Left and right ventricular function in athletes with elevated pulmonary arterial pressure

Objective: To evaluate the prevalence and potential impact of elevated pulmonary arterial systolic pressure (PASP) on left and right cardiac morphology and func-tion in young elite athletes.

Methods: 85 professional athletes (40 endurance, 20 strength and 25 mixed-training, mean age 17.8 ± 4.0) and 50 sedentary controls (mean age 18.6 ± 3.3) un-derwent transthoracic echocardiographic examination. Two-dimensional measurements of the right (RV) and left ventricle (LV) were obtained. Pulmonary artery systolic pressure (PASP) was estimated from the peak tricuspid regurgitant velocity (TRV). Speckle tracking derived longitudinal LV and RV strain measurements (RV_LS) were calculated for function estimation.

Results: Maximum TRV (2.2 ± 0.3 m/s vs. 2.0 ± 0.2 m/s, p<0.01) and PASP (26 ± 5 mmHg vs. 22 ± 5 mmHg, p<0.01) were higher in athletes compared to controls. PASP above 30 mmHg (35 ± 3 mmHg, ran-ge 31-40 mmHg) was identified in 11 athletes (12.9%). Athletes with elevated PASP demonstrated higher LV mass (p<0.01), LV stroke volume indexed (p<0.01), lar-ger RV end-systolic area (ESAi), RV-end-diastolic area (EDAi), right atrium ES volume and ED volume and decreased RV fractional area change (FAC) (p<0.01) when compared to matched controls and higher RV-EDAi (13.0 ± 1.6 vs. 11.1 ± 1.5, p<0.01), RV-ESAi (8.25 vs. 6.1 ± 0.9, p<0.01) and significantly reduced RV FAC (38.1 ± 5.8 vs. 44.6 ± 2.5, p<0.01) when compared to matched athletes. LV global longitudinal strain and RV_LS showed no differences between the groups.

Conclusions: Pulmonary arterial systolic pressure ele-vation in young athletes is associated with pronounced right ventricular enlargement, even when compared to matched athletes. Conventional and speckle tracking echocardiography showed preserved right ventricular function


ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)