title: Changes in Right Ventricular Function with Exercise in Healthy Subjects: Optimal Parameters and Effects of Gender and Age.
abstract: BACKGROUND
  Right ventricular (RV) function augments with exercise, and loss of this adaptive ability often determines symptoms. Reports on exercise-related changes in RV function in healthy subjects are sparse. In this study, healthy volunteers were prospectively recruited, and changes in RV function with exercise were examined, optimal parameters determined, and the effects of gender and age examined.
  
  
  METHODS
  Treadmill exercise stress echocardiography with concurrent expired gas analysis was performed in 121 healthy volunteers. Parameters of RV systolic function (RV fractional area change, Doppler tissue s' velocity, and systolic strain and strain rate) and diastolic function (peak E and A velocity, Doppler tissue e', a' and early and late diastolic strain rate) were evaluated at baseline and after exercise, with the difference (Δ) being systolic and diastolic reserve. Changes in pulmonary arterial pressure (PAP) was measured when accurate estimation was possible.
  
  
  RESULTS
  Most systolic functional parameters were augmented with exercise. However, systolic augmentation decreased with age (Δs': r = -0.31, P < .01; Δ strain: r = -0.28, P = .008; Δ systolic strain rate: r = -0.31, P < .01). Similar changes were observed with diastolic function (Δe': r = -0.33, P < .01; Δ early diastolic strain rate r = -0.20, P = .04). In the subgroup with PAP measurements, ΔPAP (r = 0.32, P < .01) increased with age. Men had greater augmentation of systolic reserve, but differences were negated when corrected for workload. S' velocity was the most robust measure of RV systolic function.
  
  
  CONCLUSIONS
  There is a modest yet significant reduction in RV systolic and diastolic reserve with age, with an increase in PAP. S' velocity is a robust and feasible measure that should be considered given the increasing use of stress testing to evaluate RV function.
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Ee-May
authors.initials: EM
authors.lastname: Chia
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia; Westmead Hospital, Sydney, Australia.
authors.forename: Calvin H C
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Phuong
authors.initials: P
authors.lastname: Pham
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Vidaic
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Xuan
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia.
authors.forename: Dominic
authors.initials: D
authors.lastname: Leung
authors.affiliation: Liverpool Hospital, University of New South Wales, Sydney, Australia. Electronic address: l.thomas@unsw.edu.au.
authors.forename: Liza
authors.initials: L
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler / Q000379:methods*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
keywords: Exercise; Pulmonary arterial pressure; RV diastolic function; RV systolic function