Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Effects of maximum exercise on left ventricular deformation and its correlation with cardiopulmonary exercise capacity
J. Kandels1, S. Stöbe1, A. Kogel1, P. Hepp2, P. Marshall3, U. M. Rudolph1, U. Laufs1, A. Hagendorff1, S. Fikenzer1
1Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig; 2Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig; 3RasenBallSport Leipzig GmbH, Leipzig;

Background

Global longitudinal strain (GLS) and global myocardial work index (GWI) are becoming increasingly important in the assessment of left ventricular (LV) function in competitive athletes. The objective of the study was to analyze the effects of maximum physical exercise on LV deformation parameters, and to investigate their correlation with cardiopulmonary exercise capacity. 

 

Methods

33 professional male athletes (mean age 24 ± 5years) underwent cardiopulmonary exercise testing (CPET), where maximum oxygen uptake (VO2max) indexed to body weight (relative VO2max) was assessed. GLS was assessed at rest and 5-10 min after CPET in all athletes. In addition, GWI was measured before and after CPET in 13 elite handball players. Changes of GLS and GWI before and after CPET were correlated with (relative) VO2max.

 

Results

GLS was reduced after CPET (-18.4 ± 1.7% vs. -17.7 ± 1.6%; P=0.002), whereas mean GWI was not (1837.7 ±316.0mmHg% vs. 1974.8 ± 222.6mmHg%; P=0.197). The most important hemodynamic and echocardiographic parameters are displayed in Table 1. In the 8 athletes with an increased GWI after CPET, relative VO2max was higher compared to the other 5 athletes (45.8 ± 5.3ml/min*kg vs. 37.3 ± 4.8ml/min*kg; P=0.019) (Figure 1). No correlations were observed between relative VO2max and GLS before and after CPET. In contrast, there was a correlation between relative VO2max and the change of GWI before and after CPET (r = 0.671; P = 0.012) (Figure 1).

 

Conclusion

Maximum physical exercise has a significant effect on LV deformation. The correlation of relative VO2max with the change in GWI identifies GWI as an echocardiographic parameter to assess athletes’ current training conditions.

Table 1:

Parameters

at rest

after CPET

P value

BPs (mmHg)

130 ± 11

152 ± 14

<0.001

BPd (mmHg)

81 ± 7

66 ± 10

<0.001

HR (bpm)

62 ± 9

91 ± 13

<0.001

VO2max (ml/min)

4307 ± 594

4147 ± 495

0.379

Relative VO2max (ml/min*kg)

55 ± 7

43 ± 6

<0.001

LVSV (ml)

109 ± 15

91 ± 16

<0.001

EF (%)

67 ± 6

65 ± 6

0.089

GLS (%)

-18.4 ± 1.7

-17.7 ± 1.6

0.002

GWI (mmHg%)

1838 ± 316

1975 ± 223

0.197


Figure 1:

 

(A) Global myocardial work index (GWI) before and after cardiopulmonary exercise test (CPET). (B) Relative VO2max in the group of athletes with increased GWI (↑­) after CPET compared to the group of athletes with decreased GWI (↓). (C) The correlation between the change of GWI (DGWI) after CPET with relative VO2max as a surrogate parameter for cardiopulmonary exercise capacity.
https://dgk.org/kongress_programme/jt2023/aV1661.html