Right ventricular fatigue developing during endurance exercise: an exercise cardiac magnetic resonance study

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Prolonged intense exercise is linked to impaired right ventricular (RV) function post-activity, unlike the left ventricle (LV).
• The cardiac effects during prolonged exercise have not been thoroughly measured.
• Understanding exercise-induced cardiac changes is crucial for athlete health.

Purpose of the Study:

• To investigate the impact of a 150-km cycling event on RV and LV function during exercise.
• To compare cardiac magnetic resonance imaging (CMR) measurements before and after intense endurance exercise.
• To assess ventricular-arterial coupling in response to prolonged exercise.

Main Methods:

• Real-time cardiac magnetic resonance imaging (CMR) was used in 14 male endurance athletes.
• Measurements were taken at rest and during incremental exercise, pre- and post-150-km cycling.
• Key parameters included ventricular volumes, ejection fraction (EF), and ventricular-arterial coupling (SV/ESV).

Main Results:

• End-of-race RV end-diastolic volume increased significantly during near-maximal exercise.
• RV end-systolic volume and RV ejection fraction (EF) were significantly impaired during near-maximal exercise post-race.
• LV function and volumes remained unchanged, showing a significant difference between RV and LV responses (P < 0.0001).

Conclusions:

• Intense endurance exercise leads to RV dilatation and reduced RV EF, more pronounced during exercise.
• LV volume and function are not affected by intense endurance exercise.
• Altered RV ventricular-arterial coupling suggests exercise-induced RV contractile impairment.