Right Ventricular Structure and Function in Adolescent Athletes: A 3D Echocardiographic Study.

Area of Science:

• Cardiology
• Sports Medicine
• Physiology

Background:

• Athletic training induces cardiac adaptations, often termed "athlete's heart."
• Understanding these changes in adolescents is crucial for differentiating normal adaptation from pathology.
• Right ventricular (RV) function and its adaptation to exercise in young athletes remain less characterized.

Purpose of the Study:

• To characterize the RV contraction pattern in adolescent athletes using three-dimensional echocardiography (3DE).
• To investigate the association between RV contraction patterns and exercise capacity (VO2/kg) in this cohort.
• To compare cardiac function between adolescent athletes and healthy sedentary controls.

Main Methods:

• Enrolled 215 adolescent athletes and 38 age- and sex-matched sedentary controls.
• Utilized resting 3DE to measure biventricular ejection fractions (EF) and the relative contributions of longitudinal and radial EF to RV EF.
• Performed cardiopulmonary exercise testing to assess maximal oxygen consumption (VO2/kg).

Main Results:

• Adolescent athletes exhibited significantly lower resting left ventricular (LV) and RV ejection fractions compared to controls.
• The relative contribution of radial shortening to RV EF was reduced in athletes, while longitudinal shortening contribution was significantly higher.
• Supernormal longitudinal RV shortening demonstrated a weak correlation with higher VO2/kg.

Conclusions:

• Cardiac adaptation in adolescent athletes includes increased biventricular volumes and reduced resting EF, with a notable supernormal RV longitudinal shortening.
• These findings suggest that exercise-induced cardiac remodeling is present even in adolescence.
• The altered RV contraction pattern may contribute to enhanced exercise capacity in young athletes.