Right ventricular morphology and function in top-level athletes: a three-dimensional echocardiographic study.

Area of Science:

• Cardiology
• Sports Medicine
• Medical Imaging

Background:

• Understanding the impact of intensive training on cardiac structure is crucial for athlete health.
• The right ventricle (RV) in athletes is less studied than the left ventricle.
• Real-time 3D echocardiography offers advanced insights into RV dimensions and function.

Purpose of the Study:

• To investigate right ventricular (RV) dimensions and function in elite athletes.
• To assess the effects of long-term intensive training on the RV.
• To establish upper limits of RV dimensions in athletes using 3D echocardiography.

Main Methods:

• Transthoracic echocardiography was performed on 430 elite athletes (endurance-trained [ETAs] and strength-trained) and 250 controls.
• Real-time 3D echocardiography was used to measure RV dimensions and volumes.
• RV end-diastolic and end-systolic volumes and ejection fraction were calculated using the summation of discs method.

Main Results:

• Endurance-trained athletes (ETAs) exhibited larger RV diameters, 3D volumes, and transmitral/transtricuspid Doppler indexes compared to strength-trained athletes and controls.
• ETAs also showed greater left ventricular stroke volume, cardiac index, and pulmonary artery systolic pressure.
• RV end-diastolic volume was independently predicted by training type, training duration, pulmonary artery systolic pressure, and left ventricular stroke volume.

Conclusions:

• Real-time 3D echocardiography successfully delineated upper limits of RV dimensions in highly trained athletes.
• The RV end-diastolic volume was significantly larger in ETAs compared to strength-trained athletes and controls.
• Training type and duration are key determinants of RV remodeling in elite athletes.