Background

It has been proposed that chronic exposure to prolonged strenuous exercise may result in maladaptation of the right ventricle (RV). The aim of this study was to establish RV structure and function, including septal insertion points, using conventional echocardiography and myocardial strain (ε) imaging in a veteran population of ultramarathon runners (UR) and age- and sex-matched controls.

Methods

A retrospective study design provided 40 UR (>35 years old; mean ± SD training experience, 18 ± 12 years) and 24 sedentary controls who had previously undergone conventional two-dimensional, tissue Doppler and speckle-tracking echocardiography to measure RV size and function. Peak RV ε and strain rate (SR) were assessed from the base, mid, and apical lateral wall. SR were assessed during systole (SRs'), early diastole (SRe′) and late diastole (SRa′). Regional assessment of RV insertion points was made at the basal inferoseptum and apical septum using left ventricular (LV) longitudinal ε and at the anteroseptum and inferoseptum using LV circumferential and radial ε.

Results

All structural indices of RV size were significantly larger in UR. RV regional and global peak ε were not different between groups, whereas basal RV SR was significantly lower in UR. UR had significantly higher peak LV circumferential ε (anteroseptum, −26% ± 8% vs −21% ± 6%; inferoseptum, −25% ± 6% vs −16% ± 9%) and higher peak LV longitudinal ε (apical septum, −28% ± 7% vs −22% ± 4%) compared with controls. There was regional heterogeneity in UR that was not observed in controls with significantly lower longitudinal ε at the basal inferoseptal insertion point when compared with the global ε (−19% ± 2% vs −22% ± 4%).

Conclusions

Myocardial ε imaging highlights no overt maladaptation in this cohort of veteran UR, although lower insertion point ε, compared with global ε, in UR may warrant further investigation.

中文翻译：

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资深超马拉松运动员的右心室结构和功能：是否有证据表明慢性适应不良？

背景

有人提出，长期进行长时间剧烈运动可能会导致右心室（RV）适应不良。这项研究的目的是在传统的超马拉松运动员（UR）人群以及年龄和性别匹配的对照人群中，使用常规超声心动图和心肌应变（ε）成像来建立RV结构和功能，包括间隔插入点。

方法

一项回顾性研究设计提供了40 UR（> 35岁；平均±SD培训经验，18±12岁）和24个久坐的对照组，他们先前曾接受过常规的二维组织多普勒和斑点跟踪超声心动图检查，以测量RV的大小和功能。RVε峰值和应变率（SR）是从基部，中部和顶端侧壁评估的。在收缩期（SRs'），舒张早期（SRe'）和舒张晚期（SRa'）期间评估SR。RV插入点的区域评估是使用左心室（LV）的纵向ε在基底下隔和顶隔膜以及LV圆周和径向ε的前隔和下隔进行的。

结果

在UR中，RV大小的所有结构指标均显着较大。RV区域峰和全局峰ε在两组之间无差异，而基础RV SR在UR中显着降低。UR的LV左室周向峰值ε明显较高（前鼻窦，-26％±8％vs -21％±6％;腹膜下，-25％±6％与−16％±9％）和更高的LV左室纵向ε（顶隔膜） ，-28％±7％与-22％±4％）。与整体ε相比，在基部下隔壁插入点的纵向ε明显较低的对照组中未观察到UR的区域异质性（−19％±2％对−22％±4％）。

结论

尽管这组经验丰富的UR患者的心肌ε显像表明没有明显的适应不良，但与整体ε相比，较低的插入点ε值得进一步研究。