Circulation, Vol 76, 1206-1213, Copyright © 1987 by American Heart Association
PS Douglas, ML O'Toole, WD Hiller, K Hackney and N Reichek
To determine the effects of prolonged exercise on systolic and diastolic
left ventricular function, we studied 21 athletes before, at the finish
(within 11 +/- 5 min), and during recovery (28 +/- 9 hr) after the Hawaii
Ironman Triathlon (2.4 mile swim, 112 mile bike, 26.2 mile run).
Two-dimensionally guided M mode echocardiograms were digitized for wall
thickness, cavity dimension, fractional shortening, and peak rates of
cavity enlargement and wall thinning. Pulsed Doppler left ventricular
inflow recordings were analyzed for peak early and late velocities and
their ratio. Left ventricular diastolic dimension was reduced at race
finish (5.4 +/- 0.6 to 5.1 +/- 0.6 cm) and remained reduced after 1 day of
recovery (5.2 +/- 0.6 cm, p less than .05). Fractional shortening fell at
race finish (39 +/- 5% to 35 +/- 5%), although systolic blood pressure was
unchanged, and rose to 40 +/- 4% after recovery (p less than .05). The
return to prerace shortening values after recovery occurred despite
continued reduction in diastolic size. Peak circumferential shortening did
not change significantly. Individual reductions in fractional shortening
were correlated with increases in systolic cavity size (r = -.64, p less
than .01), but not with decreases in diastolic size. The stress-shortening
relationship was displaced downward at race finish, but returned toward
baseline after 1 day of recovery, despite a persistent reduction in cavity
size. This suggests that the decrease in shortening was due to impaired
contractility as well as altered preload.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Cardiac fatigue after prolonged exercise
Cardiovascular Section, Hospital of the University of Pennsylvania, Philadelphia 19104.
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