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Left ventricular function immediately following prolonged exercise: A meta-analysis.

Natalie Middleton1, Rob Shave, Keith George

  • 1Centre for Sports Medicine and Human Performance, Brunel University, Middlesex, United Kingdom.

Medicine and Science in Sports and Exercise
|May 9, 2006
PubMed
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Prolonged endurance exercise impairs cardiac function, reducing ejection fraction and altering diastolic filling. This meta-analysis reveals cardiac fatigue after intense exercise, suggesting impaired relaxation and systolic function.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Sports Medicine

Background:

  • Cardiac fatigue following prolonged endurance exercise is not well understood.
  • Previous studies have yielded equivocal results regarding its impact on left ventricular function.
  • A comprehensive analysis is needed to quantify these effects.

Purpose of the Study:

  • To conduct a meta-analysis examining the short-term effects of prolonged endurance exercise on left ventricular function.
  • To quantify changes in ejection fraction (EF), systolic blood pressure/end systolic volume (SBP/ESV) ratio, and early-to-late diastolic filling (E/A).

Main Methods:

  • A random effects meta-analysis of 23 studies was performed.
  • Data analyzed included EF, SBP/ESV, and E/A, along with heart rate (HR), systolic blood pressure (SBP), and left ventricular internal diameter during diastole (LVIDd).

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  • Studies were categorized by exercise duration (moderate, long, ultra) and training status.
  • Main Results:

    • A significant overall decrease was observed in EF, SBP/ESV, and E/A (P < 0.05).
    • Reductions in EF were noted in ultra-duration and moderate-duration untrained subgroups.
    • All subgroups showed significant decreases in E/A, indicating impaired diastolic function.

    Conclusions:

    • Prolonged endurance exercise leads to reduced systolic function (decreased EF and SBP/ESV), partly due to altered cardiac loading.
    • A decrease in E/A suggests intrinsic impairment of left ventricular relaxation, independent of loading.
    • Future research should utilize load-independent indices and explore the underlying mechanisms of cardiac fatigue.