The Effect of High-Intensity Rowing and Combined Strength and Endurance Training on Left Ventricular Systolic Function and Morphology

Effects of 4-Week Low-Load Resistance Training with Blood Flow Restriction on Muscle Strength and Left Ventricular Function in Young Swimmers: A Pilot Randomized Trial

Low-load resistance training combined with blood flow restriction (BFR) is known to result in muscle hypertrophy and strength similar to that observed with higher loads. However, the effects of resistance training with BFR on cardiac structure and cardiac function remain largely unknown. Therefore, the purpose of this randomized study was to compare the effects of conventional high-load resistance training (HL-RT) with the effects of low-load resistance training with BFR (LL-BFR) on muscle strength and left ventricular function. Sixteen young swimmers (mean ± standard deviation: age = 19.7 ± 1.6 years, body mass = 78.9 ± 9.7 kg, body height = 180.8 ± 5.8 cm) were randomly allocated to a conventional HL-RT group (n = 8) or a LL-BFR group (n = 8) with a pressure band (200 mmHg) placed on both thighs of participants for 4 weeks (3 days•week-1). Outcome measures were taken at baseline and after 4 weeks of training, and included body composition, one-repetition maximum (1RM) back squat, and echocardiography measures. The 1RM back squat significantly improved (partial eta squared (Ƞ2) = 0.365; p = 0.013) in HL-RT (mean difference (Δ) = 6.6 kg; [95% confidence interval (CI) -7.09 to 20.27]) and LL-BFR groups (Δ = 14.7 kg; [95% CI 3.39 to 26.10]), with no main effect of group or group × time interaction (p > 0.05). Interventricular septum end-systolic thickness showed a slight but statistically significant increase in LL-BFR and HL-RT groups (Ƞ2 = 0.253; p = 0.047), yet there was no main effect of group or group × time interaction (p > 0.05). There were no statistically significant changes (p > 0.05) in other cardiac structure or function parameters (e.g., left ventricular (LV) mass, LV cardiac output, LV ejection fraction, LV stroke volume) after the training programs. Results suggest that 4 weeks of HL-RT and LL-BFR improve muscle strength similarly with limited effects on left ventricular function in young swimmers.

Mechanical and Structural Remodeling of Cardiac Muscle after Aerobic and Resistance Exercise Training in Rats

INTRODUCTION

Aerobic and resistance exercise training results in distinct structural changes of the heart. The mechanics of how cardiac cells adapt to resistance training and the benefits to cells when combining aerobic and resistance exercise remains largely unknown. The purpose of this study was to compare mechanical adaptations of skinned cardiac fiber bundles after chronic resistance, aerobic and combined exercise training in rats. We hypothesized that differences in mechanical function on the fiber bundle level coincide with differences previously reported in the structure of the heart.

METHOD

Twelve-week-old rats were assigned to (i) an aerobic running group (n = 6), (ii) a ladder climbing resistance group (n = 6), (iii) a combination group subjected to aerobic and resistance training (n = 6), or (iv) a sedentary (control) group (n = 5). Echocardiography was used to measure cardiac structural remodeling. Skinned cardiac fiber bundles were used to determine active and passive force properties, maximal shortening velocity, and calcium sensitivity.

RESULTS

Aerobically trained animals had 43%-49% greater ventricular volume and myocardial thickness, and a 4%-17% greater shortening velocity and calcium sensitivity compared with control group rats. Resistance-trained rats had 37%-71% thicker ventricular walls, a 56% greater isometric force production, a 9% greater shortening velocity, and a 4% greater calcium sensitivity compared with control group rats. The combination exercise-trained rats had 25%-43% greater ventricular volume and myocardial wall thickness, a 55% greater active force production, a 7% greater shortening velocity, and a 60% greater cross-bridge cooperativity compared with control group rats.

CONCLUSIONS

The heart adapts differently to each exercise modality, and a combination of aerobic and resistance training may have the greatest benefit for cardiac health and performance.

Consumption of a high-fat-high-sucrose diet partly diminishes mechanical and structural adaptations of cardiac muscle following resistance training

[Purpose]

The purpose of this study was to investigate the effects of a high-fat high-sucrose (HFHS) diet on previously reported adaptations of cardiac morphological and contractile properties to resistance training.

[Methods]

Twelve-week-old rats participated in 12-weeks of resistance exercise training and consumed an HFHS diet. Echocardiography and skinned cardiac muscle fiber bundle testing were performed to determine the structural and mechanical adaptations.

