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Influence of gender on right ventricle adaptation to endurance exercise: an ultrasound two-dimensional speckle-tracking stress study

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Abstract

Background

Characteristic right ventricle (RV) remodelling is related to endurance exercise in male athletes (MAs), but data in female athletes (FAs) are scarce. Our aim was to evaluate sex-related influence on exercise-induced RV remodelling and on RV performance during exercise.

Methods

Forty endurance athletes (>10 training hours/week, 50% female) and 40 age-matched controls (<3 h moderate exercise/week, 50% female) were included. Echocardiography was performed at rest and at maximum cycle-ergometer effort. Both ventricles were analysed by standard and speckle-tracking echocardiography.

Results

Endurance training induced similar structural and functional cardiac remodelling in MAs and FAs, characterized by bi-ventricular dilatation [~34%, left ventricle (LV); 29%, RV] and normal bi-ventricular function. However, males had larger RV size (p < 0.01), compared to females: RV end-diastolic area (cm2/m2): 15.6 ± 2.2 vs 11.6 ± 1.7 in athletes; 12.2 ± 2.7 vs 8.6 ± 1.6 in controls, respectively, and lower bi-ventricular deformation (RV global longitudinal strain (GLS) (%): −24.0 ± 3.6 vs −29.2 ± 3.1 in athletes; −24.9 ± 2.5 vs −30.0 ± 1.9 in controls, and LVGLS: −17.5 ± 1.4 vs −21.9 ± 1.9 in athletes; −18.7 ± 1.2 vs −22.5 ± 1.5 in controls, respectively, p < 0.01). During exercise, the increase in LV function was positively correlated (p < 0.01) with increased cardiac output (∆%LV ejection fraction, r = +0.46 and ∆%LVGLS, r = +0.36). Improvement in RV performance was blunted at high workloads, especially in MAs.

Conclusion

Long-term endurance training induced similar bi-ventricular remodelling in MAs and FAs. Independently of training load, males had larger RV size and lower bi-ventricular deformation. Improvement in RV performance during exercise was blunted at high workloads, especially in MAs. The potential mechanisms underlying these findings warrant further investigation.

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Abbreviations

CO:

Cardiac output

ECG:

Electrocardiogram

FAs:

Female athletes

GLS:

Global longitudinal strain

HR:

Heart rate

LV:

Left ventricle

MAs:

Male athletes

RV:

Right ventricle

RVFWLS:

Right ventricle free wall longitudinal strain

RVOT:

Right ventricle outflow tract

SV:

Stroke volume

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Authors and Affiliations

  1. Cardiology Department, IDIBAPS, Hospital Clínic, Barcelona, Spain

    Maria Sanz-de la Garza, Josefa Marin, Gonzalo Grazioli, Montserrat Esteve, Laura Sanchis & Marta Sitges

  2. Montreal Heart Institute, Montreal, Canada

    Geneviève Giraldeau & Laura Sanchis

  3. Catolic University of Chile, Santiago De Chile, Chile

    Luigi Gabrielli & Laura Sanchis

  4. Angeles del Carmen Hospital, Guadalajara, Mexico

    Carlos Brambila & Laura Sanchis

  5. ICREA, Universitat Pompeu Fabra, Barcelona, Spain

    Laura Sanchis & Bart Bijnens

Authors
  1. Maria Sanz-de la Garza
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  2. Geneviève Giraldeau
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  3. Josefa Marin
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  4. Gonzalo Grazioli
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  5. Montserrat Esteve
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  6. Luigi Gabrielli
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  7. Carlos Brambila
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  8. Laura Sanchis
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  9. Bart Bijnens
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  10. Marta Sitges
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Corresponding author

Correspondence to Maria Sanz-de la Garza.

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No disclosures to declare.

Funding sources

This work was partially funded by grants from the Generalitat de Catalunya FI-AGAUR 2014–2017 (RH 040991, M. Sanz), and from the Spanish Government (Plan Nacional I + D, Ministerio de Economia y Competitividad DEP2013-44923-P; TIN2014-52923-R and FEDER).

Additional information

Communicated by Massimo Pagani.

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Sanz-de la Garza, M., Giraldeau, G., Marin, J. et al. Influence of gender on right ventricle adaptation to endurance exercise: an ultrasound two-dimensional speckle-tracking stress study. Eur J Appl Physiol 117, 389–396 (2017). https://doi.org/10.1007/s00421-017-3546-8

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  • DOI: https://doi.org/10.1007/s00421-017-3546-8

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