Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy.
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Echocardiography. 2024 Jan;41(1):e15731. doi: 10.1111/echo.15731. Epub 2023 Dec 19.
Cardiovascular adaptations in elite athletes involve both ventricular and atrial changes. Nowadays, limited research exists on right ventricular (RV) remodeling, particularly in female athletes and across different types of exercise training.
Our study evaluated 370 athletes (61% males) participated at 2020 Tokyo and 2022 Beijing Olympic Games. Athletes were categorized according to main type of exercise into isometric and isotonic. Comprehensive echocardiographic assessments were conducted to analyze RV morpho-functional parameters, comparing genders and different sporting exercise.
Significant differences in RV parameters were observed based on exercise type and gender. Isotonic athletes showed greater RV remodeling with larger RV outflow tract (15.1 ± 2.1 vs. 14.5 ± 1.7 mm, p < .0001) end-diastolic and end-systolic area (respectively, 24.6 ± 5.5 vs. 21.7 ± 5 mm, p < .000 and 11.7 ± 3.2 vs. 10.1 ± 2.8 mm, p < .0001) and right atrium size (11.7 ± 3.2 vs. 10.2 ± 2.3 mm , p = .0001). Functional parameters, such as TDI velocities, were similar between groups. Males showed larger RV area and right atrium size (p < .0001) and lower RV TDI velocities with reduced E' (15.4 ± 2.9 vs. 16.1 ± 3.2 m/s in females, p = .031), resulting in lower E'/A' ratio (1.69 ± .6 vs. 1.84 ± .6 m/s, p = .021), while S' was lower females (14.6 ± 2.3 vs. 14.1 ± 2.4 m/s, p = .041). RV TDI velocities were similar in isotonic and isometric both in male and females.
In elite athletes, RV morphological changes are influenced by exercise modality but do not translate into functional differences. Female athletes present distinct RV functional profiles, with lower S' velocities and a higher E'/A' ratio. Functional RV TDI parameters are not affected by the typology of exercise practiced.
精英运动员的心血管适应涉及心室和心房变化。如今，关于右心室（RV）重塑的研究有限，特别是在女性运动员和不同类型的运动训练中。
我们的研究评估了参加 2020 年东京和 2022 年北京奥运会的 370 名运动员（61%为男性）。运动员根据主要运动类型分为等长运动和等张运动。进行全面的超声心动图评估，分析 RV 形态和功能参数，比较不同性别和不同运动项目。
根据运动类型和性别观察到 RV 参数的显著差异。等张运动运动员的 RV 重塑更大，RV 流出道更大（15.1±2.1 比 14.5±1.7mm，p<.0001），舒张末期和收缩末期面积更大（分别为 24.6±5.5 比 21.7±5mm，p<.000 和 11.7±3.2 比 10.1±2.8mm，p<.0001），右心房也更大（11.7±3.2 比 10.2±2.3mm，p=.0001）。各组之间的功能性参数，如 TDI 速度相似。男性的 RV 面积和右心房较大（p<.0001），RV TDI 速度较低，E'降低（女性为 15.4±2.9 比 16.1±3.2m/s，p=0.031），导致 E'/A' 比值较低（1.69±0.6 比 1.84±0.6m/s，p=0.021），而 S' 较低（女性为 14.6±2.3 比 14.1±2.4m/s，p=0.041）。男性和女性的等张和等长运动的 RV TDI 速度相似。
在精英运动员中，RV 形态变化受运动方式的影响，但不会转化为功能差异。女性运动员的 RV 功能特征明显，S'速度较低，E'/A'比值较高。RV TDI 功能参数不受所从事运动类型的影响。
