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CC BY-NC-ND 4.0 · Int J Sports Med
DOI: 10.1055/a-2259-2203
Clinical Sciences

Right Ventricular Structure and Function in Adolescent Athletes: A 3D Echocardiographic Study

Adrienn Ujvári
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Alexandra Fábián
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Bálint Lakatos
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Márton Tokodi
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Zsuzsanna Ladányi
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Nóra Sydó
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Emese Csulak
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Hajnalka Vágó
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Vencel Juhász
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Kinga Grebur
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Andrea Szűcs
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
,
Márk Zámodics
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Máté Babity 
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Orsolya Kiss
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Béla Merkely
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2   Department of Sports Medicine, Semmelweis University, Budapest, Hungary
,
Attila Kovács 
1   Heart and Vascular Center, Semmelweis University, Budapest, Hungary
3   Department of Surgical Research and Techniques, Semmelweis University, Budapest, Hungary
› Author Affiliations Funding Information Project no. RRF-2.3.1-21-2022-00003 has been implemented with the support provided by the European Union. The study was also financed by Project no. TKP2021-NKTA-46 that has been implemented with the support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund, financed under the TKP2021-NKTA funding scheme. This project was also supported by a grant from the National Research, Development and Innovation Office (NKFIH) of Hungary (K135076 to B.M.). The research was supported by the ÚNKP-22-3-II-SE-47 and ÚNKP-23-4-II-SE-37 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund. AK was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.
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Abstract

The aim of this study was to characterize the right ventricular (RV) contraction pattern and its associations with exercise capacity in a large cohort of adolescent athletes using resting three-dimensional echocardiography (3DE). We enrolled 215 adolescent athletes (16±1 years, 169 males, 12±6 hours of training/week) and compared them to 38 age and sex-matched healthy, sedentary adolescents. We measured the 3DE-derived biventricular ejection fractions (EF). We also determined the relative contributions of longitudinal EF (LEF/RVEF) and radial EF (REF/RVEF) to the RVEF. Same-day cardiopulmonary exercise testing was performed to calculate VO2/kg. Both LV and RVEFs were significantly lower (athletes vs. controls; LVEF: 57±4 vs 61±3, RVEF: 55±5 vs 60±5%, p<0.001). Interestingly, while the relative contribution of radial shortening to the global RV EF was also reduced (REF/RVEF: 0.40±0.10 vs 0.49±0.06, p<0.001), the contribution of the longitudinal contraction was significantly higher in athletes (LEF/RVEF: 0.45±0.08 vs 0.40±0.07, p<0.01). The supernormal longitudinal shortening correlated weakly with a higher VO2/kg (r=0.138, P=0.044). Similarly to the adult athlete’s heart, the cardiac adaptation of adolescent athletes comprises higher biventricular volumes and lower resting functional measures with supernormal RV longitudinal shortening. Characteristic exercise-induced structural and functional cardiac changes are already present in adolescence.

Keywords

3D echocardiography - athlete’s heart - adolescent health - right ventricle - exercise capacity

Supplementary Material



Publication History

Received: 02 November 2023

Accepted: 08 January 2024

Accepted Manuscript online:
01 February 2024

Article published online:
10 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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