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Markus MRP, Ittermann T, Kim S, Schipf S, Siewert-Markus U, Santana CC, Buchmann N, Völzke H, Bülow R, Felix SB, Bahls M, Steinhagen-Thiessen E, Dörr M. Lower muscular strength is associated with smaller left and right chambers and lower cardiac mass in the general population - The Sedentary's Heart. Prog Cardiovasc Dis 2021; 68:36-51. [PMID: 34562438 DOI: 10.1016/j.pcad.2021.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The cardiac muscle has the ability to adapt to different loading conditions. We analyzed the associations of the age-related decreasing handgrip strength (HGS), a marker of muscular fitness, on cardiac structure and function in a community-based sample. METHODS We performed cross-sectional analyses of 4646 subjects (2554 women; 55.0%) aged 20 to 93 years from two independent cohorts of the Study of Health in Pomerania (SHIP-2 and SHIP-TREND-0). We analyzed the associations of HGS with structural and functional left and right ventricular (LV and RV) and left atrial (LA) parameters as determined by echocardiography and magnetic resonance imaging (MRI) as well with log-transformed NT-proBNP values using multivariable-adjusted linear regression models. RESULTS MRI data showed that a 1 kg lower HGS was associated with a 0.40 mL (95% confidence interval: 0.26 to 0.54; p < 0.001) lower LV end-diastolic volume, a 0.011 mm (0.005 to 0.018; p = 0.001) lower LV wall-thickness, a 0.59 g (0.43 to 0.75; p < 0.001) lower LV mass, a 0.58 mL/beat (0.43 to 0.74; p < 0.001) lower LV stroke volume, a 0.03 L/min (0.02 to 0.04; p < 0.001) lower LV cardiac output, a 0.48 mL (0.27 to 0.68; p < 0.001) lower LA end-diastolic volume, and a 1.02 mL (0.71 to 1.32) lower RV end-diastolic volume. Similar findings were observed for echocardiographic parameters. Moreover, lower HGS was associated with higher echocardiographic LV diastolic stiffness and NT-proBNP levels. CONCLUSIONS In this large population-based sample, lower muscular fitness as assessed by HGS was associated with lower LV wall thickness and mass as well as with smaller chamber size, stroke volume and cardiac output of the LV, LA and RV. Moreover, HGS was inversely related to LV diastolic stiffness and NT-proBNP values. These outcomes might demonstrate the effects of an aging-related decrease in physical activity and lower muscular fitness on the heart - "the sedentary's heart".
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Affiliation(s)
- Marcello Ricardo Paulista Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), partner site Greifswald, Greifswald, Germany.
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Simon Kim
- Center for Hand-and Functional Microsurgery, University Medicine Greifswald, Greifswald, Germany
| | - Sabine Schipf
- German Center for Diabetes Research (DZD), partner site Greifswald, Greifswald, Germany; Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ulrike Siewert-Markus
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Camila Campos Santana
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; Faculty of Medical Sciences of Santos, Santos, Brazil; Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil
| | - Nikolaus Buchmann
- Department of Cardiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Stephan Burkhard Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | | | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
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Miranda DP, Alves WEFM, Lopes HHMC, Santana VJ, Bocchi EA, Salemi VMC. Association between right heart dimensions and muscle performance and cardiorespiratory capacity in strength and endurance athletes. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Douglas P. Miranda
- Heart Institute (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo Sao Paulo Brazil
- Laboratory of Physical Evaluation and Exercise Physiology (LAFFEX) Department of Physical Education University of Barretos (Unifeb) Barretos Brazil
| | | | | | - Vinícius J. Santana
- Laboratory of Physical Evaluation and Exercise Physiology (LAFFEX) Department of Physical Education University of Barretos (Unifeb) Barretos Brazil
| | - Edimar A. Bocchi
- Heart Institute (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo Sao Paulo Brazil
| | - Vera Maria C. Salemi
- Heart Institute (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo Sao Paulo Brazil
