Lord Rachel N, Adams Zoe H, George Keith, Somauroo John, Jones Helen, Oxborough David
Centre for Health Activity and Wellbeing Research, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK.
Research Institute for Sport and Exercise Sciences, Liverpool, UK.
Echo Res Pract. 2023 Dec 20;10(1):22. doi: 10.1186/s44156-023-00035-8.
A reduction in right ventricular (RV) function during recovery from prolonged endurance exercise has been documented alongside RV dilatation. A relative elevation in pulmonary artery pressure and therefore RV afterload during exercise has been implicated in this post-exercise dysfunction but has not yet been demonstrated. The current study aimed to assess RV structure and function and pulmonary artery pressure before, during and after a 6-h cycling exercise bout.
Eight ultra-endurance athletes were recruited for this study. Participants were assessed prior to exercise supine and seated, during exercise at 2, 4 and 6 h whilst cycling seated at 75% maximum heart rate, and post-exercise in the supine position. Standard 2D, Doppler and speckle tracking echocardiography were used to determine indices of RV size, systolic and diastolic function.
Heart rate and RV functional parameters increased from baseline during exercise, however RV structural parameters and indices of RV systolic and diastolic function were unchanged between in-exercise assessment points. Neither pulmonary artery pressures (26 ± 9 mmHg vs 17 ± 10 mmHg, P > 0.05) nor RV wall stress (7.1 ± 3.0 vs 6.2 ± 2.4, P > 0.05) were significantly elevated during exercise. Despite this, post-exercise measurements revealed RV dilation (increased RVD1 and 3), and reduced RV global strain (- 21.2 ± 3.5 vs - 23.8 ± 2.3, P = 0.0168) and diastolic tissue velocity (13.8 ± 2.5 vs 17.1 ± 3.4, P = 0.019) vs pre-exercise values.
A 6 h cycling exercise bout at 75% maximum heart rate did not alter RV structure, systolic or diastolic function assessments during exercise. Pulmonary artery pressures are not elevated beyond normal limits and therefore RV afterload is unchanged throughout exercise. Despite this, there is some evidence of RV dilation and altered function in post-exercise measurements.
长期耐力运动恢复期间右心室（RV）功能下降并伴有RV扩张，这一点已有文献记载。运动期间肺动脉压力相对升高，进而导致RV后负荷增加，这被认为与运动后功能障碍有关，但尚未得到证实。本研究旨在评估6小时自行车运动前后RV的结构和功能以及肺动脉压力。
招募了8名超耐力运动员参与本研究。在运动前仰卧位和坐位时、运动期间（2小时、4小时和6小时，以75%最大心率坐位骑行）以及运动后仰卧位时对参与者进行评估。使用标准二维、多普勒和斑点追踪超声心动图来确定RV大小、收缩和舒张功能指标。
运动期间心率和RV功能参数较基线水平升高，然而在运动评估点之间，RV结构参数以及RV收缩和舒张功能指标未发生变化。运动期间肺动脉压力（26±9 mmHg对17±10 mmHg，P>0.05）和RV壁应力（7.1±3.0对6.2±2.4，P>0.05）均未显著升高。尽管如此，运动后测量结果显示RV扩张（RVD1和3增加），与运动前相比，RV整体应变降低（-21.2±3.5对-23.8±2.3，P = 0.0168），舒张期组织速度降低（13.8±2.5对17.1±3.4，P = 0.019）。
以75%最大心率进行6小时自行车运动不会改变运动期间RV的结构、收缩或舒张功能评估。肺动脉压力未升高至正常范围以上，因此整个运动过程中RV后负荷未改变。尽管如此，运动后测量结果仍有一些证据表明存在RV扩张和功能改变。
