Comparison of echocardiographic methods for calculating left ventricular mass in elite rugby football league athletes and the impact on chamber geometry.

Background: Recommendations for the echocardiographic assessment of left ventricular (LV) mass in the athlete suggest the use of the linear method using a two-tiered classification system (2TC). The aims of this study were to compare the linear method and the area-length (A-L) method for LV mass in elite rugby football league (RFL) athletes and to establish how any differences impact the classification of LV geometry using 2TC and four-tier (4TC) classification systems. Methods: Two hundred and twenty (220) male RFL athletes aged 25 ± 5 (14-34 years) were recruited. All athletes underwent echocardiography and LV mass was calculated by the American Society of Echocardiography (ASE) corrected Linear equation (2D) and the A-L method. Left ventricular mass Index (LVMi) was used with relative wall thickness to determine geometry in the 2TC and with concentricity and LV end diastolic volume index for the 4TC. Method specific recommended cut-offs were utilised. Results: Higher values of absolute (197 ± 34 vs. 181 ± 34 g; p < 0.0001) and indexed (92 ± 13 vs. 85 ± 13 g/m2; p < 0.0001) measures of LV mass were obtained from A-L compared to the linear method. Normal LV geometry was demonstrated in 98.2% and 80% of athletes whilst eccentric hypertrophy in 1.4% and 19.5% for linear and A-L respectively. Both methods provided 0.5% as having concentric remodelling and 0% as having concentric hypertrophy. Allocation to the 4TC resulted in 97% and 80% with normal geometry, 0% and 8.6% with eccentric dilated hypertrophy, 0% and 7.7% with eccentric non-dilated hypertrophy, 1.4% and 0.5% with concentric remodelling and 1.4% and 3% with concentric non-dilated hypertrophy for linear and A-L methods respectively. No participants had concentric dilated hypertrophy from either methods. Conclusion: The linear and A-L method for calculation of LV mass in RFL athletes are not interchangeable with significantly higher values obtained using A-L method impacting on geometry classification. More athletes present with eccentric hypertrophy using 2TC and eccentric dilated/non-dilated using 4TC. Further studies should be aimed at establishing the association of A-L methods of LV mass and application of the 4TC to the multi-factorial demographics of the athlete.

Seasonal variation of cardiac structure and function in the elite rugby football league athlete.

BACKGROUND: Pre-participation cardiac screening (PCS) of "Super-League" rugby football league (RFL) athletes is mandatory but may be completed at any time point. The aim of this study was to assess cardiac electrical, structural and functional variation across the competitive season. METHODS: Elite, male, RFL athletes from a single Super-League club underwent cardiac evaluation using electrocardiography (ECG), 2D echocardiography and speckle tracking echocardiography (STE) at four time points across the RFL season; (1) End pre-season (ENDPRE), (2) mid-season (MIDCOMP), (3) end-season (ENDCOMP) and (4) End off-season (ENDOFF). Training loads for each time point were also determined. One-way ANOVA with post-hoc Bonferroni were used for statistical analyses. RESULTS: Total workload undertaken by athletes was lower at both MIDCOMP and ENDCOMP compared to ENDPRE (P < 0.001). ECG patterns were normal with training-related changes that were largely consistent across assessments. Structural data did not vary across assessment points. Standard functional data was not different across assessment points but apical rotation and twist were higher at ENDPRE (9.83˚ and 16.55˚, respectively compared to all other time points (MIDCOMP, 6.13˚ and 12.62˚; ENDCOMP, 5.84˚ and 12.12˚; ENDOFF 6.60˚ and 12.35˚). CONCLUSIONS: Despite some seasonal variation in training load, the athletes' ECG and cardiac structure were stable across a competitive season. Seasonal variation in left ventricular (LV) apical rotation and twist, associated with higher training loads, should be noted in the context of PCS.

Player Responses to Match and Training Demands During an Intensified Fixture Schedule in Professional Rugby League: A Case Study.

Player loads and fatigue responses are reported in 15 professional rugby league players (24.3 ± 3.8 y) during a period of intensified fixtures. Repeated measures of internal and external loads, perceived well-being, and jump flight time were recorded across 22 d, comprising 9 training sessions and matches on days 5, 12, 15, and 21 (player exposure: 3.6 ± 0.6 matches). Mean training loads (session rating of perceived exertion × duration) between matches were 1177, 1083, 103, and 650 AU. Relative distance in match 1 (82 m/min) and match 4 (79 m/min) was very likely lower in match 2 (76 m/min) and likely higher in match 3 (86 m/min). High-intensity running (≥5.5 m/s) was likely to very likely lower than match 1 (5 m/min) in matches 2-4 (2, 4, and 3 m/min, respectively). Low-intensity activity was likely to very likely lower than match 1 (78 m/min) in match 2 (74 m/min) and match 4 (73 m/min) but likely higher in match 3 (81 m/min). Accumulated accelerometer loads for matches 1-4 were 384, 473, 373, and 391 AU, respectively. Perceived well-being returned to baseline values (~21 AU) before all matches but was very likely to most likely lower the day after each match (~17 AU). Prematch jump flight times were likely to most likely lower across the period, with mean values of 0.66, 0.65, 0.62, and 0.64 s before matches 1-4, respectively. Across a 22-d cycle with fixture congestion, professional rugby league players experience cumulative neuromuscular fatigue and impaired match running performance.