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Exercise Induced Left Ventricular Remodeling Among Competitive Athletes: A Phasic Phenomenon

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journal contribution
posted on 09.05.2022, 13:44 by Rory B. Weiner, James R. DeLuca, Francis Wang, Jeffrey Lin, Meagan M. Wasfy, Brant Berkstresser, Eric StohrEric Stohr, Rob Shave, Gregory D. Lewis, Adolph M. Hutter, Michael H. Picard, Aaron L. Baggish

 Background: Contemporary understanding of exercise-induced cardiac remodeling (EICR) is based on cross-sectional data and relatively short duration longitudinal studies. Temporal progression of EICR remains incompletely understood. Methods and Results: A longitudinal repeated measures study design using 2-dimensional and speckle-tracking echocardiography was used to examine “acute augmentation” phase (AAP; 90 days) and more extended “chronic maintenance” phase (CMP; 39 months) left ventricular (LV) structural and functional adaptations to endurance exercise training among competitive male rowers (n=12, age 18.6±0.5 years). LV mass was within normal limits at baseline (93±9 g/m2), increased after AAP (1057 g/m2; p=0.001), and further increased after CMP (11310 g/m2, p<0.001 for comparison to post-AAP). AAP LV hypertrophy was driven by LV dilation (ΔLVEDV = 93 mL/m2, p=0.004) with stable LV wall thickness (Δwall thickness = 0.30.1 mm, p=0.63). In contrast, CMP LV hypertrophy was attributable to LV wall thickening (Δ wall thickness = 1.10.4 mm, p=0.004) with stable LV chamber volumes (ΔLVEDV = 11 mL/m2, p=0.48). Early diastolic peak tissue velocity increased during AAP (-11.7±1.9 vs. -13.6±1.3 cm/s, p<0.001) and remained similarly increased after CMP. Conclusions: In a small sample of competitive endurance athletes, EICR follows a phasic response with increases in LV chamber size, early diastolic function, and systolic twist in an acute augmentation phase of exercise training. This is followed by a chronic phase of adaptation characterized by increasing wall thickness and regression in LV twist. Training duration is a determinant of EICR and has implications for the assessment of myocardial structure and function in athletes. 


Published in

Circulation: Cardiovascular Imaging


American Heart Association


AM (Accepted Manuscript)


Weiner RB, DeLuca JR, Wang F, Lin J, Wasfy MM, Berkstresser B, Stöhr E, Shave R, Lewis GD, Hutter AM Jr, Picard MH, Baggish AL.(2015) 'Exercise-induced left ventricular remodeling among competitive athletes: a phasic phenomenon', Circulation: Cardiovascular Imaging, 8(12), p.e003651

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Eric Stöhr Rob Shave

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

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