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Alterations in cardiac mechanics following ultra-endurance exercise: Insights from left and right ventricular area-deformation loops

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posted on 2023-01-23, 16:56 authored by Rachel LordRachel Lord, Keith George, John Somauroo, Michael StembridgeMichael Stembridge, Nikhil Jain, Martin D. Hoffman, Rob Shave, Francois Haddad, Euan Ashley, Helen Jones, David Oxborough



The aim of this study was to use novel area-deformation (ε) loops to interrogate the interaction between the right ventricular (RV) and left ventricular (LV) mechanics following a 100-mile endurance run.


Fifteen participants (mean body mass, 70.1 ± 8.8 kg; mean age, 40 ± 8 years) were recruited for the study. Echocardiography was performed before the race, after the race, and 6 hours into recovery. RV and LV area and longitudinal ε were assessed using standard and speckle-tracking echocardiography. Following cubic spline interpolation, these variables were obtained across the same cardiac cycle and used to derive area-ε loops.


The RV area-ε loop demonstrated a rightward shift after the race, with increased RV area (from 26.0 to 27.1 cm2) and reduced peak RV ε (from −28.6% to −25.8%). The recovery RV area-ε loop was similar to the postrace loop. A leftward shift was observed in the LV area-ε loop after the race, secondary to reduced LV area (from 35.8 to 32.5 cm2) and reduced peak ε (from −18.3% to −16.6%). In recovery, LV ε values returned toward baseline.


A 100-mile ultramarathon resulted in a rightward shift in the RV area-ε loop as a result of RV dilatation. There was a concomitant leftward shift in the LV area-ε loop as a result of underfilling of the left ventricle. At 6 hours after exercise, there was a partial recovery of the left ventricle, while RV function remained depressed. It appears that changes in RV function do not have a serial impact on the left ventricle during recovery from ultra-endurance activity.


Published in

Journal of the American Society of Echocardiography




  • AM (Accepted Manuscript)


Lord, R., George, K., Somauroo, J., Jain, N., Hoffman, M.D., Shave, R., Haddad, F., Ashley, E., Jones, H. and Oxborough, D. (2016) 'Alterations in cardiac mechanics following ultra-endurance exercise: Insights from left and right ventricular area-deformation loops', Journal of the American Society of Echocardiography, 29 (9), pp.879-887

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Rachel Lord Mike Stembridge

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

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  • © The Publisher


  • en

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