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Two dimensional and real-time three dimensional ultrasound measurements of left ventricular diastolic function after marathon running: results from a substudy of the BeMaGIC trial

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Abstract

Strenuous exercise results in transient but minor alterations in left ventricular diastolic function (LVDF). The aim of this study is to describe and interpret the kinetics of the well-established 2D parameters of diastolic function and the novel and very sensitive 3D parameters before/after a marathon race. LVDF was evaluated by transthoracic echocardiography (TEE) in 212 healthy male [aged 42 (36–49) years)] marathon runners (all Be-MaGIC-study) in the week prior to (V1), immediately after (V2), 24 h after (V3) and 72 h after (V4) a marathon race. Real time three-dimensional echocardiography (RT3DE) included maximal and minimal left atrium (LA) volume, total LA ejection fraction (Total-EF), total LA stroke volume (Total-SV), true ejection fraction (True-EF) and atrial stroke volume (ASV). After adjustment for possible confounders (heart rate and systolic blood pressure), 2D Parameters of left ventricular inflow (E/A-ratio) decreased from pre- to immediately post-race (− 0.3 ± 0.06, p < 0.001) and returned to baseline within 24 h. \({\text{E}}/{{\text{e}^{\prime}}}_{{{\text{mean}}}}\)-ratio remained unchanged directly post-race, but was significantly increased during follow-up of 24 and 72 h. 3D LA Vmin was increased immediately postrace and in the 24 h follow-up, LA Vmax was increased immediately post-race and in the follow-up of 24 and 72 h. During follow-up of 72 h, but not immediately postrace, TrueEF and ASV were significantly increased. Both techniques revealed acute and prolonged alterations of diastolic LV function. Considering all parameters, the recovery of diastolic LV after a marathon seems to take longer than previously assumed.

Trial registration ClinicalTrials.gov ID: NCT00933218

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Acknowledgements

The authors would like to thank the staff and the doctoral students (Amelie Trommler, Charlotte Hartmann, Jana Habermann, Tobias Rheude, Esther Seifert) of the Department of Prevention and Sports Medicine for their assistance with the project.

Funding

Funding of the study was received by Erdinger Weissbraeu, Werner Brombach GmbH. The funders had no direct rule in the study’s design, conduct, analysis, interpretation of data and reporting beyond approval of the scientific protocol in peer review for funding. No other grants were received.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany

    Astrid Roeh

  2. Department of Prevention, Rehabilitation and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany

    Astrid Roeh, Martin Halle & Johannes Scherr

  3. Department for Medical Statistics and Epidemiology, Klinikum Rechts Der Isar, Technische Universitaet Muenchen, Munich, Germany

    Tibor Schuster

  4. DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, 80802, Munich, Germany

    Martin Halle

  5. Universitäts Herz-Zentrum Freiburg - Bad Krozingen, Klinik für Kardiologie Und Angiologie II, Bad Krozingen, Germany

    Jens Schneider

  6. Medizinische Klinik und Poliklinik I, Klinikum der Universitaet Muenchen, Munich, Germany

    Philip Jung

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  1. Astrid Roeh
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Correspondence to Astrid Roeh.

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Roeh, A., Schuster, T., Jung, P. et al. Two dimensional and real-time three dimensional ultrasound measurements of left ventricular diastolic function after marathon running: results from a substudy of the BeMaGIC trial. Int J Cardiovasc Imaging 35, 1861–1869 (2019). https://doi.org/10.1007/s10554-019-01634-5

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