Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue
BackgroundThe effect of prolonged, high-intensity endurance exercise on myocardial function is unclear. This study aimed to determine the left ventricular (LV) response to increased exercise duration and intensity using novel echocardiographic tools to assess myocardial work and fatigue.Materials an...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1081664/full |
| _version_ | 1797955995804106752 |
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| author | Christine Bjørkvik Erevik Øyunn Kleiven Vidar Frøysa Magnus Bjørkavoll-Bergseth Monica Chivulescu Lars Gunnar Klæboe Lars Dejgaard Bjørn Auestad Bjørn Auestad Øyvind Skadberg Tor Melberg Stig Urheim Kristina Haugaa Thor Edvardsen Stein Ørn |
| author_facet | Christine Bjørkvik Erevik Øyunn Kleiven Vidar Frøysa Magnus Bjørkavoll-Bergseth Monica Chivulescu Lars Gunnar Klæboe Lars Dejgaard Bjørn Auestad Bjørn Auestad Øyvind Skadberg Tor Melberg Stig Urheim Kristina Haugaa Thor Edvardsen Stein Ørn |
| author_sort | Christine Bjørkvik Erevik |
| collection | DOAJ |
| description | BackgroundThe effect of prolonged, high-intensity endurance exercise on myocardial function is unclear. This study aimed to determine the left ventricular (LV) response to increased exercise duration and intensity using novel echocardiographic tools to assess myocardial work and fatigue.Materials and methodsLV function was assessed by echocardiography before, immediately, and 24 h after a cardiopulmonary exercise test (CPET) and a 91-km mountain bike leisure race. Cardiac Troponin I (cTnI) was used to assess myocyte stress.Results59 healthy recreational athletes, 52 (43–59) years of age, 73% males, were included. The race was longer and of higher intensity generating higher cTnI levels compared with the CPET (p < 0.0001): Race/CPET: exercise duration: 230 (210, 245)/43 (40, 45) minutes, mean heart rate: 154 ± 10/132 ± 12 bpm, max cTnI: 77 (37, 128)/12 (7, 23) ng/L. Stroke volume and cardiac output were higher after the race than CPET (p < 0.005). The two exercises did not differ in post-exercise changes in LV ejection fraction (LVEF) or global longitudinal strain (GLS). There was an increase in global wasted work (p = 0.001) following the race and a persistent reduction in global constructive work 24 h after exercise (p = 0.003).ConclusionIncreased exercise intensity and duration were associated with increased myocardial wasted work post-exercise, without alterations in LVEF and GLS from baseline values. These findings suggest that markers of myocardial inefficiency may precede reduction in global LV function as markers of myocardial fatigue. |
| first_indexed | 2024-04-10T23:43:01Z |
| format | Article |
| id | doaj.art-c65d7b069e784b9bac027668f9404688 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T23:43:01Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-c65d7b069e784b9bac027668f94046882023-01-11T06:39:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-01910.3389/fcvm.2022.10816641081664Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigueChristine Bjørkvik Erevik0Øyunn Kleiven1Vidar Frøysa2Magnus Bjørkavoll-Bergseth3Monica Chivulescu4Lars Gunnar Klæboe5Lars Dejgaard6Bjørn Auestad7Bjørn Auestad8Øyvind Skadberg9Tor Melberg10Stig Urheim11Kristina Haugaa12Thor Edvardsen13Stein Ørn14Department of Cardiology, Stavanger University Hospital, Stavanger, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayDepartment of Mathematics and Physics, University of Stavanger, Stavanger, NorwayResearch Department, Stavanger University Hospital, Stavanger, NorwayDepartment of Biochemistry, Stavanger University Hospital, Stavanger, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayDepartment of Cardiology, Bergen University Hospital, Bergen, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayBackgroundThe effect of prolonged, high-intensity endurance exercise on myocardial function is unclear. This study aimed to determine the left ventricular (LV) response to increased exercise duration and intensity using novel echocardiographic tools to assess myocardial work and fatigue.Materials and methodsLV function was assessed by echocardiography before, immediately, and 24 h after a cardiopulmonary exercise test (CPET) and a 91-km mountain bike leisure race. Cardiac Troponin I (cTnI) was used to assess myocyte stress.Results59 healthy recreational athletes, 52 (43–59) years of age, 73% males, were included. The race was longer and of higher intensity generating higher cTnI levels compared with the CPET (p < 0.0001): Race/CPET: exercise duration: 230 (210, 245)/43 (40, 45) minutes, mean heart rate: 154 ± 10/132 ± 12 bpm, max cTnI: 77 (37, 128)/12 (7, 23) ng/L. Stroke volume and cardiac output were higher after the race than CPET (p < 0.005). The two exercises did not differ in post-exercise changes in LV ejection fraction (LVEF) or global longitudinal strain (GLS). There was an increase in global wasted work (p = 0.001) following the race and a persistent reduction in global constructive work 24 h after exercise (p = 0.003).ConclusionIncreased exercise intensity and duration were associated with increased myocardial wasted work post-exercise, without alterations in LVEF and GLS from baseline values. These findings suggest that markers of myocardial inefficiency may precede reduction in global LV function as markers of myocardial fatigue.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1081664/fullmyocardial worksports cardiologyexerciseleft ventricular functionmyocardial strainexercise-induced cardiac fatigue |
| spellingShingle | Christine Bjørkvik Erevik Øyunn Kleiven Vidar Frøysa Magnus Bjørkavoll-Bergseth Monica Chivulescu Lars Gunnar Klæboe Lars Dejgaard Bjørn Auestad Bjørn Auestad Øyvind Skadberg Tor Melberg Stig Urheim Kristina Haugaa Thor Edvardsen Stein Ørn Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue Frontiers in Cardiovascular Medicine myocardial work sports cardiology exercise left ventricular function myocardial strain exercise-induced cardiac fatigue |
| title | Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue |
| title_full | Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue |
| title_fullStr | Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue |
| title_full_unstemmed | Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue |
| title_short | Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue |
| title_sort | myocardial inefficiency is an early indicator of exercise induced myocardial fatigue |
| topic | myocardial work sports cardiology exercise left ventricular function myocardial strain exercise-induced cardiac fatigue |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1081664/full |
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