Abstract
Purpose
To examine seasonal variation of the right heart (RH) structure and function in elite skiers-racers.
Methods
The same group of 16 male was recruited into the study in the period of preparation for national competitions. The study was carried out at the hospital in Sykyvkar, the European North of Russia, which is located near 62° NL and 51° EL. The winter resting echocardiography study was performed in December 2017 (with the average temperature of − 7.8 °C) and the summer resting echocardiography study was performed in July 2018 (with the average temperature of + 23.8 °C).
Results
No significant difference was seen between the right atrium and ventricle dimensions in diastole in winter and summer (P > 0.05). In December both early diastolic peak filling velocity of the right ventricle (RV) and late atrial diastolic peak filling velocity of the RV were greater than that measured in July: 65 ± 7 vs. 56 ± 6 cm/s and 40 ± 6 vs. 34 ± 3 cm/s, respectively (P < 0.05). It was found out that blood flow ejection time at the root of pulmonary artery in winter was greater than in summer: 371 ± 27 vs. 345 ± 27 ms, respectively (P < 0.05). Regurgitation of blood flow in the tricuspid valve (from 1 to 1.5 grade or mild/moderate) was observed in all of the sixteen skiers studied.
Conclusion
The right heart functional adaptation to cold occurs in elite skiers-racers. The right heart intracardiac hemodynamics increased in winter time.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- A:
-
Late atrial diastolic peak filling velocity of the right ventricle
- ASE:
-
American Society of Echocardiography
- AV:
-
Atrioventricular
- BP:
-
Blood pressure
- E:
-
Early diastolic peak filling velocity of the right ventricle
- IVC:
-
Inferior vena cava
- PADs:
-
Pulmonary artery diameter at the root in systole
- PAET:
-
Blood flow ejection time at the root of pulmonary artery
- PAV:
-
Blood flow velocity at the root of pulmonary artery
- PGR:
-
Pressure gradient of regurgitation in tricuspid valve
- RA:
-
Right atrium
- RALDd:
-
Right atrium longitudinal dimension in diastole
- RATDd:
-
Right atrium transverse dimension in diastole
- RH:
-
Right heart
- RV:
-
Right ventricle
- RVDd:
-
Right ventricle maximal end-diastolic diameter
- RVWTd:
-
Right ventricle wall thickness
- SD:
-
Standard deviation
- SPAP:
-
Systolic pulmonary artery pressure
- TR:
-
Tricuspid regurgitation
- TRV:
-
Tricuspid regurgitation velocity
References
Andersen K, Farahmand B, Ahlbom A, Held C, Ljunghall S, Michaëlsson K, Sundström J (2013) Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J 34:3624–3631. https://doi.org/10.1093/eurheartj/eht188
Arntz HR, Müller-Nordhorn J, Willich SN (2001) Cold Monday mornings prove dangerous: epidemiology of sudden cardiac death. Curr Opin Crit Care 7:139–144. https://doi.org/10.1097/00075198-200106000-00001
Atkinson AJ, Logantha SJ, Hao G, Yanni J, Fedorenko O, Sinha A, Gilbert SH, Benson AP, Buckley DL, Anderson RH, Boyett MR, Dobrzynski H (2013) Functional, anatomical, and molecular investigation of the cardiac conduction system and arrhythmogenic atrioventricular ring tissue in the rat heart. J Am Heart Assoc 2:e000246. https://doi.org/10.1161/JAHA.113.000246
Cohen J (1992) A power primer. Psychol Bull 112:155–159. https://doi.org/10.1037/0033-2909.112.1.155
Dobrzynski H, Anderson RH, Atkinson A, Borbas Z, D’Souza A, Fraser JF, Inada S, Logantha SJ, Monfredi O, Morris GM, Moorman AFM, Nikolaidou T, Schneider H, Szuts V, Temple IP, Yanni J, Boyett MR (2013) Structure, function and clinical relevance of the cardiac conduction system, including the atrioventricular ring and outflow tract tissues. Pharmacol Ther 139:260–288. https://doi.org/10.1016/j.pharmthera.2013.04.010
Douglas PS, O’Toole ML, Miller WD, Reichek N (1990) Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol 15:64–69
Du Bois D, Du Bois E (1916) A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17:863–871. https://doi.org/10.1001/archinte.1916.00080130010002
Evdokimov VG, Rogachevskaya OV, Varlamova NG (2007) Modulating effect of northem factors on human cardiorespiratory system in ontogenesis. Ural Branch of RAS Publ, Yekaterinburg
George KP, Gates PE, Whyte G, Fenoglio RA, Lea R (1999) Echocardiographic examination of cardiac structure and function in elite cross trained male and female Alpine skiers. Br J Sports Med 33:93–99. https://doi.org/10.1136/bjsm.33.2.93
