title: Characterizing the spectrum of right ventricular remodelling in response to chronic training.
abstract: The significance and spectrum of reduced right ventricular (RV) deformation, reported in endurance athletes, is unclear. To comprehensively analyze the cardiac performance at rest of athletes, especially focusing on integrating RV size and deformation to unravel the underlying triggers of this ventricular remodelling. Hundred professional male athletes and 50 sedentary healthy males of similar age were prospectively studied. Conventional echocardiographic parameters of all four chambers were obtained, as well as 2D echo-derived strain (2DSE) in the left (LV) and in the RV free wall with separate additional analysis of the RV basal and apical segments. Left and right-sided dimensions were larger in athletes than in controls, but with a disproportionate RA enlargement. RV global strain was lower in sportsmen (-26.8 ± 2.8% vs -28.5 ± 3.4%, p < 0.001) due to a decrease in the basal segment (-22.8 ± 3.5% vs -25.8 ± 4.0%, p < 0.001) resulting in a marked gradient of deformation from the RV inlet towards the apex. By integrating size, deformation and stroke volume, we observed that the LV working conditions were similar in all sportsmen while a wider variability existed in the RV. Cardiac remodelling in athletes is more pronounced in the right heart cavities with specific regional differences within the right ventricle, but with a wide variability among individuals. The large inter-individual differences, as well as its acute and chronic relevance warrant further investigation.
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Sitges
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino
authors.affiliation: Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Constatine
authors.initials: C
authors.lastname: Butakoff
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain. meriluprime@hotmail.com.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain. meriluprime@hotmail.com.
authors.forename: Maria Sanz
authors.initials: MS
authors.lastname: de la Garza
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Paré
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Montserrat
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Barbara
authors.initials: B
authors.lastname: Vidal
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Azqueta
authors.affiliation: Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Georgia
authors.initials: G
authors.lastname: Sarquella
authors.affiliation: Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Josep Antoni
authors.initials: JA
authors.lastname: Gutierrez
authors.affiliation: Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Canal
authors.affiliation: Cardiology Department, Hospital Clínic, IDIBAPS: Institut de Investigacions Biomèdiques August Pi iSunyer, University of Barcelona, Villarroel 136, 08036, Barcelona, Spain.|Serveis Médics Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.affiliation: Universitat Pompeu Fabra, Barcelona, Spain.|ICREA, Barcelona, Spain.
authors.forename: Bart H
authors.initials: BH
authors.lastname: Bijnens
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D056352:Athletes; D001696:Biomechanical Phenomena; D059267:Cardiomegaly, Exercise-Induced; D015150:Echocardiography, Doppler; D015444:Exercise; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D010807:Physical Endurance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D057185:Sedentary Behavior; D013997:Time Factors; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling; D055815:Young Adult
keywords: Athlete’s heart; Overload; Right ventricle remodelling