Abstract
Aortic elastic properties are important determinants of left ventricular function.
The aim of this study was to determine left ventricular diastolic function and aortic
distensibility in endurance athletes. Thirty male runners and thirty age-matched healthy
male controls took part in the study. All subjects underwent echocardiographic examination
and cardiopulmonary exercise testing. Measurements included LV cavity dimension, standard
and tissue Doppler parameters, and aortic diameter, 3 cm above aortic valve, at systole
and diastole. Maximal oxygen uptake in athletes was higher than in controls. The aortic
distensibility index was found to be higher in athletes compared with controls (5.37
± 1.50 vs. 3.37 ± 1.48 cm2 · dynes-1 · 10-6, p < 0.001). While the aortic stiffness index in athletes was significantly lower
than in controls (2.77 ± 0.28 vs. 3.43 ± 0.41, p < 0.001). Furthermore, transmitral
early peak velocity (E) and late peak velocity (A), peak velocity of myocardial systolic
wave (Sm), early (Em) and atrial (Am) diastolic waves in athletes were higher than in controls. It seemed that the association
of Em velocity with aortic distensibility was stronger than that of other LV parameters
(coefficient = 0.74, p < 0.001) by using multiple linear regression. Increased aortic
distensibility in endurance-trained athletes may cause better diastolic function as
a physiological cardiovascular adaptation factor.
Key words
Aortic distensibility - athlete - diastolic function - echocardiography
References
- 1 American College of Sports Medicine (Ed) .ACSM's Guidelines for Exercise Testing
and Prescription. Philadelphia; Lippincott Williams & Wilkins 2000: 45
- 2
Bazett H C.
An analysis of the time relations of the electrocardiogram.
Heart.
1920;
7
353-367
- 3
Benjamin E J, Levy D, Anderson K M, Wolf P A, Plehn J F, Evans J C, Comai K, Fuller D L,
Sutton M S.
Determinants of Doppler indices of diastolic function in normal subjects (The Framingham
Heart Study).
Am J Cardiol.
1992;
70
508-515
- 4
Bland J M, Altman D G.
Statical methods for assessing agreement between two methods of clinical measurement.
Lancet.
1986;
1
307-310
- 5
Bonapace S, Rossi A, Cicoira M, Franceschini L, Golia G, Zanolla L, Marino P, Zardini P.
Aortic distensibility independently affects exercise tolerance in patients with dilated
cardiomyopathy.
Circulation.
2003;
107
1603-1608
- 6
Cameron J D, Dart A M.
Exercise training increases total systemic arterial compliance in humans.
Am J Physiol.
1994;
266
693-701
- 7
Cardim N, Oliveira A G, Longo S, Ferreira T, Pereira A, Reis R P, Correia J M.
Doppler tissue imaging: regional myocardial function in hypertrophic cardiomyopathy
and in athlete's heart.
J Am Soc Echocardiogr.
2003;
16
223-232
- 8
Chen C H, Nakayama M, Nevo E, Fetics B J, Maughan W L, Kass D A.
Coupled systolic ventricular and vascular stiffening with age: implications for pressure
regulation and cardiac reserve in elderly.
J Am Coll Cardiol.
1998;
32
1221-1227
- 9
Colan S D, Sanders S P, MacPherson D, Borow K M.
Left ventricular diastolic function in elite athletes with physiologic cardiac hypertrophy.
J Am Coll Cardiol.
1985;
6
545-549
- 10
D'Andrea A, Caso P, Galderisi M, Di Maggio D, Cicala S, D'Andrea L, Mininni N, Calabrò R.
Assessment of myocardial response to physical exercise in endurance competitive athletes
by pulsed Doppler tissue imaging.
Am J Cardiol.
2001;
87
1226-1230
- 11
Dart A, Silagy C, Dewar E, Jennimgs G, McNeil J.
Aortic distensibility and left ventricular structure and function in isolated systolic
hypertension.
Eur Heart J.
1993;
14
1465-1470
- 12
Devereux R B, Reichek N.
Echocardiographic determination of left ventricular mass: anatomic validation of the
method.
Circulation.
1977;
55
613-618
- 13
Dickhuth H H, Rocker K, Hipp A, Heitkamp H C, Keul J.
Echocardiographic findings in endurance athletes with hypertrophic non-obstructive
cardiomyopathy (HNCM) compared to non-athletes with HNCM and to physiological hypertrophy
(athlete's heart).
Int J Sports Med.
1994;
15
273-277
- 14
Erol M K, Yilmaz M, Oztasyonar Y, Sevimli S, Senocak H.
Aortic distensibility is increasing in elite athletes.
Am J Cardiol.
2002;
89
1002-1004
- 15
Hirai T, Sasayama S, Kawasaki T, Yagi S.
