European Journal of Echocardiography Advance Access originally published online on July 29, 2008
European Journal of Echocardiography 2009 10(2):238-243; doi:10.1093/ejechocard/jen207
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Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking
1 Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
2 Centre for Sports Medicine and Human Performance, Brunel University, UK
3 School of Medicine and Healthcare, University of Leeds, Leeds, UK
4 Department of Chemical Pathology, St George’s Hospital, UK
5 MRC/UCT Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Rondebosch, South Africa
Received 31 March 2008; accepted after revision 5 July 2008; online publish-ahead-of-print 29 July 2008.
* Corresponding author. Tel: +44 151 231 4088; fax: +44 151 231 4353. E-mail address: k.george{at}livjm.ac.uk
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Abstract |
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Aims: Assessment of the left ventricular responses to prolonged exercise has been limited by technology available to assess cardiac tissue movement. Recently developed strain and strain rate imaging provide the unique opportunity to assess tissue deformation in all planes of motion.
Methods and results: Nineteen runners (mean ± SD age; 41 ± 9 years) were assessed prior to and within 60 min (34 ± 10 min) of race finish (Comrades Marathon, 89 km). Standard echocardiography assessed ejection fraction and the ratio of early to atrial (E/A) peak transmitral blood flow velocities. Myocardial speckle tracking determined segmental strain as well as systolic and diastolic strain rates in radial, circumferential, and longitudinal planes. Cardiac troponin T (cTnT) assessed cardiomyocyte insult. Ejection fraction (71 ± 5 to 64 ± 6%) and E/A (1.47 ± 0.35 to 1.25 ± 0.30) were reduced (P < 0.05). Peak strain and peak systolic and diastolic strain rates were altered post-race in circumferential (e.g. peak strain reduced from 21.3 ± 2.4 to 17.3 ± 3.2%, P < 0.05) and radial planes. Some individual heterogeneity was observed between segments and planes of motion. A post-race elevation in cTnT (range 0.013–0.272 µg/L) in 5/12 runners did not differentiate changes in LV function.
Conclusion: Completion of the Comrades Marathon resulted in a depression in ejection fraction, E/A, as well as radial and circumferential strain and strain rates. Group data, however, masked some heterogeneity in cardiac function.
Keywords: Cardiac function; Strain; Echocardiography
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