Assessment of right ventricular systolic function in amateur marathoners by two-dimensional specking echocardiography

doi:10.3877/cma.j.issn.1672-6448.2022.10.012

Abstract

Abstract:

Objective

To assess the right ventricular (RV) systolic function in amateur marathoners by two-dimensional specking echocardiography.

Methods

A total of 88 amateur marathon runners were recruited between January 2019 and December 2020 in Hangzhou and were divided into a short-term (ST) group (≤6 months), a more extended-term (MET) group (6 months-3 years), and a long-term (LT) group (＞3 years) based on their time of participating in a marathon. Thirty healthy volunteers from the Affiliated Hospital of Hangzhou Normal University were enrolled during the same period as a control group. Conventional echocardiography was performed to measure RV outflow tract (RVOT), RV basal diameter (RVD_basal), RV mid-diameter (RVD_mid), RV wall thickness (RVWT), tricuspid annular plane systolic excursion (TAPSE), pulsed tissue Doppler tricuspid annular plane systolic velocity (S'), RV index of myocardial performance (RIMP), and systolic pulmonary artery pressure (SPAP). RV global longitudinal strain (GLS) and RV free wall longitudinal strain (RVLS) were calculated via Qlab10.8 analysis software offline. Echocardiography was performed before marathon, 1 hour post-marathon, and 4 days post-marathon on amateur marathon runners. The correlation of GLS and RVLS with SPAP in amateur marathon runners was further analyzed.

Results

Compared with the control group, the ST group showed a significant increase in TAPSE (P＜0.05). Compared with the ST group, the MET group showed a significant increase in RVOT, RVD_basal, RVD_mid, and RVWT (P＜0.05 for all); the RVOT, RVD_basal, and RVD_mid in the LT group were further increased compared to those of the MET group (P<0.05 for all). Compared with the control group, RVWT, RIMP, and SPAP in the LT group were significantly increased (P＜0.01 for all). Compared with the control group, the ST group showed a significant increase in RVLS (P＜0.05), while GLS in the LT group was significantly decreased in the ST group and control group (P＜0.05 for both). Compared with the ST group, the MET group (Z=2.416, -2.579; Z=2.254, -3.005; P＜0.05 for both) and ST group (Z=-2.858, -2.825; Z=-3.524, -4.073; P＜0.05 for both) showed a significant decrease in GLS and RVLS at 1 hour and 4 days post-marathon. In intra-group comparisons, GLS at 1 hour post-marathon in both the MET and LT groups, and RVLS at 1 hour post-marathon in the ST, MET, and LT groups were significantly decreased in relative to pre-marathon values (Z=-1.968, -1.966; Z= 2.011, -2.258, 2.026; P＜0.05 for all). Correlation analysis revealed that pre-marathon GLS and RVLS had a correlation with SPAP (r=0.378, 0.325; P＜0.01 for both).

Conclusion

The systolic function of RV free wall of amateur marathon runners increases in the early stage. Runners who have participated in the marathon for a long time have reduced GLS of the RV. There is a temporary post-marathon decrease in the systolic function of the RV free wall.

Key words: Echocardiography, Marathon, Ventricular function, right, Specking tracking imaging

Hebin Zhang, Feng Gao, Zhelan Zheng, Xiaoman Wang, Li Chen, Cunxin Yang, Peipei Hu. Assessment of right ventricular systolic function in amateur marathoners by two-dimensional specking echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(10): 1091-1097.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.10.012

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I10/1091

Figures/Tables 6

组别	例数	心率［次/min，M（P₂₅，P₇₅）］	收缩压［mmHg，M（P₂₅，P₇₅）］	舒张压［mmHg，M（P₂₅，P₇₅）］
统计值 P值		H=66.259 ＜0.001	H=1.138 0.768	H=6.673 0.083
ST组	23	64.00（58.00，67.00）^a	122.0（115.0，127.0）	78.0（68.00，84.80）
MET组	32	54.00（49.00，58.75）^ab	120.0（118.0，127.0）	70.0（68.00，82.00）
LT组	33	53.00（48.00，58.55）^ab	124.0（116.0，128.0）	76.0（69.00，86.60）
对照组	30	71.50（59.00，76.50）	123.0（120.0，129.0）	71.0（68.00，83.00）
组别	例数	身高［cm，M（P₂₅，P₇₅）］	体重［kg，M（P₂₅，P₇₅）］	体质量指数（kg/m²， $x ¯$ ±s）	体表面积（m²， $x ¯$ ±s）
ST组	23	172.0（170.0，175.0）	64.30（60.10，69.50）	22.05±1.61	1.84±0.09
MET组	32	170.0（172.0，175.0）	65.60（60.80，68.70）	23.08±1.69	1.81±0.13
LT组	33	172.0（168.0，175.0）	66.20（63.50，71.50）	22.93±1.53	1.86±0.13
对照组	30	170.0（165.0，174.0）	66.30（60.70，70.90）	22.35±1.53	1.82±0.13
统计值 P值		H=2.154 0.540	H=3.012 0.390	F=2.060 0.109	F=1.139 0.337