Stiffness of systemic arteries in patients with myocardial infarction.
Circulation.
1989;
80
78-86
- 16
Hundley W G, Kitzman D W, Morgan T M, Hamilton C A, Darty S N, Stewart K P, Herrington D M,
Link K M, Little W C.
Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older
patients with isolated diastolic heart failure and correlate with exercise intolerance.
J Am Coll Cardiol.
2001;
38
796-801
- 17
Isaaz K, Thompson A, Ethevenot G, Cloez J L, Brembilla B, Pernot C.
Doppler echocardiographic measurement of low velocity motion of the left ventricular
posterior wall.
Am J Cardiol.
1989;
64
66-75
- 18
Kasikcioglu E, Oflaz H, Akhan H, Kayserilioglu A, Umman B, Bugra Z.
Aortic distensibility in endurance athletes.
Acta Cardiologica.
2003;
58
243-244
- 19
Keul J, Dickhuth H H, Lehmann M, Staiger J.
The athlete's heart - haemodynamics and structure.
Int J Sports Med.
1982;
3
33-43
- 20
Kingwell B A, Cameron J D, Gillies K J, Jennings G L, Dart A M.
Arterial compliance may influence baroreflex function in athletes and hypertensives.
Am J Physiol.
1995;
268
411-418
- 21
Lakatta E G, Daniel Levy.
Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises.
Circulation.
2003;
107
346-354
- 22
Levy W C, Cerqueira M D, Abrass I B, Schwartz R S, Stratton J R.
Endurance exercise training augments diastolic filling at rest and during exercise
in healthy young and older men.
Circulation.
1993;
88
116-126
- 23
Luchsinger P C, Sachs M, Patel D J.
Pressure-radius relationship in large blood vessels of man.
Circ Res.
1962;
11
885-888
- 24
Mohiaddin R H, Underwood S R, Bogren H G. et al .
Regional aortic compliance studied by magnetic resonance imaging: The effects of age,
training and coronary artery disease.
Br Heart J.
1989;
62
90
- 25
Nixon J V, Wright A R, Porter T R, Roy V, Arrowood J A.
Effects of exercise on left ventricular diastolic performance in trained athletes.
Am J Cardiol.
1991;
68
945-949
- 26
O'Rourke M F.
Arterial stiffness, systolic blood pressure and logical treatment of arterial hypertension.
Hypertension.
1990;
15
339-347
- 27
Sahn D J, DeMaria A, Kisslo J, Weyman A.
The committee on M-mode standardization of the American Society of Echocardiography:
recommendations regarding quantitation in M-mode echocardiography: results of a survey
of echocardiographic measurements.
Circulation.
1978;
58
1072-1083
- 28
Schulman S P, Fleg J L, Goldberg A P, Busby-Whitehead J, Hagberg J M, O'Connor F C,
Gerstenblith G, Becker L C, Katzel L I, Lakatta L E, Lakatta E G.
Continuum of cardiovascular performance across a broad range of fitness levels in
healthy older men.
Circulation.
1996;
94
359-367
- 29
Seals D R, Hagberg J M, Sapina R J, Rogers M A, Schechtman K B, Ehsani A A.
Enhanced left ventricular performance in endurance trained older athletes.
Circulation.
1994;
89
198-205
- 30
Stefanadis C, Dernellis J, Vlachopoulos C, Tsioufis C, Tsiamis E, Toutouzas K, Pitsavos C,
Toutouzas P.
Aortic function in arterial hypertension determined by pressure-diameter relation.
Circulation.
1997;
96
1853-1858
- 31
Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P.
Distensibility of the ascending aorta: comparison of invasive and noninvasive techniques
in healthy men and in men with coronary artery disease.
Eur Heart J.
1990;
11
990-996
- 32
Stefanadis C, Stratos C, Vlachopoulos C, Marakas S, Boudoulas H, Kallikazaros I, Tsiamis E,
Toutouzas K, Sioros L, Toutouzas P.
Pressure-diameter relation of the human aorta: a new method of determination by the
application of a special ultrasonic dimension catheter.
Circulation.
1995;
92
2210-2219
- 33
Urschel C W, Covell J W, Sonnenblick E H, Ross Jr J, Braunwald E.
Effects of decreased aortic compliance on performance of the left ventricle.
Am J Physiol.
1968;
214
298-304
- 34
Wasserman K, Whipp B J, Koyal S N, Beaver W L.
Anaerobic threshold and respiratory gas exchange during exercise.
J Appl Physiol.
1973;
35
236-243
E. Kasikcioglu
Istanbul University, Istanbul Faculty of Medicine, Department of Sports Medicine
PK 9
Avcilar 34840, Istanbul
Turkey
Telefon: + 902125093540
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eMail: erhul@hotmail.com