Functional shift of right ventricular mechanics in athletes: a three-dimensional echocardiography study
█ Original article
Fábián Alexandra, Lakatos Bálint Károly, Kiss Orsolya, Sydó Nóra, Vágó Hajnalka, Czimbalmos Csilla, Tokodi Márton, Kántor Zoltán, Bognár Csaba, Major Dávid, Kovács Attila, Merkely Béla
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
Aims: Data is limited regarding right ventricular adaptation in athlete’s heart. In this study, our aim was to characterize right ventricular morphology and function in athletes.
Materials and methods: Our study group consisted of young elite athletes (n=111, age: 19±4 years). 32 age- and gender matched healthy sedentary volunteers served as the control group. 3D echocardiography was performed to measure left- and right ventricular volumes and ejection fractions. Using our custom method we have decomposed the motion of the right ventricle to determine so-called longitudinal and radial ejection fractions for detailed characterization of right ventricular mechanics.
Results: Left- and right ventricular volumes were significantly higher in athletes (athlete vs. control; LVEDVi: 86±32 vs. 65±8 ml/m2, RVEDVi: 87±11 vs. 66±10 ml/m2). The left- and right ventricular ejection fraction were in the normal range in every athlete, however, they were significantly lower compared to controls (LVEF:57±4 vs. 62±3%, RVEF: 56±5 vs. 61±5%). In-depth assessment of right ventricular mechanics revealed characteristic features of athlete’s heart: the relative contribution of longitudinal motion to global function was significantly higher, while the relative contribution of radial motion was significantly lower in athletes compared to the sedentary group (LEF/RVEF: 0.5±0.07 vs. 0.42±0.07, REF/RVEF: 0.33±0.08 vs. 0.45±0.09).
Conclusions: According to our results marked changes in right ventricular morphology and function are found in athletes. Along with the higher volumes and lower resting global function, right ventricular mechanics also differ from sedentary controls by increased relative contribution of longitudinal and decreased relative contribution of radial function.