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Cardiac performance after an endurance open water swimming race

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Endurance exercise competitions have shown a transient negative effect on global right ventricular (RV) performance. Most published studies are based on terrestrial sports. The aim of our study was to evaluate the cardiac effects after an open water swimming race.

Methods

We evaluated 33 healthy swimmers (mean age 40.9 ± 7.2) participating in a 9.5 km open water swimming race. All subjects underwent a standard transthoracic echocardiography including an evaluation of dimensions and myocardial ventricular deformation. Echocardiography was performed 24 h before and within the first hour of arrival at the finish line. Cardiac troponin I (cTn I), NT-ProBNP and leukocytes were also evaluated.

Results

No changes in left ventricle (LV) ejection fraction or LV global longitudinal strain were observed. A significant increase in RV end-diastolic area (RVEDA) was noted after the race (RVEDA at baseline 15.12 ± 1.86; RVEDA after race 16.06 ± 2.27, p < 0.05), but no changes were seen in RV fractional area change or RV global longitudinal strain. Cardiac biomarkers and leukocytes significantly increased. No association was detected between the increase in cTn I or NT-proBNP and the RV acute dilatation or LV performance. A significant association was observed between cTn I and leukocytes (r = 0.375, p < 0.05).

Conclusions

An acute RV dilatation but without an impairment in RV deformation was observed after participating in an endurance swimming race. The correlation between the increase in cTn I and leukocytes, but not with ventricular performance, may support the hypothesis of an exercise-induced increase in myocardial sarcolemmal permeability due to an inflammatory response rather than myocardial injury.

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Data Availability

The data sets generated or analyzed during this study are available from the corresponding authors on reasonable request.

Abbreviations

BSA:

Body surface area

cTn I:

Cardiac troponin I

CO:

Cardiac output

CRP:

C-reactive protein

DBP:

Diastolic blood pressure

ET:

Ejection time

FWRV:

Free wall right ventricle

GFR:

Glomerular filtration rate

HR:

Heart rate

IVS:

Inter-ventricular septal thickness

LV:

Left ventricle

LVEF:

Left ventricle ejection fraction

LVEDV:

Left ventricle end-diastolic volume

LVGLS:

Global left ventricle peak systolic strain

PW:

Pulsed Doppler

PWT:

Posterior wall thickness

RV:

Right ventricle

RVEDA:

Right ventricle end-diastolic area

RVFAC:

Right ventricle fractional area change

RVGLS:

Global right ventricle peak systolic strain

SBP:

Systolic blood pressure

SD:

Standard deviation

SV:

Stroke volume

TDI:

Tissue Doppler imaging

TP:

Time to peak

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Authors and Affiliations

  1. Department of cardiology, Fundació Althaia, Xarxa Assistencial Universitaria de Manresa, Dr Joan Soler 1-3, 08243, Manresa, Barcelona, Spain

    Vanessa Martinez, Gloria Garcia, Pilar Corzan, Angels Clemente & Barbara González

  2. Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain

    Vanessa Martinez, Maria Sanz-de la Garza, Gonzalo Grazioli & Marta Sitges

  3. ICREA, Universitat Pompeu Fabra, Barcelona, Spain

    Bart H. Bijnens

  4. Department of Laboratory Medicine, Fundació Althaia, Xarxa Assistencial Universitaria de Manresa, Manresa, Barcelona, Spain

    Jaume Trapé

Authors
  1. Vanessa Martinez
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  2. Maria Sanz-de la Garza
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  3. Gonzalo Grazioli
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  4. Bart H. Bijnens
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  5. Jaume Trapé
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  6. Gloria Garcia
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  7. Pilar Corzan
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  8. Angels Clemente
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  9. Barbara González
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  10. Marta Sitges
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Contributions

VM conceived and designed the study; VM, MSG, and GG performed the echocardiographic studies; GG, PC, BG, and AC conducted the blood sample extractions; JT processed the blood samples; VM analyzed the data and interpreted the results; MSG, BB, and MS contributed to the interpretation of the results; VM wrote the manuscript; and MS supervised the study. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Vanessa Martinez.

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Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Human right and animal participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Keith Phillip George.

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Martinez, V., la Garza, M.Sd., Grazioli, G. et al. Cardiac performance after an endurance open water swimming race. Eur J Appl Physiol 119, 961–970 (2019). https://doi.org/10.1007/s00421-019-04085-x

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  • DOI: https://doi.org/10.1007/s00421-019-04085-x

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