Abstract
We assessed myocardial deformation in sub-endocardial and sub-epicardial layers of the left ventricle (LV) wall before and after running a marathon. Echocardiography scans were performed on 14 male, non-elite runners (mean ± SD; age 32 ± 10 years) who completed the 42.2-km London marathon. Para-sternal short axis and apical four-chamber views were recorded for off-line analysis. Peak longitudinal, radial and circumferential strains, peak systolic and early diastolic strain rates were recorded. Circumferential rotation in basal and apical LV scans was used to calculate torsion. Pre-race strain and strain rates were generally greater in the sub-endocardial layer of the LV wall. After race completion, a mixed pattern of change was observed with a reduction in sub-epicardial radial strain (32.6 ± 12.5 to 20.3 ± 9.6%; P < 0.01) and sub-endocardial circumferential strain (−26.9 ± 3.6 to −23.7 ± 4.1%; P < 0.01) at the apex. Rotation was not altered at either the apical or basal levels and thus torsion was not changed in either the sub-endocardium (6.72 ± 3.46° to 5.67 ± 4.98°) or the sub-epicardium (3.48 ± 2.68° to 3.01 ± 3.23°). Strain rates and rotation rates were only sporadically altered post-race. There are differences in deformation characteristics between the sub-endocardium and sub-epicardium at baseline, and the limited changes observed post-race were not specific to any region or depth of the LV wall.
Similar content being viewed by others
References
Banks L, Sasson Z, Busato M, Goodman J (2010) Impaired left and right ventricular function following prolonged exercise in young athletes: influence of exercise intensity and responses to dobutamine stress. J Appl Physiol 108:112–119
Becker M, Bilke E, Kühl H, Katoh M, Kramann R, Franke A, Bücker A, Hanrath P, Hoffmann R (2006) Analysis of myocardial deformation based on pixel tracking in two dimensional echocardiographic images enables quantitative assessment of regional left ventricular function. Heart 92:1102–1108
Dandel M, Hetzer R (2009) Echocardiographic strain and strain rate imaging—clinical applications. Int J Cardiol 132:11–24
Douglas P, O’Toole M, Hiller W, Hackney K, Reichek N (1987) Cardiac fatigue after prolonged exercise. Circulation 76:1206–1213
Esch B, Warburton D (2009) Left ventricular torsion and recoil: implications for exercise performance and cardiovascular disease. J Appl Physiol 106(2):362–369
George K, Oxborough D, Forster J, Whyte G, Shave R, Dawson E, Stephenson C, Dugdill L, Edwards B, Gaze D (2005) Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans. J Physiol 569:305–313
George K, Shave R, Warburton D, Scharhag J, Whyte G (2008) Exercise and the heart: can you have too much of a good thing? Med Sci Sports Exerc 40:1390–1392
George K, Shave R, Oxborough D, Cable T, Dawson E, Artis N, Gaze D, Hew-butler T, Sharwood K, Noakes T (2009) Left ventricular wall segment motion after ultra-endurance exercise in human assessed by myocardial speckle tracking. Eur J Echocardiogr 10:238–243
Goffinet C, Chenot F, Robert A, Pouleur A, Waroux J, Vancrayenest D, Gerard O, Pasquet A, Gerber B, Vanoverschelde J (2009) Assessment of subendocardial vs. subepicardial left ventricular rotation and twist using two dimensional speckle tracking echocardiography: comparison with tagged cardiac magnetic resonance. Eur Heart J. doi:10.1093/eurheartj/ehn511
Götte M, Germans T, Rüssel I, Zwanenburg J, Marcus J, Rossum A, Veldhuisen D (2006) Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function. J Am Coll Cardiol 48(10):2002–2011
Hart E, Shave R, Middleton N, George K, Whyte G, Oxborough D (2007) Effect of preload augmentation on pulsed wave and tissue Doppler echocardiographic indices of diastolic function after a marathon. J Am Soc Echocardiogr 20(12):1393–1399
Hasegawa T, Nakatani S, Kanzaki H, Abe H, Kitakaze M (2009) Heterogeneous onset of myocardial relaxation in subendocardial and subepicardial layers assessed with tissue strain imaging: comparison of normal and hypertrophied myocardium. JACC Cardiovasc Imaging 2(6):701–708
Hein I, O’Brien W (1993) Current time-domain methods for assessing tissue motion by analysis from reflected ultrasound echoes—a review. IEEE Trans Ultrason Ferroelectr Freq Control 40:84–102
Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen B, Smith H, Rosen B, Lima J, Torp H, Ihlen H, Smiseth O (2005) New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 112:3149–3156
Kim H, Sohn D, Lee S, Choi S, Park J, Kim Y, Oh B, Park Y, Choi Y (2007) Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 20:45–53
Knebel F, Schimke I, Schroeckh S, Peters H, Eddicks S, Schattke S, Brechtel L, Lock J, Wernecke K, Dreger H, Grubitz S, Schmidt J, Baumann G, Borges A (2009) Myocardial function in older male amateur marathon runners: assessment by tissue Doppler echocardiography, speckle tracking, and cardiac biomarkers. J Am Soc Echocardiogr 22(7):803–809
Korinek J, Wang J, Sengupta P, Miyazaki C, Kjaergaard J, McMahon E, Abraham T, Belohlavek M (2005) Two-dimensional strain-A Doppler-independent ultrasound method for quantitative of regional deformation: validation in vitro and in vivo. J Am Soc Echocardiogr 18(12):1247–1253
La Gerche A, Connelly K, Macisaac A, Mooney D, Prior D (2008) Biochemical and function abnormalities of left and right ventricular function following ultra-endurance exercise. Heart 94:860–866
Lorch M, Ludomirsky A, Singh G (2008) Maturational and growth-related changes in left ventricular longitudinal strain and strain rate measured by two-dimensional speckle tracking echocardiography in health paediatric population. J Am Soc Echocardiogr 21(11):1207–1215
Lucía A, Serratosa L, Saborido A, Pardo J, Boraita A, Morán M, Bandrés F, Megías A, Chicharro J (1999) Short-term effects of marathon running: no evidence of cardiac dysfunction. Med Sci Sports Exerc 31(10):1414–1421
Lumens J, Delhaas T, Arts T, Cowan B, Young A (2006) Impaired subendocardial contractile myofiber function in asymptomatic aged humans, as detected using MRI. Am J Physiol Heart Circ Physiol 291:1573–1579
Marwick T (2006) Measurement of strain and strain rate by echocardiography ready for prime time? JACC 47(7):1313–1327
Middleton N, Shave R, George K, Whyte G, Atkinson G (2006) Exercise-induced cardiac fatigue a meta-analysis. Med Sci Sports Exerc 38:681–687
Mizuguchi Y, Oishi Y, Miyoshi H, Iuchi A, Nagase N, Oki T (2008) The function role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with two-dimensional strain imaging. J Am Soc Echocardiogr 21(10):1138–1144
Neilan T, Januzzi J, Lee-Lewandrowski E, Ton-Nu T, Yoerger D, Jassal D, Lewandrowski K, Siegel A, Marshall J, Douglas P, Lawlor D, Picard M, Wood M (2006) Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation 114:2325–2333
Nottin S, Doucende G, Schuster-Beck I, Dauzat M, Obert P (2008) Alteration in left ventricular normal and shear strains evaluated by 2D-strain echocardiography in the athlete’s heart. J Physiol 585(19):4721–4733
Nottin S, Doucende G, Schuster-beck I, Tanguy S, Dauzat M, Obert P (2009) Alteration in left ventricular strains and torsional mechanics after ultra-long duration exercise in athletes. Circ Cardiovasc Imaging. doi:10.1161/CIRCIMAGING.108.811273
Scott J, Esch B, Shave R, Warburton D, Gaze D, George K (2009) Cardiovascular consequences of completing a 160-km ultramarathon. Med Sci Sports Exerc 41(1):25–33
Shave R, George K, Whyte G, Hart E (2008) Post exercise changes in left ventricular function: the evidence so far. Med Sci Sports Exerc 10:1393–1399
Zhang Q, Fang F, Liang Y, Xie J, Wen Y, Yip G, Lam Y, Chan J, Fung J, Yu C (2009) A novel multi-layer approach of measuring myocardial strain and torsion by 2D speckle tracking imaging in normal subjects and patients with heart diseases. Int J Cardiol. doi:10.1016/j.ijcard.2009.07.041
Author information
Authors and Affiliations
Corresponding author
Additional information
Communicated by Niels Secher.
Rights and permissions
About this article
Cite this article
Chan-Dewar, F., Oxborough, D., Shave, R. et al. Left ventricular myocardial strain and strain rates in sub-endocardial and sub-epicardial layers before and after a marathon. Eur J Appl Physiol 109, 1191–1196 (2010). https://doi.org/10.1007/s00421-010-1469-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-010-1469-8