Relationship between left ventricular structure and post-exercise blood pressure in endurance athletes.

BACKGROUND: The association between arterial blood pressure (BP) response to different exercise stimulus and left ventricular (LV) size in various populations remains elusive. OBJECTIVE: The objective of the study was to evaluate the relationship between BP response to strength exercise and LV size in endurance athletes. METHODS: 205 healthy young adult Caucasian males were enrolled in this study and divided into two groups: sedentary controls (n = 143) and endurance athletes (n = 62). All subjects performed an exercise test that comprised a set of pull-ups performed till exhaustion. BP was evaluated at rest and at the first minute of post-exercise recovery. Cardiac size dimensions were determined on standard two-dimensional M-mode echocardiography. RESULTS: Size-adjusted cardiac dimensions were significantly greater in the athletes than in the control subjects (P<0.001). Athletes achieved significantly higher systolic BP after pull-ups than control subjects (P<0.01), whereas systolic BP at rest was similar between the groups (P>0.05). In the athletes, post-exercise systolic BP correlated more strongly to interventricular septum thickness (r = 0.297, P = 0.021), LV posterior wall thickness (r = 0.318, P = 0.013) and LV relative wall thickness (r = 0.361, P = 0.005) than in the control subjects (r = 0.163, P = 0.064; r = 0.183, P = 0.038 and r = 0.266, P = 0.002, respectively). These associations retained significance after adjusting for body surface area and systolic BP at rest. CONCLUSIONS: Thicker LV walls and more marked systolic blood pressure response to strength exercise in endurance athletes were directly intercorrelated, and though somewhat weaker, direct association between systolic blood pressure response to LV wall thickness in sedentary control subjects was also observed.

Endurance rather than sprint running training increases left ventricular wall thickness in female athletes.

Competitive athletics is often associated with moderate left ventricular (LV) hypertrophy. The aim of this study was to shed more light on the extent and type of cardiac hypertrophic response to different athletic conditioning in females. Standard two-dimensional M-mode and Doppler echocardiography was performed at rest in Caucasian female sprinters (n = 10) and long-distance runners (n = 10) of similar age (range 16-34 years), training experience (5-18 years) and competitive level, and in age-matched healthy female sedentary controls (n = 10). No differences in echocardiographic parameters were detected between female sprinters and sedentary controls (p > 0.05). Interventricular septum and LV wall (p < 0.05) were thicker, and LV mass was greater (p < 0.01) in long-distance runners as compared with sprinters or sedentary controls. Absolute LV diameter was not increased in long-distance runners (p > 0.05), though relative LV diameter was higher in long-distance runners as compared to sprinters (p < 0.05). As compared with controls, relative wall thickness (the sum of LV wall thickness and interventricular septum thickness divided by LV diameter) was higher (p = 0.004) in long-distance runners. Neither systolic nor diastolic LV parameters were different among the groups (p > 0.05). In conclusion, sprint running training has not been found to induce alterations in cardiac morphology or function at rest in female athletes. Cardiac mass in female long-distance runners is higher mainly due to myocardial wall thickening, while integral myocardial function at rest is not affected as a consequence of either this hypertrophy or sprint training.

[Return to work after coronary artery bypass surgery]. / Ligoniu grizimas i darba po vainikiniu jungciu suformavimo operacijos.

The aim of this study was to assess the possible reasons for not returning to work after coronary artery bypass surgery. A total of 134 patients (aged 65 years and younger) who underwent coronary bypass surgery in 2003 were examined. The analysis was performed in three groups of the patients: Group I, patients who were employed before surgery and returned to work after it (n=51); Group II, patients who were employed before surgery but did not return to work after surgery (n=55); and Group III, patients who were unemployed before and remained unemployed after surgery due to health problems (n=28). Number of injured coronary arteries, the extent of operation, postoperative complications, risk factors for ischemic heart disease, clinical status of patients (angina pain and heart failure), physical tolerance, and return to work within one year after coronary bypass surgery were analyzed. It was found that 48.1% of patients who were employed before surgery returned to work after myocardial revascularization. About 30% of patients experienced recurrent symptoms of angina after 12 months. Logistic regression analysis revealed that return to work was significantly influenced by female gender, physical pattern of work, age, and severity of heart failure.

Echocardiographic parameters in athletes of different sports.

Competitive athletics is often associated with moderate left ventricular (LV) hypertrophy, and it has been hypothesized that training mode and type of exercise modulates long-term cardiac adaptation. The purpose of the study was to compare cardiac structure and function among athletes of various sports and sedentary controls. Standard transthoracic two-dimensional M-mode and Doppler echocardiography was performed at rest in Caucasian male canoe/kayak paddlers (n = 9), long distance runners (LDR, n = 18), middle distance runners (MDR, n = 17), basketball players (BP, n = 31), road cyclists (n = 8), swimmers (n = 10), strength/power athletes (n = 9) of similar age (range, 15 to 31 yrs), training experience (4 to 9 years), and age-matched healthy male sedentary controls (n = 15). Absolute interventricular septum (IVS) thickness and LV wall thickness, but not LV diameter, were greater in athletes than sedentary controls. Left ventricular mass of all athletes but relative wall thickness of only BP, swimmers, cyclists, and strength/power athletes were higher as compared with controls (p < 0.05). Among athletes, smaller IVS thickness was observed in MDR than BP, cyclists, swimmers or strength/power athletes, while LDR had higher body size-adjusted LV diameter as compared to BP, cyclists and strength/power athletes. In conclusion, relative LV diameter was increased in long distance runners as compared with basketball players, cyclists, and strength/power athletes. Basketball, road cycling, strength/power, and swimming training were associated with increased LV concentricity as compared with paddling or distance running. Key pointsThe type of cardiac hypertrophy seems to be only moderately exercise-specific.Long-distance runners develop larger left ventricular dilation as compared with basketball players, cyclists, and strength/power athletes.Myocardial wall thickening is triggered by different sporting activities that involve large muscle groups.

