P636Regional adaptation of the right ventricle in athletes: insights from myocardial deformation imaging.


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Abstract

Purpose: Despite that left ventricular (LV) remodeling in chronic endurance exercise is well described, adaptation of the right ventricle (RV) is less studied. Our aim was to evaluate global and regional RV dimensions and function in athletes, assessing if adaptation corresponds to what is observed in other states of volume overload, namely homogeneously increased regional myocardial strain.Methods: Sedentary volunteers (n=25) and elite athletes (n=65) were prospectively enrolled. Conventional echocardiographic parameters and 2D echo derived strain (2DSE) were calculated in two RV free wall segments (inlet and apex). Results: Flow in the RV and LV outflow tracts (table 1) were significantly increased in athletes as compared to healthy volunteers (RV VTI 14±2cm vs22±3cm, and LV VTI 15±3 vs 21±3, volunteers vs athletes respectively,p<0.001 for both). In 39 athletes (60%), but only in 5 volunteers (20%), there was an exaggerated strain gradient between the inlet and the apex regions of the RV. Conclusions: Adaptation of the RV to chronic exercise shows not only global dilatation, as induced by volume overload, but additionally results in regional deformation changes as would be observed in chronic pressure overload. The interplay of volume and pressure in the RV and the observed (regional) remodeling in some athletes warrant further investigation.

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