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Polito MV, Citro R, Galasso G, Hagendorff A. Analysis of Regional Right Ventricular Function by Tissue Doppler Imaging and Three-Dimensional Echocardiography in Highly Trained Athletes. J Cardiovasc Echogr 2020; 30:146-153. [PMID: 33447505 PMCID: PMC7799068 DOI: 10.4103/jcecho.jcecho_30_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/21/2020] [Accepted: 08/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Regional right ventricular (RV) function has not yet been characterized in highly trained athletes, and the effects of increased RV volumes on resting changes of regional RV deformation are unknown. Purpose: The aim of the study was to analyze global and regional RV function by a multisegmental approach using tissue Doppler imaging (TDI) and to determine whether higher RV volumes evaluated by three-dimensional echocardiography (3DE) had an impact on the RV mechanics assessed by resting regional TDI parameters. Methods: We enrolled prospectively 25 professional soccer players and 25 age- and sex-matched nonathletic controls. Transthoracic echocardiography including additional views of the RV was performed. The TDI sample volume was placed in the basal region of the anterior, inferior, and RV free wall to assess the following parameters: isovolumic contraction time (IVCTRV), isovolumic relaxation time (IVRTRV), ejection time (ETRV), and myocardial performance index (MPIRV). Furthermore, conventional left ventricular (LV) and RV parameters at two-dimensional (2D) and 3DE were determined. Results: In athletes, LV mass index/body surface area (BSA), left atrial volume index, 2D LV volumes/BSA were significantly increased in comparison with controls. Moreover, athletes had higher 2D LV and RV stroke volume (SV), lower values for A wave and E/e' ratio, higher basal RV diameter, and right atrial (RA) area (P < 0.0001). Moreover, athletes showed significantly increased LV and RV volumes and SV indexed for BSA (P < 0.0001) evaluated at 3DE. In athletes, ETRV-free wall, ETRV-anterior, IVCTRV-inferior, and IVCTRV-anterior were statistically increased (P < 0.0001). Conversely, IVRTRV-anterior was reduced in comparison with controls. A significant positive correlation between IVRTRV-inferior and three-dimensional (3D) RV end-diastolic volume (EDV), end-systolic volume, and SV was observed in athletes. Finally, a good positive correlation was observed between 3D RV EDV and 3D LV SV indexed for BSA. Conclusions: In athletes, the higher 3D RV volumes are proportionally related to an increase of IVRTRV-inferior and 3D LV SV. Further studies on the resting changes of regional RV deformation for screening and follow-up in these participants are needed.
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Affiliation(s)
- Maria Vincenza Polito
- Division of Cardiology, Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Rodolfo Citro
- Division of Cardiology, Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Gennaro Galasso
- Division of Cardiology, Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Salerno, Italy
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Right Ventricular Diastolic Dysfunction after Marathon Run. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155336. [PMID: 32722206 PMCID: PMC7432325 DOI: 10.3390/ijerph17155336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/28/2022]
Abstract
It has been raised that marathon running may significantly impair cardiac performance. However, the post-race diastolic function has not been extensively analyzed. We aimed to assess whether the marathon run causes impairment of the cardiac diastole, which ventricle is mostly affected and whether the septal (IVS) function is altered. The study included 34 male amateur runners, in whom echocardiography was performed two weeks before, at the finish line and two weeks after the marathon. Biventricular diastolic function was assessed not only with conventional Doppler indices but also using the heart rate-adjusted isovolumetric relaxation time (IVRTc). After the run, IVRTc elongated dramatically at the right ventricular (RV) free wall, to a lesser extent at the IVS and remained unchanged at the left ventricular lateral wall. The post-run IVRTc_IVS correlated with IVRTc_RV (r = 0.38, p < 0.05), and IVRTc_RV was longer in subjects with IVS hypertrophy (88 vs. 51 ms; p < 0.05). Participants with measurable IVRT_RV at baseline (38% of runners) had longer post-race IVRTc_IVS (102 vs. 83 ms; p < 0.05). Marathon running influenced predominantly the RV diastolic function, and subjects with measurable IVRT_RV at baseline or those with IVS hypertrophy can experience greater post-race diastolic fatigue.
