title: Alterations in Cardiac Mechanics Following Ultra-Endurance Exercise: Insights from Left and Right Ventricular Area-Deformation Loops.
abstract: The aim of this study was to use novel area-deformation (ε) loops to interrogate the interaction between the right ventricular (RV) and left ventricular (LV) mechanics following a 100-mile endurance run.
  
  
  
  Fifteen participants (mean body mass, 70.1 ± 8.8 kg; mean age, 40 ± 8 years) were recruited for the study. Echocardiography was performed before the race, after the race, and 6 hours into recovery. RV and LV area and longitudinal ε were assessed using standard and speckle-tracking echocardiography. Following cubic spline interpolation, these variables were obtained across the same cardiac cycle and used to derive area-ε loops.
  
  
  
  The RV area-ε loop demonstrated a rightward shift after the race, with increased RV area (from 26.0 to 27.1 cm(2)) and reduced peak RV ε (from -28.6% to -25.8%). The recovery RV area-ε loop was similar to the postrace loop. A leftward shift was observed in the LV area-ε loop after the race, secondary to reduced LV area (from 35.8 to 32.5 cm(2)) and reduced peak ε (from -18.3% to -16.6%). In recovery, LV ε values returned toward baseline.
  
  
  
  A 100-mile ultramarathon resulted in a rightward shift in the RV area-ε loop as a result of RV dilatation. There was a concomitant leftward shift in the LV area-ε loop as a result of underfilling of the left ventricle. At 6 hours after exercise, there was a partial recovery of the left ventricle, while RV function remained depressed. It appears that changes in RV function do not have a serial impact on the left ventricle during recovery from ultra-endurance activity.
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Lord
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Keith
authors.initials: K
authors.lastname: George
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Countess of Chester Hospital, NHS Trust, Chester, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Somauroo
authors.affiliation: Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Stembridge
authors.affiliation: Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Jain
authors.affiliation: Department of Physical Medicine & Rehabilitation, Department of Veterans Affairs Northern California Health Care System, Sacramento, California; University of California Davis Medical Center, Sacramento, California.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Hoffman
authors.affiliation: Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom.
authors.forename: Rob
authors.initials: R
authors.lastname: Shave
authors.affiliation: Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Francois
authors.initials: F
authors.lastname: Haddad
authors.affiliation: Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Euan
authors.initials: E
authors.lastname: Ashley
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Jones
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom. Electronic address: d.l.oxborough@ljmu.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Oxborough
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods; D055119:Elastic Modulus / Q000502:physiology; D005260:Female; D006244:Hardness / Q000502:physiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D064797:Physical Conditioning, Human / Q000379:methods*; D010807:Physical Endurance / Q000502:physiology*; D012420:Running / Q000502:physiology*; D013314:Stress, Mechanical; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Area-deformation loops; Cardiac mechanics; Echocardiography; Endurance exercise; Strain imaging