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Clinical Trial
. 2005 Nov 15;569(Pt 1):305-13.
doi: 10.1113/jphysiol.2005.095588. Epub 2005 Aug 18.

Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans

Keith George  1 , David Oxborough, Jan Forster, Greg Whyte, Robert Shave, Ellen Dawson, Claire Stephenson, Lindsey Dugdill, Ben Edwards, David Gaze
Affiliations
Clinical Trial

Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans

Keith George et al. J Physiol. .

Abstract

We assessed segmental and global left ventricular (LV) diastolic function via tissue-Doppler imaging (TDI) as well as Doppler flow variables before and after a marathon race to extend our knowledge of exercise-induced changes in cardiac function. Twenty-nine subjects (age 18-62 year) volunteered to participate and were assessed pre- and post-race. Measurements of longitudinal plane TDI myocardial diastolic velocities at five sites on the mitral annulus included peak early myocardial tissue velocity (E'), peak late (or atrial) myocardial tissue velocity (A') and the ratio E'/A'. Standard pulsed-wave Doppler transmitral and pulmonary vein flow indices were also recorded along with measurements of body mass, heart rate, blood pressures and cardiac troponin T (cTnT), a biomarker of myocyte damage. Pre- to post-race changes in LV diastolic function were analysed by repeated measures ANOVA. Delta scores for LV diastolic function were correlated with each other and alterations in indices of LV loading. Diastolic longitudinal segmental and mean TDI data were altered post-race such that the mean E'/A' ratio was significantly depressed (1.51 +/- 0.34 to 1.16 +/- 0.35, P < 0.05). Changes in segmental and global TDI data were not related to an elevated post-race HR, a decreased post-race pre-load or an elevated cTnT. The pulsed wave Doppler ratio of peak early transmitral flow velocity (E)/peak late (or atrial) flow velocity (A) was also significantly reduced post-race (1.75 +/- 0.46 to 1.05 +/- 0.30, P < 0.05); however, it was significantly correlated with post-race changes in heart rate. The lack of change in E/E' from pre- to post-race (3.4 +/- 0.8 and 3.3 +/- 0.7, respectively) suggests that the depression in diastolic function is likely to be due to altered relaxation of the left ventricle; however, the exact aetiology of this change remains to be determined.

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Figures

Figure 1
Figure 1. Segmental and global longitudinal diastolic TDI myocardial velocities
A, E′; B, A′; C, E′/A′. LAT, lateral; SEP, septal; INF, inferior; ANT, anterior; POST, posterior; TDI, tissue Doppler imaging; *Significant difference between pre- and post-race.
Figure 2
Figure 2. ΔE′/A′ plotted against ΔE/E′
Figure 3
Figure 3. ΔE′/A′ plotted against Δbody mass
Figure 4
Figure 4. ΔE′/A′ plotted against ΔLVIDD
Figure 5
Figure 5. ΔE′/A′ plotted against ΔHR
Figure 6
Figure 6. ΔE′/A′ plotted against finishing time
Figure 7
Figure 7. ΔE′/A′ plotted against cTnT
See this image and copyright information in PMC

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