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Kamimura Y, Okumura N, Adachi S, Shimokata S, Tajima F, Nakano Y, Hirashiki A, Murohara T, Kondo T. Usefulness of scoring right ventricular function for assessment of prognostic factors in patients with chronic thromboembolic pulmonary hypertension. Heart Vessels 2018; 33:1220-1228. [PMID: 29704099 PMCID: PMC6133067 DOI: 10.1007/s00380-018-1168-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/20/2018] [Indexed: 12/12/2022]
Abstract
Right ventricular (RV) function is associated with prognosis in chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to establish an RV dysfunction score using RV echocardiographic parameters to clarify the clinical characteristics in patients with CTEPH and to compare RV dysfunction score with parameters such as World Health Organization (WHO) functional class, hemodynamics, exercise capacity, and plasma BNP level. We enrolled 35 inpatients with CTEPH (mean age, 62 ± 15 years, 15 males). We constructed ‘an RV dysfunction score’ calculated as the summation of each point awarded for the presence of four parameters: tricuspid annular plane systolic excursion (TAPSE) < 16 mm, 1 point; tissue Doppler-derived tricuspid lateral annular systolic velocity (S′) < 10 cm/s, 1 point; right ventricular fractional area change (RVFAC) < 35%, 1 point; and right ventricular myocardial performance index (RV-MPI) > 0.4, 1 point. TAPSE, S′, RVFAC, and RV-MPI was 18.7 ± 4.8 mm, 11.9 ± 3.1 cm/s, 33.5 ± 13.9%, and 0.39 ± 0.2, respectively. The RV dysfunction score was associated with symptom [WHO functional class (p = 0.026)], hemodynamics [mean PAP (p = 0.01), cardiac index (p = 0.009), pulmonary vascular resistance (p = 0.001), and SvO2 (p = 0.039)], exercise capacity [6-min walk distance (p = 0.046), peakVO2 (p = 0.016), and VE/VCO2 slope (p = 0.031)], and plasma BNP level (p = 0.005). This RV dysfunction score using the four RV echocardiographic parameters could be a simple and useful scoring system to evaluate prognostic factors in patients with CTEPH.
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Affiliation(s)
- Yoshihiro Kamimura
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan
| | - Naoki Okumura
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8560, Japan
| | - Shiro Adachi
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8560, Japan
| | - Shigetake Shimokata
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan
| | - Fumitaka Tajima
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan
| | - Yoshihisa Nakano
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan
| | - Akihiro Hirashiki
- Department of Cardiology, National Center for Geriatrics and Gerontology, Morioka-cho 7-430, Obu, 474-8511, Japan
| | - Toyoaki Murohara
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8550, Japan
| | - Takahisa Kondo
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-8560, Japan.
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Churchill TW, Baggish AL. The Right Heart: Acute and Chronic Issues. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:83. [DOI: 10.1007/s11936-017-0581-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Long-term intensive training leads to morphological and mechanical changes in the heart generally known as "athlete's heart". Previous studies have suggested that the diastolic and systolic function of the ventricles is unaltered in athletes compared to sedentary. The purpose of this study was to investigate myocardial performance index (MPI) by pulsed wave Doppler (PWD) and by tissue Doppler imaging (TDI) in female elite athletes compared to sedentary controls. METHODS The study consisted of 32 athletes (mean age 20 ± 2 years) and 34 sedentary controls (mean age 23 ± 2 years). MPI by PWD and TDI were measured in the left (LV) and right ventricle (RV) in both groups. Moreover, comparisons of MPI by the two methods and between the LV and RV within the two groups were made. RESULTS There were no significant differences in MPI between athletes and controls (p > 0.05), whereas the LV had significantly higher MPI compared to RV (p < 0.001, in athletes and controls). The agreement and the correlation between the two methods measuring MPI showed low agreement and no correlation (athletes RV r = -0.027, LV r = 0.12; controls RV r = 0.20, LV r = 0.30). CONCLUSION The global function of the LV and RV measured by MPI with PWD and TDI is similar in female athletes compared to sedentary controls. Conversely, both MPI by PWD and by TDI shows a significant difference between the LV and RV. However, the agreement and correlation between conventional methods of measuring MPI by PWD compared to MPI by TDI is very poor in both these populations.
