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Echocardiographic doppler assessments of left ventricular filling and ejection during upright exercise in endurance athletes
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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2007 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 27, no 1, 36-41 p.Article in journal (Refereed) Published
Abstract [en]

Doppler echocardiography was used to describe left ventricular filling and ejection during upright bicycle exercise in 24 healthy male endurance athletes. The transmitral pressure gradient was estimated and isovolumetric relaxation, filling and ejection time and transmitral and aortic flow velocities were measured at rest and during exercise. From rest to peak exercise (at a heart rate of 160 bpm), the mean left ventricular filling time was shortened by 73%, the ejection time by 31%, while the isovolumetric relaxation time was shortened by 62%. At peak exercise, the maximum aortic flow velocity almost doubled and the maximum transmitral flow velocity more than doubled, with a tenfold increase in the mean transmitral pressure gradient. The increase was significant (P<0·001) at each level of exercise. The left ventricular filling rate measured as volume per time was 185 ± 62 ml s−1 at rest and it increased to 986 ± 192 ml s−1 at peak exercise. This study demonstrates large changes in diastolic filling indices during upright exercise and it shows that the heart is able to increase its filling rate five times from rest to peak exercise.

Place, publisher, year, edition, pages
2007. Vol. 27, no 1, 36-41 p.
Keyword [en]
athletes, Doppler echocardiography, exercise, left ventricular dynamics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96335DOI: 10.1111/j.1475-097X.2007.00715.xISI: 000242862200007PubMedID: 17204036OAI: oai:DiVA.org:uu-96335DiVA: diva2:170876
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
Opponent
Supervisors
Available from: 2007-10-25 Created: 2007-10-25Bibliographically approved

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