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European Journal of Applied Physiology

, Volume 115, Issue 1, pp 71–80 | Cite as

The right ventricle following ultra-endurance exercise: insights from novel echocardiography and 12-lead electrocardiography

  • Rachel Lord
  • John Somauroo
  • Mike Stembridge
  • Nikhil Jain
  • Martin D. Hoffman
  • Keith George
  • Helen Jones
  • Rob Shave
  • Francois Haddad
  • Euan Ashley
  • David Oxborough
Original Article

Abstract

Purpose

There is contradictory evidence related to the impact of ultra-marathon running on right ventricular (RV) structure and function. Consequently, the aims of this study were to: (1) comprehensively assess RV structure and function before and immediately following a 100-mile ultra-marathon in highly trained runners, (2) determine the nature of RV recovery 6 h post-race, and (3) document 12-lead electrocardiogram (ECG) changes post-exercise.

Methods

Echocardiography and 12-lead ECG were assessed in 15 competitors in a repeated measures design before and immediately after completion of the 2013 Western States Endurance Race. A subset of nine was reassessed 6 h into recovery. Standard echocardiography was used to determine RV size, function and wall stress. Myocardial speckle tracking (MST) provided peak, time to peak and temporal indices for RV longitudinal strain and strain rates (ε and SR).

Results

RV size was increased post-race (inflow tract 14 %, outflow tract 11 %, P = 0.004 and 0.002). RV wall stress was elevated by 11 % post-race. Peak RV ε was reduced by 10 % (P = 0.007) and significantly delayed post-race (P = 0.008). Most changes in RV function persisted at the 6-h assessment. Post-race there was an increase in the prevalence of right-sided ECG changes.

Conclusions

Completion of a 100-mile ultra-marathon resulted in acute changes in RV structure and function that persisted 6 h into recovery and are consistent with sustained exposure to an elevated RV wall stress. These findings were supported by right-sided changes to the 12-lead ECG.

Keywords

Endurance Exercise Ultrasound Running Cardiology physiology 

Abbreviations

A

Late diastolic myocardial tissue velocity

AP4CH

Apical 4 chamber view

ASE

American Society of Echocardiography

E

Early diastolic myocardial tissue velocity

ECG

Electrocardiogram

EI

Eccentricity index

EICF

Exercise-induced cardiac fatigue

FAC

Fractional area change

HR

Heart rate

IVCT

Isovolumic contraction time

IVRT

Isovolumic relaxation time

LV

Left ventricle

MST

Myocardial speckle tracking

PASP

Pulmonary artery systolic pressure

PLAX

Parasternal long axis view

PSAX

Parasternal short axis view

PW

Pulsed wave

RA

Right atrium

RAD

Right axis deviation

RV

Right ventricle

RVAs

Right ventricular systolic area

RVH

Right ventricular hypertrophy

RVOT

Right ventricular outflow tract

RVSp

Right ventricular systolic pressure

S

Systolic myocardial tissue velocity

ε

Myocardial strain

SRA

Late diastolic strain rate

SRE

Early diastolic strain rate

SRS

Systolic strain rate

SV

Stroke volume

TDI

Tissue Doppler imaging

TsPeak

Time to peak strain

TSRAPeak

Time to peak late diastolic strain rate

TSREPeak

Time to peak early diastolic strain rate

TSRSPeak

Time to peak systolic strain rate

TVI

Tissue velocity imaging

Notes

Acknowledgments

We would like to thank the Western States Endurance Run Foundation for their support with this study.

Conflict of interest

None.

Ethical standards

Ethics approval was granted by the Liverpool John Moores Ethics committee and the study complied with the current laws of the USA where the research was undertaken.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Rachel Lord
    • 1
  • John Somauroo
    • 1
    • 2
  • Mike Stembridge
    • 3
  • Nikhil Jain
    • 4
  • Martin D. Hoffman
    • 5
    • 6
  • Keith George
    • 1
  • Helen Jones
    • 1
  • Rob Shave
    • 3
  • Francois Haddad
    • 4
  • Euan Ashley
    • 4
  • David Oxborough
    • 1
  1. 1.Research Institute for Sport and Exercise Sciences, Tom Reilly BuildingLiverpool John Moores UniversityLiverpoolUK
  2. 2.Countess of Chester Hospital, NHS TrustChesterUK
  3. 3.Cardiff School of SportCardiff Metropolitan UniversityCardiffUK
  4. 4.Stanford University School of Medicine, Falk Cardiovascular Research CenterStanfordUSA
  5. 5.Departments of Physical Medicine and RehabilitationUniversity of California Davis Medical CenterSacramentoUSA
  6. 6.Department of Veterans AffairsNorthern California Health Care SystemSacramentoUSA

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