Older endurance athletes with lower left ventricular efficiency exhibited reduced right ventricular-arterial coupling (RV FWS/PASP -1.11 vs -1.73, p=0.036) compared to younger, more efficient athletes.
Cross-Sectional (n=25)
In endurance athletes, older age is associated with lower left ventricular efficiency, increased arterial stiffness, and reduced right ventricular-arterial coupling despite preserved exercise capacity.
Absolute Event Rate: -1.11% vs -1.73%
p-value: p=0.036
Abstract Background/Introduction The definition "athlete’s heart" has been introduced to describe a benign enlargement of the heart as a result of training-induced stimuli, which is more evident in subjects who practice endurance sports such as triathlon, running and cycling. Moreover, one of the most frequently observed adaptations in these athletes is a left ventricular (LV) function at the lower limits of the normal range. Purpose The aim of this study is to assess heart structural and functional adaptation according to LV performance and right ventricular-arterial coupling. Methods 25 endurance athletes underwent clinical evaluation, comprehensive echocardiography, cardiopulmonary exercise testing (CPET), and Pulse Wave Velocity (PWV) assessment. Subjects were divided into two groups based on cardiac contraction efficiency, determined through analysis of Global Work Efficiency (GWE) and Global Work Waste (GWW); these parameters were assessed using non-invasive myocardial work (MW) quantification. This novel method, which incorporates measurements of LV strain and estimated LV pressure, provides a load-independent evaluation of myocardial performance. Group 1 exhibited lower efficiency and higher work waste, whereas Group 2 showed higher efficiency and lower work waste. Statistical analysis was performed using the unpaired t-test, with statistical significance defined as a P value 0.05. Results The two groups of subjects were similar by systolic, diastolic blood pressure (SBP and DBP), heart rate (HR) and left ventricular end diastolic volume index (LVEDVi), (SBP 116,15±7,12 mmHg vs 111,83±12,25 mmHg, p=0,14; DBP 80,54±6,48 mmHg vs 77,25±8,11 mmHg, p=0,14; HR 55,08±6,40 bpm vs 53,83±9,60 bpm, p=0,35; LVEDVi 77,35±12,27 ml/mq vs 77,35±13,70 ml/mq, p=0,50). There was also no significant difference in exercise performance (peak VO2/kg 58,83±8,10 ml/kg/min vs 60,43±10,52 ml/kg/min, p=0,66). However the two groups were different in age and PWV (Age 40,92±9,30 years vs 34,17±9,35 years, p=0,042; PWV 6,38±0,66 m/s vs 5,68±0,74 m/s, p=0,011). In the first group a reduction in right ventricular-arterial coupling (Right Ventricle Free Wall Strain/Pulmonary Artery Systolic Pressure ratio, RV FWS/PASP), RV FWS and Right Ventricle Global Longitudinal Strain (RV GLS) was also found (RV FWS/PASP -1,11±0,65 vs -1,73±0,92, p=0,036; FWS -27,03±3,46% vs -30,86±3,64%, p=0,009; RV GLS -22,12±2,41% vs -25,20±2,93%, p=0,005). Conclusions The classification of the athletes according to MW, identified two groups different in age but with comparable exercise performance and haemodynamic characteristics. However, the older athletes exhibit lower right ventricular-arterial coupling, underlying initial involvement in cardiac work efficiency, requiring to perform greater work to achieve the same performance compared to the younger group.
Favarato et al. (Mon,) conducted a cross-sectional in Endurance athletes (n=25). Lower cardiac contraction efficiency vs. Higher cardiac contraction efficiency was evaluated on Right ventricular-arterial coupling (RV FWS/PASP) (p=0.036). Older endurance athletes with lower left ventricular efficiency exhibited reduced right ventricular-arterial coupling (RV FWS/PASP -1.11 vs -1.73, p=0.036) compared to younger, more efficient athletes.