Gjerdalen GF, Hisdal J, Solberg EE, Andersen TE, Radunovic Z, Steine K (2015) Atrial size and function in athletes. Int J Sports Med 36:1170–1176. https://doi.org/10.1055/s-0035-1555780
Grazioli G, Merino B, Montserrat S, Vidal B, Azqueta M, Pare C, Sarquella-Brugada G, Yangüas X, Pi R, Til L, Escoda J, Brugada J, Sitges M (2014) Usefulness of echocardiography in preparticipation screening of competitive athletes. Rev Esp Cardiol 67:701–705. https://doi.org/10.1016/j.rec.2013.11.023
Gudkov AB, Popova ON, Manuilov IV (2014) Seasonal changes in hemodynamic parameters in skiers in the European North of Russia. Arctic Environ Res No 1:56–63
Harmon K, Drezner J, Maleszewski J, Lopez-Anderson M, Owens D, Prutkin J, Asif I, Klossner D, Ackerman M (2014) Pathogenesis of sudden cardiac death in national collegiate athletic association athletes. Circ Arrhythm Electrophysiol 7:198–204. https://doi.org/10.1161/CIRCEP.113.001376
Holmberg HC (2015) The elite cross-country skier provides unique insights into human exercise physiology. Scand J Med Sci Sports 25(Suppl. 4):100–109. https://doi.org/10.1111/sms.12601
Kose S, Aytemir K, Can I, Iyisoy A, Kilic A, Amasyali B, Kursaklioglu H, Isik E, Oto A, Demirtas E (2002) Seasonal variation of P-wave dispersion in healthy subjects. J Electrocardiol 35:307–311. https://doi.org/10.1054/jelc.2002.35848
Kose S, Aytemir K, Can I, Iyisoy A, Kursaklioglu H, Amasyali B, Kilic A, Isik E, Oto A, Demirtas E (2003) Seasonal variability of QT dispersion in healthy young males. Ann Noninvasive Electrocardiol 8:8–13. https://doi.org/10.1046/j.1542-474X.2003.08102.x
La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, Macisaac AI, Heidbüchel H, Prior DL (2012) Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 33:998–1006. https://doi.org/10.1093/eurheartj/ehr397
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt J (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1–39. https://doi.org/10.1016/j.echo.2014.10.003
Levin ER, Gardner DG, Samson WK (1998) Natriuretic peptides. N Engl J Med 339:321–328. https://doi.org/10.1056/NEJM199807303390507
Logantha SJ, Kharche SR, Zhang Y, Atkinson AJ, Hao G, Boyett MR, Dobrzynski H (2019) Sinus node-like pacemaker mechanisms regulate ectopic pacemaker activity in the adult rat atrioventricular ring. Sci Rep 9:11781. https://doi.org/10.1038/s41598-019-48276-0
Loomba RS (2015) Seasonal variation in paroxysmal atrial fibrillation: a systematic review. J Atr Fibrillation 7:1201–1212. https://doi.org/10.4022/jafib.1201
Manuilov IV (2014) Seasonal dynamics of bioelectrical activity of myocard in athletes-skiers in the European North. Hum Ecol. https://doi.org/10.33396/1728-0869-2014-3-14-17
Maron BJ, Pelliccia A (2006) The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 114:1633–1644. https://doi.org/10.1161/CIRCULATIONAHA.106.613562
Marra AM, Naije R, Ferrara F, Vriz O, Stanziola AA, D´Alto M, D´Andrea A, Carannante L, Eichstaedt CA, Cittadini A, Benjamin N, Grünig E, Bossone E (2018) Reference ranges and determinants of tricuspid regurgitation velocity in healthy adults assessed by two-dimensional Doppler-Echocardiography. Respiration 96:425–433. https://doi.org/10.1159/000490191
Milovanov AP (1981) Adaptation of the pulmonary circulation in the North. Nauka, Novosibirsk
Mohammad MA, Koul S, Rylance R, Fröbert O, Alfredsson J, Sahlén A, Witt N, Jernberg T, Muller J, Erlinge D (2018) Association of weather with day-to-day incidence of myocardial infarction: A SWEDEHEART nationwide observational study. JAMA Cardiol 3:1081–1089. https://doi.org/10.1001/jamacardio.2018.3466
Morton JB, Sanders P, Das A, Vohra JK, Sparks PB, Kalman JM (2001) Focal atrial tachycardia arising from the tricuspid annulus: electrophysiologic and electrocardiographic characteristics. J Cardiovasc Electrophysiol 12:653–659. https://doi.org/10.1046/j.1540-8167.2001.00653.x
Pelliccia A, Kinoshita N, Pisicchio C, Quattrini F, Dipaolo FM, Ciardo R, Di Giacinto B, Guerra E, De Blasiis E, Casasco M, Culasso F, Maron BJ (2010) Long-term clinical consequences of intense, uninterrupted endurance training in Olympic athletes. J Am Coll Cardiol 55:1619–1625. https://doi.org/10.1016/j.jacc.2009.10.068
Persch H, Steinacker JM (2020) Echocardiographic criteria for athlete’s heart with cut-off parameters and special emphasis on the right ventricle. Dtsch Z Sportmed 71:151–158. https://doi.org/10.5960/dzsm.2020.433
