Structural and functional remodeling for elite cyclists during exercise; pressure-volume loops and hemodynamic forces...

Area of Science:

• Cardiovascular Physiology
• Exercise Physiology
• Sports Cardiology

Background:

• Elite athletes demonstrate distinct physiological adaptations to training.
• Understanding cardiac mechanics during exercise is crucial for assessing performance and health.
• Hemodynamic forces (HDFs) and myocardial performance are key indicators of cardiac function.

Purpose of the Study:

• To investigate intraventricular hemodynamic forces (HDFs) and myocardial performance during incremental exercise in elite cyclists (ECs).
• To compare cardiac function between ECs and age-matched sedentary controls (SCs).
• To identify exercise-induced functional changes in the left ventricle (LV) of ECs.

Main Methods:

• Transthoracic stress echocardiography was performed on 19 ECs and 13 SCs.
• Left ventricular (LV) HDFs were computed using endocardial boundary tracking.
• Noninvasive pressure-volume (PV) loops were analyzed using the single-beat approach.

Main Results:

• ECs showed increased stroke work and systolic HDF generation during exercise compared to SCs.
• ECs exhibited facilitated left ventricular relaxation in early diastole, indicated by lower HDF deceleration.
• No significant differences in contractility (ventricular elastance) were observed between groups during exercise.

Conclusions:

• Elite cyclists display unique patterns of LV HDF generation and relaxation during exercise.
• These adaptations involve increased systolic force production and enhanced diastolic function.
• This study provides novel insights into exercise-induced cardiac remodeling in elite athletes.