Effect of maximum exercise on left ventricular deformation and its correlation with cardiopulmonary exercise capacity in competitive athletes

J Kandels; S Stöbe; A Kogel; P Hepp; H Riepenhof; J N Droste; T Stoeggl; R P Marshall; U Rudolph; U Laufs; S Fikenzer; A Hagendorff

doi:10.1186/s44156-023-00029-6

Effect of maximum exercise on left ventricular deformation and its correlation with cardiopulmonary exercise capacity in competitive athletes

Echo Res Pract. 2023 Oct 4;10(1):17. doi: 10.1186/s44156-023-00029-6.

Authors

J Kandels^#¹, S Stöbe^#², A Kogel², P Hepp³, H Riepenhof^{4

5}, J N Droste^{5

6}, T Stoeggl^{6

7}, R P Marshall^{4

8}, U Rudolph², U Laufs², S Fikenzer^#², A Hagendorff^#²

Affiliations

¹ Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. Joscha.Kandels@medizin.uni-leipzig.de.
² Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
³ Klinik und Poliklinik für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum, 04103, Leipzig, Germany.
⁴ RasenBallsport Leipzig GmbH, Cottaweg 3, 04177, Leipzig, Germany.
⁵ Center for Rehabilitation and Sports Medicine, BG Klinikum Hamburg, 21033, Hamburg, Germany.
⁶ Red Bull Athlete Performance Center, 5303, Salzburg, Austria.
⁷ Department of Sport and Exercise Science, Universität Salzburg, 5020, Salzburg, Austria.
⁸ Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120, Halle, Germany.

^# Contributed equally.

Abstract

Background: Global longitudinal strain (GLS) and global myocardial work index (GWI) allow early detection of subclinical changes in left ventricular (LV) systolic function. The aim of the study was to investigate the immediate effects of maximum physical exercise by different exercise testing methods on early post exercise LV deformation parameters in competitive athletes and to analyze their correlation with cardiopulmonary exercise capacity.

Methods: To reach maximum physical exercise, cardiopulmonary exercise testing (CPET) was performed by semi-recumbent ergometer in competitive handball players (n = 13) and by treadmill testing in competitive football players (n = 19). Maximum oxygen uptake (VO_2max) indexed to body weight (relative VO_2max) was measured in all athletes. Transthoracic echocardiography and blood pressure measurements were performed at rest and 5 min after CPET in all athletes. GLS, GWI and their changes before and after CPET (ΔGLS, ΔGWI) were correlated with (relative) VO_2max.

Results: In handball and football players, GLS and GWI did not differ significantly before and after CPET. There were no significant correlations between GLS and relative VO_2max, but moderate correlations were found between ΔGWI and relative VO_2max in handball (r = 0.631; P = 0.021) and football players (r = 0.592; P = 0.008). Furthermore, handball (46.7 ml/min*kg ± 4.7 ml/min*kg vs. 37.4 ml/min*kg ± 4.2; P = 0.004) and football players (58.3 ml/min*kg ± 3.7 ml/min*kg vs. 49.7 ml/min*kg ± 6.8; P = 0.002) with an increased ΔGWI after CPET showed a significant higher relative VO_2max.

Conclusion: Maximum physical exercise has an immediate effect on LV deformation, irrespective of the used testing method. The correlation of relative VO_2max with ΔGWI in the early post exercise period, identifies ΔGWI as an echocardiographic parameter for characterizing the current individual training status of athletes.

Keywords: Athletes; Cardiopulmonary exercise test; Deformation; Echocardiography; Longitudinal strain; Work index.