P656Right ventricular dysfunction occurs in amateur male marathon runners: a three-dimensional echocardiography examination study

Abstract

BACKGROUND Oderate physical activity has a number of positive effects, but its upper limit has not been determined yet. Marathon run participation has become very popular recently. Several studies reported on the post-exercise “cardiac fatigue” with left ventricular (LV) mild dysfunction. Recently it was suggested that right ventricle (RV) may be more susceptible to injury due to volume and pressure overload during marathon. AIM We aimed to analyze changes in RV function after the marathon run by means of transthoracic three-dimensional echocardiography (3DE) which enables assessment of its complicated structure. METHODS We included 33 amateur healthy males (mean age: 39 ± 8.5 years) who participated in the 2nd PZU Marathon in Gdansk, Poland. The 3DE was performed two times: 2 weeks before (stage I) and at the marathon finish line (stage II) using standard projections. Tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC) were calculated using 3DE software. RESULTS When comparing results obtained at stage I and II, a significant reduction in the indexed LV end-systolic (LVESV) and end-diastolic (LVEDV) volumes was observed after the marathon run (Table). On the contrary, there was a significant increase in the indexed RV end-systolic (RVESV) and end-diastolic (RVEDV) volumes. Moreover, a significant decrease in the RV ejection fraction (RVEF), TAPSE and RVFAC was found after the marathon run. CONCLUSIONS Marathon run results in a significant RV dysfunction. This endurance exercise causes dilation and reduction in the RV contractile reserve, with little influence on LV function. Our results indicate that RV may be the “Achilles heel” of the competing heart. (Table Presented).