Left ventricular function and mechanics following prolonged endurance exercise: an update and meta-analysis with insights from novel techniques.
Background
The cardiac consequences of undertaking endurance exercise are the topic of recent debate. The purpose of this review is to provide an update on a growing body of literature, focusing on left ventricular (LV) function following prolonged endurance exercise over 2 h in duration which have employed novel techniques, including myocardial speckle tracking, to provide a more comprehensive global and regional assessment of LV mechanics.
Methods
Prospective studies were filtered independently following a pre-set criteria, resulting in the inclusion of 27 studies in the analyses. A random-effects meta-analysis was used to determine the weighted mean difference and 95% confidence intervals (CI) of LV functional and mechanical data from pre-to-post-exercise. Narrative commentary was also provided where volume of available evidence precluded meta-analysis.
Results
A significant overall reduction in LV longitudinal strain (Ɛ) n = 22 (− 18 ± 1 to − 17 ± 1%; effect size (d) − 9: − 1 to − 0.5%), strain rate n = 10 (SR;d − 0.9: − 0.1.3 to − 0.5 l/s) and twistn = 5 (11.9 ± 2.2 to 8.7 ± 2.2°,d − 1: − 1.6 to − 0.3°) was observed following strenuous endurance exercise (range 120–1740 min) (P < 0.01). A smaller number of studies (n = 4) also reported a non-significant reduction in global circumferential and radial Ɛ (P > 0.05).
Conclusion
The meta-analysis and narrative commentary demonstrated that a reduction in LV function and mechanics is evident following prolonged endurance exercise. The mechanism(s) responsible for these changes are complex and likely multi-factorial in nature and may be linked to right and left ventricular interaction.
History
Published in
European Journal of Applied PhysiologyPublisher
SpringerVersion
- VoR (Version of Record)
Citation
Lord, R.N., Utomi, V., Oxborough, D.L., Curry, B., Brown, M. and George, K.P. (2018) 'Left ventricular function and mechanics following prolonged endurance exercise: an update and meta-analysis with insights from novel techniques', European Journal of Applied PhysiologyPrint ISSN
1439-6319Electronic ISSN
1439-6327Cardiff Met Affiliation
- Cardiff School of Sport and Health Sciences
Cardiff Met Authors
Rachel LordCardiff Met Research Centre/Group
- Cardiovascular Physiology
Copyright Holder
- © The Authors
Language
- en