV diastolic coupling based mainly on passive hemodynamics instead of active contraction.…”

Section: Discussionmentioning

confidence: 98%

“…The nature of these changes is also influenced by other factors, such as age, gender, ethnicity, type of sport, cumulative years of training, and degree of conditioning. 4,[17][18][19][20] To the best of our knowledge, our study is the first to correlate LA morphology and function assessed by 3D echocardiography with CPET in a relatively large set of elite athletes. The atrial enlargement and low-normal function found in our population do not represent dysfunction but a physiologic aspect of the ''athlete's heart'': less contraction in a higher volume chamber can achieve the same stroke volume as a smaller one with more pronounced shortening.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Functional measurements often result in low-normal values at rest. 1,4 Despite the pronounced cardiac remodeling in athletes, it is still a matter of debate whether exercise capacity can be predicted by cardiac size or by resting functional measurements. [5][6][7] Traditionally, the left ventricle (LV) is the main focus of physiologic and clinical cardiovascular research, but the importance of left atrial (LA) structure and mechanics should not be underestimated.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography

Lakatos

Molnár

Kiss

et al. 2020

Journal of the American Society of Echocardiography

View full text Add to dashboard Cite

Background: Data are scarce regarding left atrial (LA) adaptation to regular physical exercise. The aim of this study was to examine left ventricular (LV) and also LA morphologic and functional remodeling in elite athletes using three-dimensional (3D) echocardiography. Methods: In this retrospective analysis, the study group consisted of 138 elite athletes (mean age, 20 6 4 years; 62% men) and 50 sedentary control subjects. Electrocardiographically gated full-volume 3D data sets were obtained for offline analysis using dedicated software for 3D LA and LV measurements. Body surface areaindexed LA maximal volume (LAVmax) and LV end-diastolic volume were determined. LA total emptying fraction, LA passive and LA active emptying fraction, and LV global longitudinal strain were also calculated. Athletes also underwent cardiopulmonary exercise testing to determine peak oxygen uptake. Results: Athletes demonstrated higher 3D LAVmax (32 6 6 vs 26 6 8 mL/m 2) and indexed LV end-diastolic volume (85 6 12 vs 62 6 10 mL/m 2) compared with control subjects (P < .001 for both). Functional measures of the left ventricle and left atrium, such as the absolute value of 3D LV global longitudinal strain (19 6 2% vs 22 6 2%), LA total emptying fraction (58 6 6% vs 64 6 6%), and active emptying fraction (24 6 10% vs 32 6 10%) were lower in athletes (P < .001 for all). Male athletes had higher indexed LV end-diastolic volume compared with female athletes (89 6 13 vs 80 6 8 mL/m 2 , P < .001), but LAVmax did not differ between genders (32 6 6 vs 33 6 5 mL/m 2 , P = .18). Besides heart rate, gender, and body surface area, 3D LAVmax, LV global longitudinal strain, and LA passive emptying fraction were independent predictors of peak oxygen uptake. Conclusions: Regular physical exercise results in marked LA and LV remodeling with considerable gender differences as explored by 3D echocardiography. In contrast with various cardiovascular diseases, more pronounced LA dilation and lower resting functional measures are associated with better exercise performance.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography

Lakatos

Molnár

Kiss

et al. 2020

Journal of the American Society of Echocardiography

View full text Add to dashboard Cite

show abstract

“…In this issue of Circulation: Cardiovascular Imaging, Dawes et al 14 present a valuable data set that begins to examine the relationship between intermediate doses of exercise (ie, exercise doses less than those typical of competitive athletes) and cardiac variable. Using a sizable cohort of healthy adult volunteers (n=1096; 54% female; median age: 39.2 years; ≈ 80% white) recruited through the UK Digital Heart Project, the investigators measured conventional parameters of left and right ventricular structure using cardiac magnetic resonance imaging.…”

Section: See Article By Dawes Et Almentioning

confidence: 99%

Exercise-Induced Cardiac Remodeling

Baggish

2016

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

“…In recent studies, LV dilatation and impaired systolic function were reported in physically active healthy subjects using either a self-reported questionnaire or wearable device assessment of activity [4,5]. Approximately 38% of healthy subjects had a dilated LV on cardiovascular magnetic resonance (CMR) and physical activity was independently associated with more than a two-fold increased risk of LV dilatation [4]. These observations support the notion that exercise-induced cardiac remodeling is a continuum, not only observed in highly trained athletes but also present in active adults who are otherwise healthy.…”

Section: Introductionmentioning

confidence: 99%

The application of exercise stress cardiovascular magnetic resonance in patients with suspected dilated cardiomyopathy

Bryant

Ang

et al. 2020

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

Objectives: The imaging features of dilated cardiomyopathy (DCM) overlap with physiological exercise-induced cardiac remodeling in active and otherwise healthy individuals. Distinguishing the two conditions is challenging. This study examined the diagnostic and prognostic roles of exercise stress imaging in asymptomatic patients with suspected DCM. Methods: Exercise stress cardiovascular magnetic resonance (CMR) was performed in 60 asymptomatic patients with suspected DCM (dilated left ventricle and/or impaired systolic function on CMR), who also underwent DNA sequencing for DCM-causing genetic variants. Confirmed DCM was defined as genotype-and phenotype-positive (G+P+). Another 100 healthy subjects were recruited to establish normal exercise capacities (peak exercise cardiac index; Peak CI). The primary outcome was a composite of all-cause mortality, cardiac decompensation and ventricular arrhythmic events. Results: No patients with confirmed G+P+ DCM had Peak CI exceeding the 35th percentile specific for age and sex. Applying this threshold in G-P+ patients, those with Peak CI below 35th percentile had characteristics similar to confirmed DCM while patients with higher Peak CI were younger, more active and higher longitudinal strain. Adverse cardiovascular events occurred only in patients with low exercise capacity (P = 0.004). Conclusions: In individuals with suspected DCM, exercise stress CMR demonstrates diagnostic and prognostic potential in distinguishing between pathological DCM and physiological exercise-induced cardiac remodeling.

show abstract

Moderate Physical Activity in Healthy Adults Is Associated With Cardiac Remodeling

Abstract: Supplemental Digital Content is available in the text.

Cited by 44 publications

References 38 publications

Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography

Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography

Exercise-Induced Cardiac Remodeling

The application of exercise stress cardiovascular magnetic resonance in patients with suspected dilated cardiomyopathy

Contact Info

Product

Resources

About