Training-induced right ventricular remodelling in pre-adolescent endurance athletes: The athlete's heart in children. (1st June 2017)

• Record Type: Journal Article
• Authors: D'Ascenzi, Flavio; Pelliccia, Antonio; Valentini, Francesca; Malandrino, Angela; Natali, Benedetta Maria; Barbati, Riccardo; Focardi, Marta; Bonifazi, Marco; Mondillo, Sergio
• Is Part Of: International journal of cardiology. Volume 236(2017)
• Page Start: 270
• Page End: 275
• Publication Date: 2017-06-01
• Subjects: Athlete's heart -- Children -- ARVC -- Exercise-induced ARVC -- Speckle-tracking echocardiography -- Strain; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.01.121
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Aims: Little is known about the adaptation of the right ventricle (RV) to endurance exercise in children. The aim of this study was to assess the effects of 5 months of intensive training on RV morphology and function in preadolescent endurance athletes. Methods: Ninety-four children were evaluated in this study. Fifty-seven male competitive swimmers (aged 10.8 ± 0.2 years) were evaluated before (baseline) and after 5 months of the training (peak-training), and compared to 37 age- and sex-matched non-athlete children evaluated at baseline and after 5 months of natural growth. All subjects were asymptomatic, with negative family history for cardiomyopathies. Results: At baseline no differences were found between athletes and controls for indexed RV outflow tract (RVOT) (18.5 ± 2.7 vs. 16.8 ± 5.0 mm/m 2, p = 0.18) and RV basal end-diastolic diameter (EDD) (24.9 ± 4.1 vs. 23.6 ± 3.0 mm/m 2, p = 0.15). After 5 months, indexed RVOT and RV basal EDD significantly increased in athletes (20.2 ± 2.9 mm/m 2 and 25.4 ± 3.3 mm/m 2, p < 0.0001 vs. baseline) while no differences were observed in controls ( p = 0.84 and p = 0.25). Despite the increase in RV size, RV function remained normal in athletes, with no changes in RV fractional area change ( p = 0.97), s′ value ( p = 0.22), and RV longitudinal strain ( p = 0.28). Conclusions: Endurance training influences the growing heart of male preadolescent athletes with an addictive increase in RV dimensions, with a preserved RV function. Therefore, in children engaged in endurance sports the increase in RV size associated with normal RV function represents a physiological expression of the athlete's heart and should not be misinterpreted as an expression of incipient RV cardiomyopathy. Highlights: The right ventricle adapts even in the early phases of a career of an athlete. Training-induced right ventricular dilatation is associated with a normal function. Right ventricular dilatation is not accompanied by wall motion abnormalities. Right ventricular dilatation is association with left ventricular enlargement.