PhD Scientific Days 2023

Budapest, 22-23 June 2023

Clinical Medicine - Posters A

Biventricular structural and functional adaptation to regular, intense exercise in the young: a 3D echocardiographic study in adolescent athletes

Alexandra Fabian1, Adrienn Ujvari1, Bálint Károly Lakatos1, Márton Tokodi1, Orsolya Kiss2, M. Babity1, Nóra Sydo2, Emese Csulak1, Hajnalka Vago, Vencel Juhász1, Anna Réka Kiss1, Andrea Szucs1, Béla Merkely2, Attila Kovacs1
1 Semmelweis University, Heart and Vascular Center, Budapest, Hungary
2 Semmelweis University, Department of Sports Medicine, Budapest, Hungary

Text of the abstract

Resting measures of biventricular function of the athlete’s heart imply a balanced reduction of both longitudinal and circumferential deformation of the left ventricle (LV), whereas the longitudinal shortening of the right ventricular (RV) is supernormal in adult athletes. However, data are scarce concerning exercise-induced structural and functional adaptation in adolescent athletes.

We enrolled 215 adolescent athletes (16±1 years, 169 males, 12±6 hours of training/week) and compared them to 38 age- and sex-matched healthy, sedentary children. 3D echocardiographic datasets were acquired. We measured the biventricular end-diastolic volume indices (EDVi) and ejection fractions (EF) along with LV mass index (LVMi) using dedicated software. We determined LV global longitudinal (GLS) and circumferential strains (GCS) and in the RV we calculated the relative contributions of longitudinal EF (LEFi) and radial EF (REFi) to the RV EF using the ReVISION method.

LV and RV volumes and LV mass were higher in athletes compared to controls (LV EDVi: 80±13 vs 64±10, RV EDVi: 81±14 vs 68±10 ml/m2, LVMi: 84±14 vs 68±13 g/m2, p<0.01). Notably, both LV and RV EFs were significantly lower (LV EF: 57±4 vs 61±3, RV EF: 55±5 vs 60±5%, p<0.001), along with LV GLS (-19.6±2 vs -21.6±2%, p<0.001) and GCS (-28±3 vs -30±3%, p<0.001). Interestingly, while the relative contribution of radial shortening to the global RV EF was also reduced (REFi: 0.40±0.10 vs 0.49±0.06, p<0.001), the contribution of the longitudinal contraction was significantly higher in athletes (LEFi: 0.45±0.08 vs 0.40±0.07, p<0.01).

Similarly to the adult athlete’s heart, the cardiac adaptation of adolescent athletes comprises higher biventricular volumes and lower resting LV functional measures with supernormal RV longitudinal shortening. Our study suggests that characteristic exercise-induced structural and functional cardiac changes are already present in childhood.

The research was supported by the ÚNKP-22-3-II-SE-42 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.