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D'Ascenzi F, Pelliccia A, Solari M, Piu P, Loiacono F, Anselmi F, Caselli S, Focardi M, Bonifazi M, Mondillo S. Normative Reference Values of Right Heart in Competitive Athletes: A Systematic Review and Meta-Analysis. J Am Soc Echocardiogr 2017; 30:845-858.e2. [DOI: 10.1016/j.echo.2017.06.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Indexed: 01/23/2023]
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Kim H, Bae Lee J, Park JH, Yoo BS, Son JW, Yang DH, Lee BR. A comparison of echocardiographic variables of right ventricular function with exercise capacity after bosentan treatment in patients with pulmonary arterial hypertension: Results from a multicenter, prospective, cohort study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:28-34. [PMID: 27619758 DOI: 10.1002/jcu.22396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/06/2016] [Accepted: 08/12/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Bosentan reduces pulmonary arterial pressure and improves exercise capacity in patients with pulmonary arterial hypertension (PAH). However, there are limited data regarding the extent to which the changes in echocardiographic variables reflect improvements in exercise capacity. We aimed to assess the improvement of echocardiographic variables and exercise capacity after 6 months of bosentan treatment for PAH. METHODS We performed a prospective study from June 2012 to June 2015 in seven participating medical centers. Echocardiography, including tissue Doppler imaging (TDI) and the 6-minute walk test distance (6MWD), was performed at baseline and after 6 months of bosentan treatment. RESULTS We analyzed 19 patients with PAH: seven with congenital shunt, six with collagen vascular disease, and six with idiopathic PAH. After bosentan treatment, mean 6MWD increased by 50 meters. Right ventricle (RV) systolic pressure, tricuspid annular plane systolic excursion, myocardial performance index (MPI) derived from TDI (MPI-TDI) of RV and left ventricle (LV), RV fractional area change, and RV ejection fraction were significantly improved. In particular, the magnitude of RV and LV MPI-TDI showed good correlation with changes in the 6MWD. CONCLUSIONS The magnitude of RV and LV MPI-TDI was strongly associated with improvements in exercise capacity. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:28-34, 2017.
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Affiliation(s)
- Hyungseop Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jin Bae Lee
- Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Jae-Hyeong Park
- Cardiology Division in Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Jang-Won Son
- Division of Cardiology, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Bong-Ryeol Lee
- Department of Cardiology, Fatima General Hospital, Daegu, Korea
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Effect of E-OJ-01 on Cardiac Conditioning in Young Exercising Adults: A Randomized Controlled Trial. Am J Ther 2016; 24:e298-e307. [PMID: 27930383 DOI: 10.1097/mjt.0000000000000542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Cardiac health is a determinant of athletic performance. A body of data suggests that in healthy young adults, an increase in maximal cardiac output leads to an increase in endurance. Terminalia arjuna (TA) has been studied for multiple benefits in cardiovascular health although its effects as a cardioprotective ergogenic aid require further exploration. The current trial was planned to study the effect of the proprietary TA extract (E-OJ-01) on the markers of cardiac conditioning in healthy young adults. STUDY QUESTION No study has assessed the effect of TA extract on cardiac conditioning by improvement of left ventricular ejection fraction (LVEF) in young exercising individuals. STUDY DESIGN, MEASURES AND OUTCOMES A randomized, double-blind, placebo-controlled, parallel group study was conducted to determine the efficacy and safety of E-OJ-01 for use as an ergogenic supplements in young exercising adults. This trial was registered at ClinicalTrials.gov (NCT02207101) and reported according to Consolidated Standards of Reporting Trials (CONSORT) requirements. Thirty-two healthy males, aged 18-40 years performing regular endurance exercise, were randomly assigned to 400 mg of E-OJ-01 or placebo for 56 days. LVEF, right and left ventricular Myocardial Performance Index, and Borg Rated Perceived Exertion (RPE) were assessed at baseline, day 28, and day 56; creatine kinase-MB and troponin-T were assessed at baseline and at day 56. RESULTS As compared with placebo, 56 days of E-OJ-01 supplementation significantly improved the LVEF (P = 0.0001) and decreased the right ventricular Myocardial Performance Index (P = 0.001). The fatigue level captured by Borg Scale after completion of exercise showed a greater decrease in the E-OJ-01 group as compared with placebo. Creatine kinase-MB and troponin-T did not change significantly. CONCLUSIONS TA (E-OJ-01) significantly increased cardiovascular efficiency and improved the cardiac conditioning in young healthy adults.
