title: The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.
abstract: Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m(2)) completed an incremental cardiopulmonary exercise test (25 W · 3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V̇o 2peak) of 40.6 ± 8.9 ml · kg(-1) · min(-1) and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V̇o 2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology.
authors.affiliation: Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals, Bristol NHS Foundation Trust, and National Institute for Health Research Cardiovascular Biomedical, Research Unit, Bristol Heart Institute, Bristol, United Kingdom guido.pieles@bristol.ac.uk.
authors.forename: Guido E
authors.initials: GE
authors.lastname: Pieles
authors.affiliation: Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom;
authors.forename: Lucy
authors.initials: L
authors.lastname: Gowing
authors.affiliation: Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals, Bristol NHS Foundation Trust, and.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Forsey
authors.affiliation: Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom;
authors.forename: Paramanantham
authors.initials: P
authors.lastname: Ramanujam
authors.affiliation: Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom;
authors.forename: Felicity
authors.initials: F
authors.lastname: Miller
authors.affiliation: Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals, Bristol NHS Foundation Trust, and.
authors.forename: A Graham
authors.initials: AG
authors.lastname: Stuart
authors.affiliation: Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom;
authors.forename: Craig A
authors.initials: CA
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D015308:Anaerobic Threshold / Q000502:physiology; D000886:Anthropometry; D004452:Echocardiography; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D010101:Oxygen Consumption / Q000502:physiology; D012146:Rest / Q000502:physiology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
keywords: exercise echocardiography; exercise testing; myocardial exercise performance; myocardial reserve; ventricular function