Popple E, George K, Somauroo J, Sharma S, Utomi V, Lord R, Cooper R, Malhotra A, Forster J, Oxborough D (2018) Right ventricular structure and function in senior and academy elite footballers. Scand J Med Sci Sports 28:2617–2624. https://doi.org/10.1111/sms.13272
Prosheva V, Kaseva N (2016) Location and functional characterization of the right atrioventricular pacemaker ring in the adult avian heart. J Morphol 277:363–369. https://doi.org/10.1002/jmor.20502
Rosso R, Kistler PM (2010) Focal atrial tachycardia. Heart 96:181–185. https://doi.org/10.1136/hrt.2008.143552
Rudski L, Lai W, Afilalo J, Hua L, Handschumacher M, Chandrasekaran K, Solomon S, Louie E, Schiller N (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713. https://doi.org/10.1016/j.echo.2010.05.010
Sadeghpour A, Hassanzadeh M, Kyavar M, Bakhshandeh H, Naderi N, Ghadrdoost B, Talab AH (2013) Impact of severe tricuspid regurgitation on long term survival. Res Cardiovasc Med 2:121–126. https://doi.org/10.5812/cardiovascmed.10686
Schwarz K, Singh S, Dawson D, Frenneaux MP (2013) Right ventricular function in left ventricular disease: pathophysiology and implications. Heart Lung Circ 22:507–511. https://doi.org/10.1016/j.hlc.2013.03.072
Singh JP, Evans J, Levi D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ (1999) Prevalence and clinical determinants of mitral, tricuspid and aortic regurgitation (Framingham heart study). Am J Cardiol 83:897–902. https://doi.org/10.1016/s0002-9149(98)01064-9
Takigawa M, Noda T, Shimizu W, Miyamoto K, Okamura H, Satomi K, Suyama K, Aihara N, Kamakura S, Kurita T (2008) Seasonal and circadian distributions of ventricular fibrillation in patients with Brugada syndrome. Heart Rhythm 5:1523–1527. https://doi.org/10.1016/j.hrthm.2008.08.022
Teske AJ, Prakken NH, De Boeck BW, Velthuis BK, Martens EP, Doevendans PA, Cramer MJ (2009) Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes. Eur Heart J 30:969–977. https://doi.org/10.1093/eurheartj/ehp040
Trivax JE, Franklin BA, Goldstein JA, Chinnaivan KM, Gallagher MJ, deJong AT, Colar JM, Haines DE, McCullough PA (2010) Acute cardiac effects of marathon running. J Appl Physiol 108:1148–1153. https://doi.org/10.1152/japplphysiol.01151.2009
Watanabe E, Kuno Y, Takasuga H, Tong M, Sobue Y, Uchiyama T, Kodama I, Hishida H (2007) Seasonal variation in paroxysmal atrial fibrillation documented by 24-hour Holter electrocardiogram. Heart Rhythm 4:27–31. https://doi.org/10.1016/j.hrthm.2006.09.030
Wilkenshoff U, Kruck I (2017) Handbuch der Echokardiografie. Georg Thieme Verlag, Stuttgart
Yang J, Zhou M, Ou C, Yin P, Li M, Tong S, Gasparrini A, Liu X, Li J, Cao L, Wu H, Liu Q (2017) Seasonal variations of temperature-related mortality burden from cardiovascular disease and myocardial infarction in China. Environ Pollut 224:400–406. https://doi.org/10.1016/j.envpol.2017.02.020
Zenchenko TA, Varlamova NG (2015) Hemodynamic response characteristics of healthy people to changes in meteorological and geomagnetic factors in the north. Izv Atmos Ocean Phys 51:858–870
Funding
This study was performed in the framework of the Program for Fundamental Research of the Russian Academy of Sciences 2016–2021 (Project number AAAA-A16-116040110021-7).
Author information
Authors and Affiliations
Contributions
Conceptualization, VP; methodology, VP and BD; formal analysis, VP and BD; investigation, VP, BD and VN; writing—original draft preparation, VP and BD; writing—review and editing, VP, BD and VN.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Ethics approval
The study protocol was approved by the ethics committee of the Institute of Physiology of the Komi Scientific Center of the Russian Academy of Sciences (Approval Number 38). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.
Consent to participate
The written informed consent was obtained from all individual participants included in this study.
Consent for publication
All authors read and approved the final version of this manuscript.
Additional information
Communicated by Massimo Pagani .
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Dernovoj, B., Nuzhny, V. & Prosheva, V. Seasonal variation of right heart function in elite skiers-racers: an echocardiographic study. Eur J Appl Physiol 122, 1261–1268 (2022). https://doi.org/10.1007/s00421-022-04907-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-022-04907-5