[Results]

Compared to chow-fed sedentary animals, both HFHS- and chow-fed resistance-trained animals had thicker left ventricular walls. Isolated trabecular fiber bundles from chow-fed resistance-trained animals had greater force output, shortening velocities, and calcium sensitivities than those of chow-fed sedentary controls. However, trabeculae from the HFHS resistance-trained animals had greater force output but no change in unloaded shortening velocity or calcium sensitivity than those of the chow-fed sedentary group animals.

[Conclusion]

Resistance exercise training led to positive structural and mechanical adaptations of the heart, which were partly offset by the HFHS diet.

Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study

The present study aimed to investigate the effects of a 12-week concurrent training intervention on cardiometabolic health in obese men. Twelve obese men (42.5 ± 5.3 years old) participated in the current 12−week randomized controlled trial with a parallel group design. The participants were randomly assigned to a concurrent training group or to a no-exercise control group. Anthropometry and body composition assessment were determined by electrical bio-impedance. Blood samples were obtained and a cardiometabolic risk Z-Score was calculated. Energy metabolism-related parameters [i.e., resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation in both resting conditions and during exercise] were determined by indirect calorimetry. Echocardiographic studies were performed using an ultrasound system equipped with a transducer to measure cardiac function. A significant decrease of weight (Δ = −4.21 kg; i.e., primary outcome), body mass index (Δ = −1.32 kg/m²), fat mass (FM; Δ = −3.27 kg), blood pressure (BP; Δ = −10.81 mmHg), and cardiometabolic risk Z-Score (Δ = −0.39) was observed in the exercise group compared with the control group (all P < 0.05), while no significant changes were noted in waist circumference (WC), lean mass (LM), bone mineral content, glycemic and lipid profiles, liver function, nor in energy metabolism-related parameters (all P > 0.1). Moreover, a significant increment of left ventricular (LV) end diastolic diameter (Δ = −4.35 mm) was observed in the exercise group compared with the control group (P = 0.02). A 12-week concurrent training intervention is an effective strategy to induce weight and fat loss with simultaneous reductions of BP and cardiometabolic risk, and improving cardiac function in obese men.

Effects of Equal Volume Heavy-Resistance Strength Training Versus Strength Endurance Training on Physical Fitness and Sport-Specific Performance in Young Elite Female Rowers

Strength training is an important means for performance development in young rowers. The purpose of this study was to examine the effects of a 9-week equal volume heavy-resistance strength training (HRST) versus strength endurance training (SET) in addition to regular rowing training on primary (e.g., maximal strength/power) and secondary outcomes (e.g., balance) in young rowers. Twenty-six female elite adolescent rowers were assigned to an HRST (n = 12; age: 13.2 ± 0.5 yrs; maturity-offset: +2.0 ± 0.5 yrs) or a SET group (n = 14; age: 13.1 ± 0.5 yrs; maturity-offset: +2.1 ± 0.5 yrs). HRST and SET comprised lower- (i.e., leg press/knee flexion/extension), upper-limbs (i.e., bench press/pull; lat-pull down), and complex exercises (i.e., rowing ergometer). HRST performed four sets with 12 repetitions per set at an intensity of 75–95% of the one-repetition maximum (1-RM). SET conducted four sets with 30 repetitions per set at 50–60% of the 1-RM. Training volume was matched for overall repetitions × intensity × training per week. Pre-post training, tests were performed for the assessment of primary [i.e., maximal strength (e.g., bench pull/knee flexion/extension 1-RM/isometric handgrip test), muscle power (e.g., medicine-ball push test, triple hop, drop jump, and countermovement jump), anaerobic endurance (400-m run), sport-specific performance (700-m rowing ergometer trial)] and secondary outcomes [dynamic balance (Y-balance test), change-of-direction (CoD) speed (multistage shuttle-run test)]. Adherence rate was >87% and one athlete of each group dropped out. Overall, 24 athletes completed the study and no test or training-related injuries occurred. Significant group × time interactions were observed for maximal strength, muscle power, anaerobic endurance, CoD speed, and sport-specific performance (p ≤ 0.05; 0.45 ≤ d ≤ 1.11). Post hoc analyses indicated larger gains in maximal strength and muscle power following HRST (p ≤ 0.05; 1.81 ≤ d ≤ 3.58) compared with SET (p ≤ 0.05; 1.04 ≤ d ≤ 2.30). Furthermore, SET (p ≤ 0.01; d = 2.08) resulted in larger gains in sport-specific performance compared with HRST (p < 0.05; d = 1.3). Only HRST produced significant pre-post improvements for anaerobic endurance and CoD speed (p ≤ 0.05; 1.84 ≤ d ≤ 4.76). In conclusion, HRST in addition to regular rowing training was more effective than SET to improve selected measures of physical fitness (i.e., maximal strength, muscle power, anaerobic endurance, and CoD speed) and SET was more effective than HRST to enhance sport-specific performance gains in female elite young rowers.