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Duppen N, Geerdink LM, Kuipers IM, Bossers SSM, Koopman LP, van Dijk APJ, Roos-Hesselink JW, De Korte CL, Helbing WA, Kapusta L. Regional ventricular performance and exercise training in children and young adults after repair of tetralogy of Fallot: randomized controlled pilot study. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.114.002006. [PMID: 25784723 DOI: 10.1161/circimaging.114.002006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Public-health guidelines recommend patients with congenital heart disease to exercise. Studies have shown that patients with congenital heart disease can improve physical exercise capacity. The effect of training on regional ventricular performance has hardly been studied. We performed a pilot study to assess whether an exercise training program would result in adverse changes of regional ventricular performance in patients with corrected tetralogy of Fallot. METHODS AND RESULTS Multicenter prospective randomized controlled pilot study in patients with tetralogy of Fallot aged 10 to 25 years. A 12-week standardized aerobic dynamic exercise training program (3 one-hour sessions per week) was used. Pre- and post-training cardiopulmonary exercise tests, MRI, and echocardiography, including tissue-Doppler imaging, were performed. Patients were randomized to the exercise group (n=28) or control group (n=20). One patient in the exercise group dropped out. Change in tissue-Doppler imaging parameters was similar in the exercise group and control group (change in right ventricle free wall peak velocity E' exercise group, 0.8±2.6 cm/s; control group, 0.9±4.1; peak velocity A' exercise group, 0.4±2.4 m/s; control group 4.6±18.1 cm/s). CONCLUSIONS This randomized controlled pilot study provides preliminary data suggesting that regional ventricular performance is well maintained during 3-month aerobic dynamic exercise training in children and young adults with repaired tetralogy of Fallot. This information might help patients adhere to current public-health guidelines. CLINICAL TRIAL REGISTRATION URL: http//:www.trialregister.nl. Unique identifier: NTR2731.
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Affiliation(s)
- Nienke Duppen
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Lianne M Geerdink
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Irene M Kuipers
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Sjoerd S M Bossers
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Laurens P Koopman
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Arie P J van Dijk
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Jolien W Roos-Hesselink
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Chris L De Korte
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
| | - Willem A Helbing
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.).
| | - Livia Kapusta
- From the Division of Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands (N.D., S.S.M.B., L.P.K., W.A.H.); Departments of Radiology (N.D., S.S.M.B., W.A.H.) and Cardiology (J.W.R.-H.), Erasmus MC, Rotterdam, the Netherlands; Departments of Pediatric Cardiology (L.M.G., L.K.), Cardiology (A.P.J.v.D.), and Radiology, Laboratory of Clinical Physics (C.L.D.K.), Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, the Netherlands (I.M.K.); and Pediatric Cardiology Unit, Department of Pediatrics, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel (L.K.)
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D'Andrea A, La Gerche A, Golia E, Padalino R, Calabrò R, Russo MG, Bossone E. Physiologic and pathophysiologic changes in the right heart in highly trained athletes. Herz 2015; 40:369-378. [PMID: 25822292 DOI: 10.1007/s00059-015-4220-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Exercise causes changes in the heart in response to the hemodynamic demands of increased systemic and pulmonary requirements during exercise. Understanding these adaptations is of great importance, since they may overlap with those caused by pathological conditions. Initial descriptions of athlete's heart focused mainly on chronic adaptation of the left heart to training. In recent years, the substantial structural and functional adaptations of the right heart have been documented, highlighting the complex interplay with left heart. Moreover, there is evolving evidence of acute and chronic cardiac damage, mainly involving the right heart, which may predispose subjects to atrial and ventricular arrhythmias, configuring an exercise-induced cardiomyopathy. The aim of this article is to review the current knowledge on the physiologic and pathophysiologic changes in the right heart in highly trained athletes.
