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Excerpt
PURPOSE: Recent data has reported a transient decrease in systolic and diastolic left ventricular (LV) function after prolonged exercise. Standard echocardiography provides some insight into LV function, however, indices that are independent of hemodynamic loading may be more useful. Therefore this study employed Tissue- Doppler methods to assess this phenomenon in recreational runners completing a marathon. METHODS: Twenty-nine subjects (mean ± SD age 35 ± 10 yr and marathon finishing time 245 ± 46 min) had longitudinal Tissue-Doppler velocities assessed in systole (s) and both early (E) and late/atrial (A) diastole at five sites (lateral, septal, inferior, anterior, posterior) around the mitral annular ring pre and immediately post– race. The mean of the five sites for S, E, A and the ratio E:A were calculated. Students T-test analyzed pre-post changes in all variables and delta pre-post scores were correlated with age and finishing time. RESULTS: Mean S mitral annular velocity was not significantly altered pre-post race (17.1 ± 2.2 vs. 17.7 ± 2.9 cm.s−1, P>0.05). Alterations in both mean E (24.4 ± 5.1 vs. 19.8 ± 4.3 cm.s−1, P<0.05) and A (16.3 ± 2.0 vs. 17.9 ± 3.6 cm.s−1, P<0.05) mitral annular velocities were responsible for a significantly depressed E:A mitral annular velocity ratio post-race (1.51 ± 0.34 vs. 1.16 ± 0.35, P<0.05). The post-race depression in E:A was not strongly related to either participant age (r2=14%) or finishing time (r2=4%). CONCLUSIONS: Running a marathon resulted in a depression in diastolic function as assessed by Tissue-Doppler although systolic function remained unaltered. The mechanism underpinning this decrement in diastolic function remains to be elucidated.