Effects of strength training on physical fitness and sport-specific performance in recreational, sub-elite, and elite rowers: A systematic review with meta-analysis

The purpose of this systematic review with meta-analysis was to examine the effects of strength training (ST) on selected components of physical fitness (e.g., lower/upper limb maximal strength, muscular endurance, jump performance, cardiorespiratory endurance) and sport-specific performance in rowers. Only studies with an active control group were included if they examined the effects of ST on at least one proxy of physical fitness and/or sport-specific performance in rowers. Weighted and averaged standardized mean differences (SMD) were calculated using random-effects models. Subgroup analyses were computed to identify effects of ST type or expertise level on sport-specific performance. Our analyses revealed significant small effects of ST on lower limb maximal strength (SMD = 0.42, p = 0.05) and on sport-specific performance (SMD = 0.32, p = 0.05). Non-significant effects were found for upper limb maximal strength, upper/lower limb muscular endurance, jump performance, and cardiorespiratory endurance. Subgroup analyses for ST type and expertise level showed non-significant differences between the respective subgroups of rowers (p ≥ 0.32). Our systematic review with meta-analysis indicated that ST is an effective means for improving lower limb maximal strength and sport-specific performance in rowers. However, ST-induced effects are neither modulated by ST type nor rowers' expertise level.

ABBREVIATIONS

CON: control group; ICC: intraclass correlation coefficient; CRE: cardiorespiratory endurance; F: female; IG: intervention group; INT: intervention group; M: male; Sets: number of sets per exercise; SMD: standardized mean differences; SMD_wm: weighted mean SMD; ST: strength training; RCT: randomized controlled trial; Reps: repetitions; RM: repetition maximum; TF: training frequency (times per week); TI: training intensity (eg., % of 1 repetition maximum); TP: training periods (weeks).

Exploring the Aortic Root Diameter and Left Ventricle Size Among Lithuanian Athletes

Background and objectives: Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic roots and left ventricle sizes are contingent upon the physical workload. Materials and Methods: Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 were strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as AA relative index with body surface area (rAA) and VS relative index with body surface area (rVS). Left ventricle (LV) measures included LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, and LV end-diastolic diameter index (LVEDDI). Results: Results indicated that VS was higher in female athletes (28.9 ± 2.36 mm) than in non-athletes (27.19 ± 2.87 mm, p = 0.03). On the other hand, rAA was higher in strength athletes (12.19 ± 1.48 mm/m²) than in endurance athletes (11.12 ± 0.99 mm/m², p = 0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19 ± 1.78 mm/m², 12.19 ± 1.48 mm/m²) than female basketball players (15.49 ± 1.08 mm/m², p = 0.03, 10.75 ± 1.06 mm/m², p = 0.02). No significant differences regarding aortic root were found between male athletes and non-athletes. Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS, and LVEDDI parameters in all athletes. Conclusion: The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes.

The Effect of Concurrent Plyometric Training Versus Submaximal Aerobic Cycling on Rowing Economy, Peak Power, and Performance in Male High School Rowers

BACKGROUND

Plyometric training has been shown to increase muscle power, running economy, and performance in athletes. Despite its use by rowing coaches, it is unknown whether plyometrics might improve rowing economy or performance. The purpose was to determine if plyometric training, in conjunction with training on the water, would lead to improved rowing economy and performance.

METHODS

Eighteen male high school rowers were assigned to perform 4 weeks of either plyometric training (PLYO, n = 9) or steady-state cycling below ventilatory threshold (endurance, E, n = 9), for 30 min prior to practice on the water (matched for training volume) 3 days per week. Rowing performance was assessed through a 500-m rowing time trial (TT) and peak rowing power (RP), while rowing economy (RE) was assessed by measuring the oxygen cost over four work rates (90, 120, 150, and 180 W).

RESULTS

Rowing economy was improved in both PLYO and E (p < 0.05). The 500-m TT performance improved significantly for PLYO (from 99.8 ± 9 s to 94.6 ± 2 s, p < 0.05) but not for E (from 98.8 ± 6 s to 98.7 ± 5 s, p > 0.05). Finally, RP was moderately higher in the PLYO group post-training (E 569 ± 75 W, PLYO 629 ± 51 W, ES = 0.66) CONCLUSIONS: In a season when the athletes performed no rowing sprint training, 4 weeks of plyometric training improved the 500-m rowing performance and moderately improved peak power. This increase in performance may have been mediated by moderate improvements in rowing power, but not economy, and warrants further investigation.

