Exercise-induced shift in right ventricular contraction pattern: novel marker of athlete’s heart?

BACKGROUND: Data is limited about the functional adaptation of the right ventricle (RV) to intense exercise. Our aim was to characterize the RV mechanical pattern in top-level athletes using 3D echocardiography. METHODS AND RESULTS: A total of 60 elite water polo athletes (19±4 years, 17±6 hours of training/week, 50% female) and 40 healthy, sedentary controls were enrolled. We measured RV end-diastolic volume index (RVEDVi) and ejection fraction (RVEF) using dedicated software. Furthermore, we have determined RV global longitudinal (RV GLS) and circumferential strain (RV GCS) and the relative contribution of longitudinal (LEF) and radial ejection fraction (REF) to RVEF using the ReVISION method. Athletes also underwent cardiopulmonary exercise testing (VO2/kg). Athletes had significantly higher RVEDVi compared to controls (athletes vs. controls; 88±11 vs. 65±10 ml/m2, p<0.001), however, they also demonstrated lower RVEF (56±4 vs. 61±5 %, p<0.001). RV GLS was comparable between the two groups (-22±5 vs. -2...