Improved Right Ventricular Performance with Increased Tricuspid Annular Excursion in Athlete's Heart

Area of Science:

• Cardiovascular Imaging
• Cardiac Physiology
• Sports Cardiology

Background:

• Left ventricular (LV) overload is observed in marathon runners (MTH) and mitral regurgitation (MR) patients.
• Previous studies reported LV geometric changes in these groups.
• This study investigates right ventricular (RV) adaptation, septal remodeling, and tricuspid annulus (TA) motion in MTH and MR.

Purpose of the Study:

• To evaluate RV adaptation to chronic volume overload in MTH and MR.
• To assess interventricular septal remodeling in these groups.
• To analyze tricuspid annulus (TA) motion and its relation to RV performance.

Main Methods:

• 60 subjects (19 MTH, 17 MR, 24 controls) underwent cardiac MRI.
• Myocardial strain and curvature computed on interventricular septum and RV free wall.
• RV volume-time curves and TA displacement over time were generated.

Main Results:

• Septal curvature was significantly lower in MTH and MR compared to controls.
• No significant differences in RV free-wall strain or RV ejection fraction were found.
• Longitudinal TA excursion was higher in MTH; peak late diastolic TA velocity was faster in MR.

Conclusions:

• Increased TA kinetics enhances RV performance in MTH.
• Septal remodeling occurs in both MR and MTH.
• A direct relationship between septal remodeling and TA kinetics in athlete's heart requires further investigation.