Mortality and causes of death among Croatian male Olympic medalists

Aim

To compare the overall and disease-specific mortality of Croatian male athletes who won one or more Olympic medals representing Yugoslavia from 1948 to 1988 or Croatia from 1992 to 2016, and the general Croatian male population standardized by age and time period.

Methods

All 233 Croatian male Olympic medalists were included in the study. Information on life duration and cause of death for the Olympic medalists who died before January 1, 2017, was acquired from their families and acquaintances. We asked the families and acquaintances to present medical documentation for the deceased. Data about the overall and disease-specific mortality of the Croatian male population standardized by age and time period were obtained from the Croatian Bureau of Statistics (CBS). Overall and disease-specific standard mortality ratios (SMR) with 95% confidence intervals (CI) were calculated to compare the mortality rates of athletes and general population.

Results

Among 233 Olympic medalists, 57 died before the study endpoint. The main causes of death were cardiovascular diseases (33.3%), neoplasms (26.3%), and external causes (17.6%). The overall mortality of the Olympic medalists was significantly lower than that of general population (SMR 0.73, 95% CI 0.56-0.94, P = 0.013). Regarding specific causes of death, athletes’ mortality from cardiovascular diseases was significantly reduced (SMR 0.61, 95% CI 0.38-0.93, P = 0.021).

Conclusions

Croatian male Olympic medalists benefit from lower overall and cardiovascular mortality rates in comparison to the general Croatian male population.

Chronic treatment with angiotensin-converting enzyme inhibitor increases cardiac fibrosis in young rats submitted to early ovarian failure

BACKGROUND

We investigated whether the treatment with enalapril maleate, combined with aerobic physical training, promotes positive effects on the autonomic balance, the morphology and the cardiac function in female rats submitted to early ovarian failure.

METHODS

Thirty-five female Wistar rats, ovariectomized at 10weeks of age, were assigned into Ovariectomized rats (OVX) and Ovariectomized rats treated with enalapril maleate (OVX-EM, 10mg^-1·kg^-1·d^-1) Each group was subdivided into sedentary and trained (aerobic swimming training for 10weeks). All animals were submitted to a) double pharmacological autonomic blockade, b) study of morphology and cardiac function by echocardiography, and c) analysis of cardiac fibrosis.

RESULTS

The OVX-EM sedentary group showed a significant increase in cardiac fibrosis, relative heart weight, interventricular septum thickness and increased sympathetic participation and reduced participation of the vagal tone in the determination of the basal heart rate when compared to the OVX sedentary group. Physical training reduced cardiac fibrosis in both groups, however, with less intensity in the OVX-EM group. It also increased the absolute and relative heart weight and the end-systolic volume. Finally, the OVX-EM trained group showed higher values for left ventricular end-systolic volume and lower values for ejection fraction and shortening fraction than the sedentary OVX-EM group.

CONCLUSION

Enalapril maleate exacerbated cardiac fibrosis and increased sympathetic participation in the basal heart rate determination, without significantly affecting the cardiac function. Aerobic physical training did not change the cardiac autonomic control, but reduced cardiac fibrosis and had little effect on the cardiac function.

Row for your life: a century of mortality follow-up of French olympic rowers

BACKGROUND/AIM

Strenuous endurance training required to participate in the highest sports level has been associated with deleterious effects on elite athletes' health and cardiac abnormalities. We aimed to describe overall mortality and main causes of deaths of male French rowers participating in at least one Olympic Game (OG) from 1912 to 2012 in comparison with the French general population.

METHODS

Identity information and vital status of French Olympic rowers were validated by National sources from 1912 to 2013 (study's endpoint) among 203 rowers; 52 out of 255 (20.3%) were excluded because their vital statuses could not be confirmed. Main causes of deaths were obtained from the National registry from 1968 up to 2012. Overall and disease-specific mortalities were calculated through standardised mortality ratios (SMRs) with its 95% confidence intervals (CIs). The overall mortality was calculated for the whole rowers' cohort (PT) and for two periods apart: (P1) including rowers from 1912 to 1936 OG, a cohort in which all rowers have deceased and (P2) considering rowers from 1948 to 2012 OG.

RESULTS

Among the 203 rowers analysed, 46 died before the study's endpoint, mainly from neoplasms (33%), cardiovascular diseases (21%) and external causes (18%). PT demonstrates a significant 42% lower overall mortality (SMR: 0.58, 95% CI: 0.43-0.78, p<0.001), P1 a 37% reduction (SMR: 0.63, 95% CI: 0.43-0.89, p = 0.009) and P2 a 60% reduction (SMR: 0.40, 95% CI: 0.23-0.65, p<0.001) compared with their compatriots. Mortality due to cardiovascular diseases is significantly reduced (SMR: 0.41, 95% CI: 0.16-0.84, p = 0.01) among rowers.

