Range of right heart measurements in top-level athletes: the training impact.

To explore the full range of right heart dimensions and the impact of long-term intensive training in athletes. Although echocardiography has been widely used to distinguish the athlete's heart from pathologic left ventricular (LV) hypertrophy, only few reports have described right ventricular (RV) and right atrial (RA) adaptations to extensive physical exercise. 650 top-level athletes [395 endurance- (ATE) and 255 strength-trained (ATS); 410 males (63.1%); mean age 28.4 ± 10.1; 18-40 years] and 230 healthy age- and sex-comparable controls underwent a transthoracic echocardiographic exam. Along with left heart parameters, right heart measurements included: RV end-diastolic diameters at the basal and mid-cavity level; RV base-to-apex length; RV proximal and distal outflow tract diameters; RA long and short diameters; and RA area. Tricuspid annular plane systolic excursion and RV tissue Doppler systolic peak velocity were assessed as indexes of RV systolic function. Pulmonary artery systolic pressure (PASP) was estimated from the peak tricuspid regurgitant velocity. ATS showed increased sum of wall thickness and relative wall thickness, whereas left atrial volume, LV end-diastolic volume, LV stroke volume and PASP were significantly higher in ATE. RV and RA measurements were all significantly greater in ATE than in ATS and controls. ATE also showed improved early diastolic RV function, whereas RV systolic indexes were comparable among groups. On multivariate analysis, type and duration of training (p<0.01), PASP (p<0.01) and LV stroke volume (p<0.001) were the only independent predictors of the main RV and RA dimensions in athletes. This study delineates the upper limits of RV and RA dimensions in highly-trained athletes. Right heart measurements were all significantly greater in elite endurance-trained athletes than in age- and sex-matched strength athletes and controls. This should be considered as a "physiologic phenomenon" when evaluating athletes for sports eligibility.

D'Andrea A ，Riegler L ，Golia E ，Cocchia R ，Scarafile R ，Salerno G ，Pezzullo E ，Nunziata L ，Citro R ，Cuomo S ，Caso P ，Di Salvo G ，Cittadini A ，Russo MG ，Calabrò R ，Bossone E ... -  《-》

Right ventricular morphology and function in top-level athletes: a three-dimensional echocardiographic study.

Our objective was to explore the right ventricular (RV) dimensions and function and the effect of long-term intensive training in a large population of top level athletes using real-time three-dimensional (3D) echocardiography. A total of 430 top-level athletes (220 endurance-trained athletes [ETAs] and 210 strength-trained athletes; 265 men [61.6%]; mean age 27.4 ± 10.1 years, range 18-40) and 250 healthy controls underwent a transthoracic echocardiographic examination. Three-dimensional RV measurements included serial short-axis reconstructions of the RV volumetric data sets, and the RV endocardial contour was traced with cross-reference to the long-axis images for identification of the tricuspid annulus. The end-diastolic and end-systolic RV volumes and ejection fraction were calculated off-line using the method of the summation of discs. The strength-trained athletes had a greater heart rate, body surface area, and systolic blood pressure at rest than the ETAs and controls. All RV diameters and 3D volumes and all transmitral and transtricuspid Doppler indexes were greater in the ETAs. Also, the left ventricular stroke volume, cardiac index, and pulmonary artery systolic pressure were greater in the ETAs, and all two-dimensional and 3D RV systolic indexes were comparable. On univariate analysis, the 3D RV end-diastolic volume was significantly associated with advanced age, male gender, duration of training, endurance training, increased left ventricular stroke volume, and pulmonary artery systolic pressure. On multivariate analysis, in the overall study population, the type and duration of training (P < .01), pulmonary artery systolic pressure (P < .01), and left ventricular stroke volume (P < .001) were the only independent predictors of RV end-diastolic volume. The results of the present study have delineated the upper limits of the RV dimensions in highly trained athletes as measured by real-time 3D echocardiography. The RV end-diastolic volume was significantly greater in the ETA than in the strength-trained athletes and controls.

D'Andrea A ，Riegler L ，Morra S ，Scarafile R ，Salerno G ，Cocchia R ，Golia E ，Martone F ，Di Salvo G ，Limongelli G ，Pacileo G ，Bossone E ，Calabrò R ，Russo MG ... -  《-》

Myocardial adaptation and efficiency in response to intensive physical training in elite speedskaters.

Poh KK ，Ton-Nu TT ，Neilan TG ，Tournoux FB ，Picard MH ，Wood MJ ... -  《-》

Right ventricular myocardial adaptation to different training protocols in top-level athletes.

D'Andrea A ，Caso P ，Sarubbi B ，Limongelli G ，Liccardo B ，Cice G ，D'Andrea L ，Scherillo M ，Cotrufo M ，Calabrò R ... -  《-》

Biventricular myocardial adaptation to different training protocols in competitive master athletes.

D'Andrea A ，Caso P ，Scarafile R ，Salerno G ，De Corato G ，Mita C ，Di Salvo G ，Allocca F ，Colonna D ，Caprile M ，Ascione L ，Cuomo S ，Calabrò R ... -  《-》