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Affiliation(s)
- A D'Andrea
- Second University of Naples, Monaldi Hospital, Via M. Schipa 44, 80122, Naples, Italy,
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13
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D'Andrea A, Morello A, Iacono AM, Scarafile R, Cocchia R, Riegler L, Pezzullo E, Golia E, Bossone E, Calabrò R, Russo MG. Right Ventricular Changes in Highly Trained Athletes: Between Physiology and Pathophysiology. J Cardiovasc Echogr 2015; 25:97-102. [PMID: 28465945 PMCID: PMC5353418 DOI: 10.4103/2211-4122.172486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Several studies have described the adaptive remodeling of the heart during exercise. In some more practiced endurance athletes, there is a disproportionate load on the right ventricle (RV), at least during exercise, and this might be the basis for a chronic pro-arrhythmic RV remodeling. Especially, in these kinds of athletes the recovery after detraining might be incomplete, in particular for RV changes. The observation of acute myocardial injury based on transient elevation of biomarkers and chronic myocardial scar, not completely reversible changes of the RV and an increased prevalence of some arrhythmias support the existence of an “exercise-induced cardiomyopathy.” The aim of this paper is to review current knowledge about changes in the right heart in highly trained athletes and how these change influence cardiac function.
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Affiliation(s)
- Antonello D'Andrea
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Alberto Morello
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Agostino Mattera Iacono
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Raffaella Scarafile
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Rosangela Cocchia
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Lucia Riegler
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Enrica Pezzullo
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Enrica Golia
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Eduardo Bossone
- Department of Heart, Cardiology Division, Cava de' Tirreni and Amalfi Coast Hospital, University of Salerno, Salerno, Italy
| | - Raffaele Calabrò
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
| | - Maria Giovanna Russo
- Department of Cardiology, Integrated Diagnostic Cardiology, AORN dei Colli, Second University of Naples, Naples, Italy
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D'Andrea A, La Gerche A, Golia E, Teske AJ, Bossone E, Russo MG, Calabrò R, Baggish AL. Right Heart Structural and Functional Remodeling in Athletes. Echocardiography 2015; 32. [DOI: 10.1111/echo.12226] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Long‐term intensive exercise training programs lead to numerous progressive cardiac adaptations, which are collectively termed “athlete's heart.” Noninvasive diagnostic techniques, such as color Doppler echocardiography, have been widely used in the analysis of the athlete's heart. Initial experiences focused mainly on left heart adaptations to training. However, in recent years, substantial structural and functional adaptations of the right heart have been documented. The present review article focuses on recent data defining right heart adaptation to short‐ and long‐term periods of exercise training. Right ventricular (RV) morphology and function may be more profoundly affected by intense exercise and, in some cases, functional recovery may be incomplete. Moreover, there is speculation that such changes may represent a substrate for proarrhythmic RV remodeling in some highly trained athletes, even in the absence of a known familial redisposition.
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Affiliation(s)
| | - Andrè La Gerche
- Department of Medicine St. Vincent's Hospital University of Melbourne Melbourne Australia
| | - Enrica Golia
- Chair of Cardiology Second University of Naples Naples Italy
| | - Arco J. Teske
- Department of Cardiology Division of Heart and Lungs University Medical Center Utrecht Utrecht The Netherlands
| | - Eduardo Bossone
- Department of Cardiac Surgery Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato San Donato Milanese Milan Italy
| | | | | | - Aaron L. Baggish
- Cardiovascular Performance Program Massachusetts General Hospital Boston Massachusetts USA
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Pagourelias ED, Kouidi E, Efthimiadis GK, Deligiannis A, Geleris P, Vassilikos V. Right Atrial and Ventricular Adaptations to Training in Male Caucasian Athletes: An Echocardiographic Study. J Am Soc Echocardiogr 2013; 26:1344-52. [DOI: 10.1016/j.echo.2013.07.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Indexed: 11/30/2022]
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Speckle-tracking echocardiographic imaging of the right ventricular systolic and diastolic parameters in chronic exercise. Int J Cardiovasc Imaging 2013; 29:1265-71. [DOI: 10.1007/s10554-013-0204-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/01/2013] [Indexed: 10/27/2022]