CONCLUSIONS

French Olympic rowers benefit of lower overall mortality compared with the French general population. Among rowers' main causes of death, cardiovascular diseases are reduced in relation to their compatriots. Analytical studies with larger samples are needed to understand the reasons for such reductions.

Metabolic adaptations in skeletal muscle, adipose tissue, and whole-body oxidative capacity in response to resistance training

PURPOSE

The effects of resistance training on mitochondrial biogenesis and oxidative capacity in skeletal muscle are not fully characterized, and even less is known about alterations in adipose tissue. We aimed to investigate adaptations in oxidative metabolism in skeletal muscle and adipose tissue after 8 weeks of heavy resistance training in apparently healthy young men.

METHODS

Expression of genes linked to oxidative metabolism in the skeletal muscle and adipose tissue was assessed before and after the training program. Body composition, peak oxygen uptake (VO2 peak), fat oxidation, activity of mitochondrial enzyme in muscle, and serum adiponectin levels were also determined before and after resistance training.

RESULTS

In muscle, the expression of the genes AdipoR1 and COX4 increased after resistance training (9 and 13 %, respectively), whereas the expression levels of the genes PGC-1α, SIRT1, TFAM, CPT1b, and FNDC5 did not change. In adipose tissue, the expression of the genes SIRT1 and CPT1b decreased after training (20 and 23 %, respectively). There was an increase in lean mass (from 59.7 ± 6.1 to 61.9 ± 6.2 kg), VO2 peak (from 49.7 ± 5.5 to 56.3 ± 5.0 ml/kg/min), and fat oxidation (from 6.8 ± 2.1 to 9.1 ± 2.7 mg/kg fat-free mass/min) after training, whereas serum adiponectin levels decreased significantly and enzyme activity of citrate synthase and 3-hydroxyacyl-CoA dehydrogenase did not change.

CONCLUSION

Despite significant increases in VO2 peak, fat oxidation, and lean mass following resistance training, the total effect on gene expression and enzyme activity linked to oxidative metabolism was moderate.

Left ventricular mechanics and arterial-ventricular coupling following high-intensity interval exercise

High-intensity exercise induces marked physiological stress affecting the secretion of catecholamines. Sustained elevations in catecholamines are thought to desensitize cardiac beta receptors and may be a possible mechanism in impaired cardiac function following strenuous exercise. In addition, attenuated arterial-ventricular coupling may identify vascular mechanisms in connection with postexercise attenuations in ventricular function. Thirty-nine normally active (NA) and endurance-trained (ET) men and women completed an echocardiographic evaluation of left ventricular function before and after an acute bout of high-intensity interval exercise (15 bouts of 1:2 min work:recovery cycling: 100% peak power output and 50 W, respectively). Following exercise, time to peak twist and peak untwisting velocity were delayed (P < 0.01) but did not differ by sex or training status. Interactions for sex and condition (rest vs. exercise) were found for longitudinal diastolic strain rate (men, 1.46 ± 0.19 to 1.28 ± 0.23 s(-1) vs. women, 1.62 ± 0.25 to 1.63 ± 0.26 s(-1); P = 0.01) and arterial elastance (men 2.20 ± 0.65 to 3.24 ± 1.02 mmHg · ml(-1) · m(-2) vs. women 2.51 ± 0.61 to 2.93 ± 0.68 mmHg · ml(-1) · m(-2); P = 0.04). No cardiac variables were found associated with catecholamine levels. The change in twist mechanics was associated with baseline aortic pulse-wave velocity (r(2) = 0.27, P = 0.001). We conclude that males display greater reductions in contractility in response to high-intensity interval exercise, independent of catecholamine concentrations. Furthermore, a novel association of arterial stiffness and twist mechanics following high-intensity acute exercise illustrates the influence of vascular integrity on cardiac mechanics.

The effect of aerobic continuous and interval training on left ventricular structure and function in male non-athletes

Exercise plays an important role to improve cardiovascular performance. The aim of this study was to compare the effect of aerobic continuous and interval training on the left ventricular structure and function. Twenty untrained healthy male students (aged 18-22 years) were randomly divided into two groups: continuous (C; n = 10) and interval (I; n = 10). The training programme consisted of countryside jogging for 45 min during 8 weeks three times a week at 70% of maximum heart rate (MHR). In each session group C was jogging for 45 min and in group I jogging was performed in 5 nine-minute stages with a four-minute inactive rest between them. M-mode, 2-dimensional, colour and Doppler transthoracic echocardiography were performed, during resting conditions, before and after the training period. After 8-week training the end diastolic diameter, systolic blood pressure and diastolic blood pressure in groups C and I, and the posterior wall thickness and the end systolic diameter in group I showed no significant difference (P > 0.05). On the other hand, the percentage of ejection fraction and shortening fraction in groups C and I, the end systolic diameter and the posterior wall thickness in group C and the interventricular septum thickness in group I demonstrated a significant difference (P ≤ 0.05). Comparing the two groups, only the value of the interventricular septum thickness was significant (P ≤ 0.05). In general, eight-week aerobic continuous and interval training can affect left ventricular structure and function.

