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Left ventricular volumes during exercise in endurance athletes assessed by contrast echocardiography
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
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2004 (English)In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 182, no 1, 45-51 p.Article in journal (Refereed) Published
Abstract [en]

Aim:  The objective was to assess left ventricular (LV) volumes at rest and during upright submaximal exercise in endurance athletes to see whether changes in heart volume could explain the large predicted increase in cardiac output in endurance athletes.

Method:  Contrast echocardiography was used to assess changes in LV volumes during upright bicycle exercise in 24 healthy male endurance athletes. Maximal oxygen uptake and oxygen pulse were measured by using cardiopulmonary exercise testing.

Results:  From rest to exercise at a heart rate of 160 beats min−1 end-diastolic volume increased by 18% (P < 0.001) and end-systolic volume decreased by 21% (P = 0.002). Stroke volume showed an almost linear increase during exercise (45% increase, P < 0.001). The increase in end-diastolic volume contributed to 73% of the increase in stroke volume. No significant differences were observed between stroke volume calculated from LV volumes with contrast echocardiography and stroke volume calculated from oxygen pulse at heart rates of 130 and 160 beats min−1. Using the linear regression equation between oxygen uptake and cardiac output assessed by echocardiography during exercise (r = 0.87, P = 0.002), cardiac output at maximal exercise was estimated at 33 ± 3 L min−1, with an estimated increase in stroke volume by 69% from rest to maximal exercise.

Conclusion:  By using contrast echocardiography, a large increase in stroke volume in endurance athletes could be explained by an almost linear increase in end-diastolic volume and an initial small decrease in end-systolic volume during incremental upright exercise.

Place, publisher, year, edition, pages
2004. Vol. 182, no 1, 45-51 p.
Keyword [en]
contrast echocardiography, left ventricular dynamics, stroke volume
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96334DOI: 10.1111/j.1365-201X.2004.01304.xISI: 000223537600006OAI: oai:DiVA.org:uu-96334DiVA: diva2:170875
Available from: 2007-10-25 Created: 2007-10-25 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Left Ventricular Dynamics During Exercise in Endurance Athletes
Open this publication in new window or tab >>Left Ventricular Dynamics During Exercise in Endurance Athletes
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Large quantities of data have described left ventricular adaptation to endurance training, but basic concepts on left ventricular performance during exercise remain controversial. In this thesis, we present the results of studies of left ventricular dynamics during exercise in 89 endurance-trained athletes.

Using radionuclide ventriculography, 35 female and 30 male endurance athletes were studied in supine position. During supine exercise at 70% of the age-expected maximal heart rate, the adjustments in left ventricular volumes were small, suggesting a high preload before exercise. Stroke volume increased by changes in the left ventricular end-diastolic volumes but no changes were observed in the end-systolic volumes. Moreover, no significant differences were noted between male and female athletes.

Contrast echocardiography was utilized when 24 male endurance athletes were studied during upright exercise. An almost linear increase in stroke volume was seen from upright rest to upright exercise at a heart rate of 160 beats per minute. Stroke volume increased by an almost linear increase in end-diastolic volume and showed an initial small decrease in end-systolic volume. The left ventricular cavity became geometrically more spherical with the largest increase in the left ventricular end-diastolic short-axis cavity diameters in the mid and apical part of the left ventricle. Left ventricular long-axis length obtained from the epicardial apex to the middle of the mitral annulus at end-diastole showed no significant change from rest to exercise. The mitral annulus motion contributed to more than 50% of the stroke volume during exercise with no significant difference between septal and lateral annular motion at peak exercise. Major changes were observed in left ventricular filling indices during upright exercise. The mean transmitral pressure gradient showed a linear increase and increased several times as the mean diastolic time decreased, with large reductions in mean left ventricular filling time. Despite the shortened filling time, the heart was able to increase the filling rate (measured as volume per time) five times. This observation verifies that the heart has large reserves at rest and reveals the increase in capacity during exercise.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 61 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 281
Keyword
Physiology, athletes, exercise, left ventricular dynamics, stroke volume, mitral annular motion, Fysiologi
Identifiers
urn:nbn:se:uu:diva-8276 (URN)978-91-554-6998-6 (ISBN)
Public defence
2007-11-17, Aulan, Gamla vårdgymnasiet, Västerås, 13:15
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Supervisors
Available from: 2007-10-25 Created: 2007-10-25Bibliographically approved

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Hedberg, PärHenriksen, Egil

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