title: Alteration in left ventricular strains and torsional mechanics after ultralong duration exercise in athletes.
abstract: BACKGROUND
  Numerous studies have reported evidence of cardiac injury associated with transient left ventricular (LV) systolic and diastolic dysfunction after prolonged and strenuous exercise. We used 2D ultrasound speckle tracking imaging to evaluate the effect of an ultralong-duration exercise on LV regional strains and torsion. We speculated that systolic dysfunction after exercise is associated with depressed LV strains and torsion, and diastolic dysfunction results from decreased and delayed untwisting, a key factor of LV suction and early filling.
  
  
  RESULTS
  Twenty-three triathletes underwent conventional and speckle tracking imaging echocardiography at rest before and immediately after an ultralong distance triathlon. Measurements included LV longitudinal, circumferential and radial strains, LV rotations, and LV torsion. After the race, LV systolic dysfunction was characterized by a decrease in LV longitudinal, radial, and circumferential strains, especially for apical radial strains (44.6+/-15.1% versus 31.1+/-13.8%, P<0.001). Peak torsion was slightly decreased (8.3+/-5.1 degrees versus 6.4+/-3.9 degrees , respectively, P=0.09) and significantly delayed (91+/-18% versus 128+/-31% of systolic duration, P<0.001) beside end-ejection. Peak untwisting was also depressed and delayed beside isovolumic relaxation.
  
  
  CONCLUSIONS
  This study documented major alterations in cardiac strains and torsion after an ultralong distance triathlon. LV systolic strains were depressed but not delayed, whereas twisting was decreased and delayed. This altered pattern hampered the rapid untwisting during isovolumic relaxation phase, reducing LV diastolic suction and early filling.
authors.affiliation: Physiology and Physiopathology of Cardiovascular Adaptations to Exercise Laboratory, Faculty of Sciences, Avignon, France. stephane.nottin@univ-avignon.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Nottin
authors.forename: Grégory
authors.initials: G
authors.lastname: Doucende
authors.forename: Iris
authors.initials: I
authors.lastname: Schuster
authors.forename: Stéphane
authors.initials: S
authors.lastname: Tanguy
authors.forename: Michel
authors.initials: M
authors.lastname: Dauzat
authors.forename: Philippe
authors.initials: P
authors.lastname: Obert
mesh_terms: D000328:Adult; D001642:Bicycling; D001696:Biomechanical Phenomena; D015150:Echocardiography, Doppler; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010807:Physical Endurance; D012420:Running; D013550:Swimming; D013997:Time Factors; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D054159:Torsion, Mechanical; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*