Effect of rowing ergometry and oral volume loading on cardiovascular structure and function during bed rest

This study examined the effectiveness of a short-duration but high-intensity exercise countermeasure in combination with a novel oral volume load in preventing bed rest deconditioning and orthostatic intolerance. Bed rest reduces work capacity and orthostatic tolerance due in part to cardiac atrophy and decreased stroke volume. Twenty seven healthy subjects completed 5 wk of -6 degree head down bed rest. Eighteen were randomized to daily rowing ergometry and biweekly strength training while nine remained sedentary. Measurements included cardiac mass, invasive pressure-volume relations, maximal upright exercise capacity, and orthostatic tolerance. Before post-bed rest orthostatic tolerance and exercise testing, nine exercise subjects were given 2 days of fludrocortisone and increased salt. Sedentary bed rest led to cardiac atrophy (125 ± 23 vs. 115 ± 20 g; P < 0.001); however, exercise preserved cardiac mass (128 ± 38 vs. 137 ± 34 g; P = 0.002). Exercise training preserved left ventricular chamber compliance, whereas sedentary bed rest increased stiffness (180 ± 170%, P = 0.032). Orthostatic tolerance was preserved only when exercise was combined with volume loading (-10 ± 22%, P = 0.169) but not with exercise (-14 ± 43%, P = 0.047) or sedentary bed rest (-24 ± 26%, P = 0.035) alone. Rowing and supplemental strength training prevent cardiovascular deconditioning during prolonged bed rest. When combined with an oral volume load, orthostatic tolerance is also preserved. This combined countermeasure may be an ideal strategy for prolonged spaceflight, or patients with orthostatic intolerance.

A prospective randomised longitudinal MRI study of left ventricular adaptation to endurance and resistance exercise training in humans

The principle that 'concentric' cardiac hypertrophy occurs in response to strength training, whilst 'eccentric' hypertrophy results from endurance exercise has been a fundamental tenet of exercise science. This notion is largely based on cross-sectional comparisons of athletes using echocardiography. In this study, young (27.4 ± 1.1 years) untrained subjects were randomly assigned to supervised, intensive, endurance (END, n = 10) or resistance (RES, n = 13) exercise and cardiac MRI scans and myocardial speckle tracking echocardiography were performed at baseline, after 6 months of training and after a subsequent 6 weeks of detraining. Aerobic fitness increased significantly in END (3.5 to 3.8 l min(-1), P < 0.05) but was unchanged in RES. Muscular strength significantly improved compared to baseline in both RES and END ( = 53.0 ± 1.1 versus 36.4 ± 4.5 kg, both P < 0.001) as did lean body mass (2.3 ± 0.4 kg, P < 0.001 versus 1.4 ± 0.6 kg P < 0.05). MRI derived left ventricular (LV) mass increased significantly following END (112.5 ± 7.3 to 121.8 ± 6.6 g, P < 0.01) but not RES, whilst training increased end-diastolic volume (LVEDV, END: +9.0 ± 5.0 versus RES +3.1 ± 3.6 ml, P = 0.05). Interventricular wall thickness significantly increased with training in END (1.06 ± 0.0 to 1.14 ± 0.06, P < 0.05) but not RES. Longitudinal strain and strain rates did not change following exercise training. Detraining reduced aerobic fitness, LV mass and wall thickness in END (P < 0.05), whereas LVEDV remained elevated. This study is the first to use MRI to compare LV adaptation in response to intensive supervised endurance and resistance training. Our findings provide some support for the 'Morganroth hypothesis', as it pertains to LV remodelling in response to endurance training, but cast some doubt over the proposal that remodelling occurs in response to resistance training.

