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Left ventricular end-diastolic geometrical adjustments during 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.
2008 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, Vol. 28, no 2, 76-80 p.Article in journal (Refereed) Published
Abstract [en]

The increase in left ventricular (LV) end-diastolic volume has recently been shown to explain more than 70% of the increase in stroke volume during upright exercise in endurance athletes. As the end-diastolic volume enhancement not could be explained by an increase in axial cavity length an augmentation in LV short-axis diameters is to be expected. To investigate LV end-diastolic geometrical alterations during exercise, 15 endurance athletes were examined using contrast exercise echocardiography. LV end-diastolic short-axis diameters were made from apical views at several LV cavity levels. From upright rest to upright exercise the LV end-diastolic internal cavity measurements increased significantly. During exercise, the LV cavity became geometrically more spherical with the largest increase in the LV end-diastolic short-axis cavity diameters in the mid and apical parts of the left ventricle. The LV internal long axis showed significant increase from rest to exercise but the absolute increase was small.

Place, publisher, year, edition, pages
2008. Vol. 28, no 2, 76-80 p.
Keyword [en]
athletes, echocardiography, exercise, left ventricular geometry
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96337DOI: 10.1111/j.1475-097X.2007.00768.xISI: 000252897100002OAI: oai:DiVA.org:uu-96337DiVA: diva2:170878
Available from: 2007-10-25 Created: 2007-10-25 Last updated: 2010-01-13Bibliographically 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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