title: Right ventricle best predicts the race performance in amateur ironman athletes.
abstract: OBJECTIVE
  The ironman (IM) triathlon is a popular ultraendurance competition, consisting of 3.8 km of swimming, 180.2 km of cycling, and 42.2 km of running. The aim of this study was to investigate the predictors of IM race time, comparing echocardiographic findings, anthropometric measures, and training characteristics.
  
  
  METHODS
  Amateur IM athletes (ATHL) participating in the Zurich IM race in 2010 were included. Participants were examined the day before the race by a comprehensive echocardiographic examination. Moreover, anthropometric measurements were obtained the same day. During the 3 months before the race, each IM-ATHL maintained a detailed training diary. Recorded data were related to total IM race time.
  
  
  RESULTS
  Thirty-eight IM finishers (mean ± SD age = 38 ± 9 yr, 32 men [84%]) were evaluated. Total race time was 684 ± 89 min (mean ± SD). For right ventricular fractional area change (45% ± 7%, Spearman ρ = -0.33, P = 0.05), a weak correlation with race time was observed. Race performance exhibited stronger associations with percent body fat (15.2 ± 5.6%, ρ = 0.56, P = 0.001), speed in running training (11.7 ± 1.2 km · h(-1), ρ = -0.52, P = 0.002), and left ventricular myocardial mass index (98 ± 24 g · m(-2), ρ = -0.42, P = 0.009). The strongest association was found between race time and right ventricular end-diastolic area (22 ± 4 cm2, ρ = -0.64, P < 0.0001). In multivariate analysis, right ventricular end-diastolic area (β = -16.7, 95% confidence interval = -27.3 to -6.1, P = 0.003) and percent body fat (β = 6.8, 95% confidence interval = 1.1-12.6, P = 0.02) were independently predictive of IM race time.
  
  
  CONCLUSIONS
  In amateur IM-ATHL, RV end-diastolic area and percent body fat were independently related to race performance. RV end-diastolic area was the strongest predictor of race time. The role of the RV in endurance exercise may thus be more important than previously thought and needs to be further studied.
authors.affiliation: Department of Cardiology, Stadtspital Triemli, Zurich, Switzerland. Alain.Bernheim@triemli.stzh.ch
authors.forename: Alain Marcel
authors.initials: AM
authors.lastname: Bernheim
authors.forename: Christine Helena
authors.initials: CH
authors.lastname: Attenhofer Jost
authors.forename: Michel
authors.initials: M
authors.lastname: Zuber
authors.forename: Monica
authors.initials: M
authors.lastname: Pfyffer
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Pasquale
authors.forename: Andre
authors.initials: A
authors.lastname: Linka
authors.forename: Anja
authors.initials: A
authors.lastname: Faeh-Gunz
authors.forename: Argelia
authors.initials: A
authors.lastname: Medeiros-Domingo
authors.forename: Beat
authors.initials: B
authors.lastname: Knechtle
mesh_terms: D000328:Adult; D000886:Anthropometry; D056352:Athletes; D054874:Athletic Performance / Q000502:physiology*; D001823:Body Composition; D015444:Exercise / Q000502:physiology*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D013557:Switzerland; D014463:Ultrasonography