[Left ventricular remodeling in ischemic heart disease patients with signs and symptoms of chronic heart failure: an impact of the long-term exercise training]. / Ilgalaikio fizinio treniravimo poveikis sirdies kairiojo skilvelio remodeliacijai sergant isemine sirdies liga ir sirdies nepakankamumu.

Our study aimed at determining the effects of long-term exercise training on cardiorespiratory function and left ventricular remodeling in ischemic heart disease patients with the evidence of chronic heart failure, who had undergone a successful coronary angioplasty. One hundred thirty-five patients were entered into one-year study: 70 patients were assigned to the long-term exercise training group, and the remaining 65 persons--to the control group. All the patients were subjected to ergospirometry and echocardiography at study entry and at 6 and 12 months. At the outset, both groups showed no significant difference (P>0.05) in terms of ergospirometry findings. However, after 6 months, the rehabilitation group demonstrated significant changes (P<0.05) in exercise time, double product, RQ, AT VO2, VE/VO2, while the control group displayed no significant changes. After 12 months, the patients of rehabilitation group showed further increase in exercise time (from 5.6+/-1.9 min to 6.5+/-2.1 min) and AT VO2 (from 17.3+/-7.2 ml/kg/min to 20.8+/-5.4 ml/kg/min) indices (P<0.05). Those of double product and VE/VO2 decreased slightly when compared with findings at 6 months. RQ remained virtually at the same level, but significantly differed from the corresponding indices at the outset. Echocardiography performed at the entry and at 6 and 12 months revealed significant changes in systolic left ventricular function among the patients of rehabilitation group: wall movement index, ejection fraction as well as the left atrial long axis and left ventricular wall thickness. Echocardiographic changes indicate a positive impact of complex rehabilitative measures on systolic left ventricular function as evidenced by the ejection fraction and wall movement index values, as well as by regression of left ventricular wall thickness and left atrial long axis. Ergospirometry findings allow us to propose that the adequate choice of rehabilitative tools favorably affects the cardiovascular system, and this is reflected in exercise time and AT VO2 indices.

Structure and function of distance runners' heart.

OBJECTIVE: To compare ultra-long distance runners' heart morphologic and functional parameters at rest with those of long distance runners' and middle distance runners'. MATERIALS AND METHODS: Standard Doppler, M-mode and 2-D-mode echocardiography was performed at rest to 22 middle, 31 long and 11 ultra-long adult male distance runners. RESULTS: Long and ultra-long distance runners' left ventricular mass and left ventricular mass index were larger (p<0.05) than that of middle distance runners' (groups' means--approximately 288, 305 and 250 g as well as 153, 160 and 130 g/m(2), respectively) due to both larger (p<0.05) end-diastolic interventricular wall thickness (10.6, 11.1 and 9.8 mm, respectively) and left ventricular posterior wall thickness (10.7, 11.5 and 10.0 mm, respectively). Ultra-long distance runners' left ventricular mass and mass index did not differ significantly from long distance runners' (p>0.05), but end-diastolic posterior wall thickness was higher (p<0.05). Relative left ventricular wall thickness was larger in ultra-long distance runners as compared with middle distance runners (0.402 and 0.362, respectively; p<0.05). Ultra-long distance runners' right ventricular end-diastolic diameter was significantly larger (p<0.05) than that of middle and long distance runners (groups' means--25.8, 20.7 and 21.4 mm, respectively). Right ventricular end-diastolic free wall was thicker in ultra-long distance runners as compared with middle distance runners (groups' means--6.7 and 5.9 mm, respectively; p<0.05). Diastolic left ventricular function (evaluated as E/A) as well as end-diastolic left ventricular diameter (groups' mean--55.5-56.4 mm) did not differ between groups (p>0.05). CONCLUSIONS: The hypertrophy of ultra-long (as well as long) distance runners' myocardium of both ventricles is more pronounced than that of middle distance runners'.

Relationship between echocardiographic and aerobic capacity parameters in distance runners.

We report that anaerobic thresholds of distance runners are related mostly to training volume and not to left ventricular (LV) morphofunction. Significant correlation between LV diastolic function at rest and anaerobic thresholds was not detected. However, we found an inverse correlation between LV mass (wall thickness too) and resting as well as exercise heart rate. No significant correlation seems to exist between distance runners' LV size and anaerobic thresholds despite of positive association between training volume and degree of LV concentric hypertrophy as well as anaerobic thresholds. In conclusion, the anaerobic thresholds are related mostly to endurance training volume but not echocardiographic parameters.