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SPENCE ANGELAL, CARTER HOWARDH, MURRAY CONORP, OXBOROUGH DAVID, NAYLOR LOUISEH, GEORGE KEITHP, GREEN DANIELJ. Magnetic Resonance Imaging–Derived Right Ventricular Adaptations to Endurance versus Resistance Training. Med Sci Sports Exerc 2013; 45:534-41. [DOI: 10.1249/mss.0b013e3182780b0e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Aaron CP, Tandri H, Barr RG, Johnson WC, Bagiella E, Chahal H, Jain A, Kizer JR, Bertoni AG, Lima JAC, Bluemke DA, Kawut SM. Physical activity and right ventricular structure and function. The MESA-Right Ventricle Study. Am J Respir Crit Care Med 2011; 183:396-404. [PMID: 20813888 PMCID: PMC3056232 DOI: 10.1164/rccm.201003-0469oc] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Accepted: 06/17/2010] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Intense exercise in elite athletes is associated with increased left ventricular (LV) and right ventricular (RV) mass and volumes. However, the effect of physical activity on the RV in an older community-based population is unknown. OBJECTIVES We studied the association between levels of physical activity in adults and RV mass and volumes. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac magnetic resonance imaging on community-based participants without clinical cardiovascular disease. RV volumes were determined from manually contoured endocardial margins. RV mass was determined from the difference between epicardial and endocardial volumes multiplied by the specific gravity of myocardium. Metabolic equivalent-minutes/day were calculated from the self-reported frequency, duration, and intensity of physical activity. MEASUREMENTS AND MAIN RESULTS The study sample (n = 1,867) was aged 61.8 ± 10 years, 48% male, 44% white, 27% African American, 20% Hispanic, and 9% Chinese. Higher levels of moderate and vigorous physical activity were linearly associated with higher RV mass (P = 0.02) after adjusting for demographics, anthropometrics, smoking, cholesterol, diabetes mellitus, hypertension, and LV mass. Higher levels of intentional exercise (physical activity done for the sole purpose of conditioning or fitness) were nonlinearly associated with RV mass independent of LV mass (P = 0.03). There were similar associations between higher levels of physical activity and larger RV volumes. CONCLUSIONS Higher levels of physical activity in adults were associated with greater RV mass independent of the associations with LV mass; similar results were found for RV volumes. Exercise-associated RV remodeling may have important clinical implications.
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Affiliation(s)
- Carrie P. Aaron
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Harikrishna Tandri
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - R. Graham Barr
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - W. Craig Johnson
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Emilia Bagiella
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Harjit Chahal
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Aditya Jain
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Jorge R. Kizer
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Alain G. Bertoni
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - João A. C. Lima
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - David A. Bluemke
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Steven M. Kawut
- Department of Medicine, College of Physicians and Surgeons and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, University of Washington, Seattle, Washington; Departments of Medicine and Public Health, Weill-Cornell Medical Center, New York, New York; Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina; Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland; and Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Çolak T, Bamaç B, Çolak S, Duman C, Bayazit B, Öztürk S, Meriç B, Özbek A, Yildiz F. The Influence of a Single Bout of Wrestling Exercise on Serum Levels of Ischemia-modified Albumin. J Exerc Sci Fit 2010. [DOI: 10.1016/s1728-869x(10)60010-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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La Gerche A, Taylor AJ, Prior DL. Athlete's heart: the potential for multimodality imaging to address the critical remaining questions. JACC Cardiovasc Imaging 2009; 2:350-63. [PMID: 19356581 DOI: 10.1016/j.jcmg.2008.12.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 12/16/2008] [Indexed: 12/26/2022]
Abstract
Moderate exercise is a powerful therapy in the treatment and prevention of cardiac disease, but intense habitual exercise leads to cardiac adaptations for which the prognostic benefits are less clear. The athlete's heart syndrome refers to the morphological and electrical remodeling which occurs to varying extents dependent upon the sporting discipline. Its accurate differentiation from pathological entities is critical. This review describes the role multi-modality imaging serves in determining the limitations and consequences of intense exercise. Tissue characterization and imaging studies during exercise are emphasized as important future directions of inquiry with the potential to address remaining controversies.
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Affiliation(s)
- Andre La Gerche
- St Vincent's Hospital and University of Melbourne, Melbourne, Australia
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Teske AJ, Prakken NH, De Boeck BW, Velthuis BK, Martens EP, Doevendans PA, Cramer MJ. Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes. Eur Heart J 2008; 30:969-77. [DOI: 10.1093/eurheartj/ehp040] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Functional implications of the right ventricular myocardial performance index in patients after surgical repair of tetralogy of Fallot. Heart Vessels 2008; 23:112-7. [DOI: 10.1007/s00380-007-1016-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 09/12/2007] [Indexed: 10/22/2022]
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