Strength testing and training of rowers: a review

In the quest to maximize average propulsive stroke impulses over 2000-m racing, testing and training of various strength parameters have been incorporated into the physical conditioning plans of rowers. Thus, the purpose of this review was 2-fold: to identify strength tests that were reliable and valid correlates (predictors) of rowing performance; and, to establish the benefits gained when strength training was integrated into the physical preparation plans of rowers. The reliability of maximal strength and power tests involving leg extension (e.g. leg pressing) and arm pulling (e.g. prone bench pull) was high (intra-class correlations 0.82-0.99), revealing that elite rowers were significantly stronger than their less competitive peers. The greater strength of elite rowers was in part attributed to the correlation between strength and greater lean body mass (r = 0.57-0.63). Dynamic lower body strength tests that determined the maximal external load for a one-repetition maximum (1RM) leg press (kg), isokinetic leg extension peak force (N) or leg press peak power (W) proved to be moderately to strongly associated with 2000-m ergometer times (r = -0.54 to -0.68; p < 0.05). Repetition tests that assess muscular or strength endurance by quantifying the number of repetitions accrued at a fixed percentage of the strength maximum (e.g. 50-70% 1RM leg press) or set absolute load (e.g. 40 kg prone bench pulls) were less reliable and more time consuming when compared with briefer maximal strength tests. Only leg press repetition tests were correlated with 2000-m ergometer times (e.g. r = -0.67; p < 0.05). However, these tests differentiate training experience and muscle morphology, in that those individuals with greater training experience and/or proportions of slow twitch fibres performed more repetitions. Muscle balance ratios derived from strength data (e.g. hamstring-quadriceps ratio <45% or knee extensor-elbow flexor ratio around 4.2 ± 0.22 to 1) appeared useful in the pathological assessment of low back pain or rib injury history associated with rowing. While strength partially explained variances in 2000-m ergometer performance, concurrent endurance training may be counterproductive to strength development over the shorter term (i.e. <12 weeks). Therefore, prioritization of strength training within the sequence of training units should be considered, particularly over the non-competition phase (e.g. 2-6 sets × 4-12 repetitions, three sessions a week). Maximal strength was sustained when infrequent (e.g. one or two sessions a week) but intense (e.g. 73-79% of maximum) strength training units were scheduled; however, it was unclear whether training adaptations should emphasize maximal strength, endurance or power in order to enhance performance during the competition phase. Additionally, specific on-water strength training practices such as towing ropes had not been reported. Further research should examine the on-water benefits associated with various strength training protocols, in the context of the training phase, weight division, experience and level of rower, if limitations to the reliability and precision of performance data (e.g. 2000-m time or rank) can be controlled. In conclusion, while positive ergometer time-trial benefits of clinical and practical significance were reported with strength training, a lack of statistical significance was noted, primarily due to an absence of quality long-term controlled experimental research designs.

Effects of high intensity exercise on biventricular function assessed by cardiac magnetic resonance imaging in endurance trained and normally active individuals

Although several investigations have demonstrated that prolonged aerobic exercise results in decreased left ventricular (LV) function, few have examined the impact of an acute bout of high-intensity exercise on right ventricular (RV) and LV systolic and diastolic function. Cardiac magnetic resonance imaging with tagging was used to study the impact of high-intensity interval exercise on biventricular function in 9 endurance-trained (ET; Vo(2)max 69 +/- 7 ml/kg/min) and 9 normally active (NA; Vo(2)max 44 +/- 9 ml/kg/min) men. Subjects underwent baseline cardiac magnetic resonance imaging assessments (pre) and then performed an average of 14 1-minute intervals at 97 +/- 11% (NA) and 99 +/- 6% (ET) of peak power output, separated by 2 minutes of recovery at 21 +/- 6% (NA) and 21 +/- 9% (ET) of peak power output. After exercise, 2 cardiac magnetic resonance imaging assessments (post 1 at 6.2 +/- 2.6 minutes and post 2 at 38.4 +/- 3.8 minutes) were completed. RV and LV ejection fractions, twist, basal and apical rotation rates, rate of untwisting, circumferential strain, and timings were examined. No significant change in RV and LV ejection fractions, twist, untwisting rate, or strain after exercise occurred in the NA group. In the ET group, RV ejection fraction (pre 56 +/- 4%, post 1 54 +/- 4%, post 2 54 +/- 3%) and LV ejection fraction (pre 62 +/- 4%, post 1 59 +/- 4%, post 2 58 +/- 4%) were decreased at post 1 and post 2, while untwisting rate, apical rotation rate, and circumferential strain were decreased at post 2 (all p values <0.05). In conclusion, biventricular systolic and diastolic dysfunction occurred after 14 minutes of high-intensity exercise in ET athletes, a phenomenon not observed in NA subjects.

Influence of 12 weeks of jogging on magnetic resonance-determined left ventricular characteristics in previously sedentary subjects free of cardiovascular disease

Hypertrophy of the left ventricle is a diagnostic dilemma in subjects who engage in regular endurance exercise. We studied prospectively whether endurance training in previously sedentary young and middle-aged men and women can alter left ventricular (LV) characteristics. We recruited 33 healthy young and middle-aged subjects (18 women, 15 men, ages 21 to 59 years) to undergo 12 weeks of home-based brisk walking and jogging at a target heart rate > or =120 beats/min for > or =30 minutes 3 times a week. LV characteristics were measured by cine magnetic resonance imaging. Training intensity as estimated by heart rate correlated positively with the increase in LV myocardial area (r = 0.51, p = 0.005) in the 28 men and women completing the study. In the 13 men and women who trained with heart rate of > or =120 beats/min, LV myocardial area was larger after than before training (17.7 +/- 2.9 vs 16.8 +/- 2.8 cm(2), p <0.05). Moreover, in these subjects LV myocardial area increased more (5.5 +/- 9.0% vs -3.0 +/- 5.0%) than in the 15 men and women who trained at a lower intensity (p <0.05). LV end-systolic and end-diastolic area and ejection fraction did not change significantly. In conclusion, moderate-to-vigorous endurance training at moderate volumes does not influence LV end-diastolic volume or ejection fraction, but has a minor influence on LV hypertrophy in previously sedentary young and middle-aged men and women.

The impact of endurance exercise training on left ventricular systolic mechanics

Although exercise training-induced changes in left ventricular (LV) structure are well characterized, adaptive functional changes are incompletely understood. Detailed echocardiographic assessment of LV systolic function was performed on 20 competitive rowers (10 males and 10 females) before and after endurance exercise training (EET; 90 days, 10.7 +/- 1.1 h/wk). Structural changes included LV dilation (end-diastolic volume = 128 +/- 25 vs. 144 +/- 28 ml, P < 0.001), right ventricular (RV) dilation (end-diastolic area = 2,850 +/- 550 vs. 3,260 +/- 530 mm2, P < 0.001), and LV hypertrophy (mass = 227 +/- 51 vs. 256 +/- 56 g, P < 0.001). Although LV ejection fraction was unchanged (62 +/- 3% vs. 60 +/- 3%, P = not significant), all direct measures of LV systolic function were altered. Peak systolic tissue velocities increased significantly (basal lateral S'Delta = 0.9 +/- 0.6 cm/s, P = 0.004; and basal septal S'Delta = 0.8 +/- 0.4 cm/s, P = 0.008). Radial strain increased similarly in all segments, whereas longitudinal strain increased with a base-to-apex gradient. In contrast, circumferential strain (CS) increased in the LV free wall but decreased in regions adjacent to the RV. Reductions in septal CS correlated strongly with changes in RV structure (DeltaRV end-diastolic area vs. DeltaLV septal CS; r2 = 0.898, P < 0.001) and function (Deltapeak RV systolic velocity vs. DeltaLV septal CS, r2 = 0.697, P < 0.001). EET leads to significant changes in LV systolic function with regional heterogeneity that may be secondary to concomitant RV adaptation. These changes are not detected by conventional measurements such as ejection fraction.

Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes

This prospective, longitudinal study examined the effects of participation in team-based exercise training on cardiac structure and function. Competitive endurance athletes (EA, n = 40) and strength athletes (SA, n = 24) were studied with echocardiography at baseline and after 90 days of team training. Left ventricular (LV) mass increased by 11% in EA (116 ± 18 vs. 130 ± 19 g/m2; P < 0.001) and by 12% in SA (115 ± 14 vs. 132 ± 11 g/m2; P < 0.001; P value for the compared Δ = NS). EA experienced LV dilation (end-diastolic volume: 66.6 ± 10.0 vs. 74.7 ± 9.8 ml/m2, Δ = 8.0 ± 4.2 ml/m2; P < 0.001), enhanced diastolic function (lateral E ′: 10.9 ± 0.8 vs. 12.4 ± 0.9 cm/s, P < 0.001), and biatrial enlargement, while SA experience LV hypertrophy (posterior wall: 4.5 ± 0.5 vs. 5.2 ± 0.5 mm/m2, P < 0.001) and diminished diastolic function (E′ basal lateral LV: 11.6 ± 1.3 vs. 10.2 ± 1.4 cm/s, P < 0.001). Further, EA experienced right ventricular (RV) dilation (end-diastolic area: 1,460 ± 220 vs. 1,650 ± 200 mm/m2, P < 0.001) coupled with enhanced systolic and diastolic function (E′ basal RV: 10.3 ± 1.5 vs. 11.4 ± 1.7 cm/s, P < 0.001), while SA had no change in RV parameters. We conclude that participation in 90 days of competitive athletics produces significant training-specific changes in cardiac structure and function. EA develop biventricular dilation with enhanced diastolic function, while SA develop isolated, concentric left ventricular hypertrophy with diminished diastolic relaxation.