组别	例数	心率［次/min，M（P₂₅，P₇₅）］	收缩压［mmHg，M（P₂₅，P₇₅）］	舒张压［mmHg，M（P₂₅，P₇₅）］
统计值 P值		H=66.259 ＜0.001	H=1.138 0.768	H=6.673 0.083
ST组	23	64.00（58.00，67.00）^a	122.0（115.0，127.0）	78.0（68.00，84.80）
MET组	32	54.00（49.00，58.75）^ab	120.0（118.0，127.0）	70.0（68.00，82.00）
LT组	33	53.00（48.00，58.55）^ab	124.0（116.0，128.0）	76.0（69.00，86.60）
对照组	30	71.50（59.00，76.50）	123.0（120.0，129.0）	71.0（68.00，83.00）
组别	例数	身高［cm，M（P₂₅，P₇₅）］	体重［kg，M（P₂₅，P₇₅）］	体质量指数（kg/m²， $x ¯$ ±s）	体表面积（m²， $x ¯$ ±s）
ST组	23	172.0（170.0，175.0）	64.30（60.10，69.50）	22.05±1.61	1.84±0.09
MET组	32	170.0（172.0，175.0）	65.60（60.80，68.70）	23.08±1.69	1.81±0.13
LT组	33	172.0（168.0，175.0）	66.20（63.50，71.50）	22.93±1.53	1.86±0.13
对照组	30	170.0（165.0，174.0）	66.30（60.70，70.90）	22.35±1.53	1.82±0.13
统计值 P值		H=2.154 0.540	H=3.012 0.390	F=2.060 0.109	F=1.139 0.337

组别	例数	TAPSE（mm）	S'（cm/s）	FAC（%）	RIMP［M（P₂₅，P₇₅）］	SPAP（mmHg）
统计值 P值		F=2.993 0.034	F=1.754 0.160	F=1.852 0.142	H=23.570 ＜0.001	F=5.351 0.002
ST组	23	25.24±1.80^a	15.88±2.92	49.54±5.58	0.43（0.39，0.45）	21.65±3.81
MET组	32	24.24±2.25	14.63±3.50	47.46±5.10	0.48（0.46，0.48）^{a b}	24.57±3.97
LT组	33	23.72±2.36^b	14.11±3.68	46.25±5.48	0.49（0.47，0.49）^{a b}	28.17±5.31^{a b}
对照组	30	23.68±1.96	14.55±2.75	47.64±5.20	0.44（0.42，0.44）	20.43±3.11
组别	例数	RVOT（mm）	RVD_basal（mm）	RVD_mid（mm）	RVWT（mm）
ST组	23	26.36±2.43	29.50±2.79	24.93±3.38	3.98±0.45
MET组	32	28.55±3.49^{a b}	33.03±4.73^{a b}	28.28±4.67^{a b}	4.28±0.55^{a b}
LT组	33	30.41±4.01^{a b c}	36.57±5.11^{a b c}	31.79±5.40^{a b c}	4.43±0.58^{a b}
对照组	30	25.85±2.37	28.52±2.74	23.93±2.67	3.96±0.46
统计值 P值		F=13.154 ＜0.001	F=24.207 ＜0.001	F=21.369 ＜0.001	F=6.167 ＜0.001

组别	例数	右心室整体纵向应变（%）			右心室游离壁纵向应变（%）
组别	例数	运动前（ $x ¯$ ±s）	运动后1 h［M（P₂₅，P₇₅）］	运动后第4天［M（P₂₅，P₇₅）］	运动前（ $x ¯$ ±s）	运动后1 h［M（P₂₅，P₇₅）］	运动后第4天［M（P₂₅，P₇₅）］
ST组	23	-25.91±3.20	-24.60（-21.80，-26.90）	-24.98（-22.80，-28.80）	-31.34±3.65^a	-28.90（-26.40，-32.60）^c	-30.50（-28.60，-34.00）
MET组	32	-23.82±2.89^b	-22.00（-21.00，-23.80）^{b c}	-22.75（-21.93，-24.90）^b	-28.86±3.74^b	-26.00（-24.65，-29.70）^{b c}	-27.80（-26.33，-30.65）^b
LT组	33	-23.15±3.03^{a b}	-21.30（-20.65，-22.40）^{b c}	-22.20（-21.10，-23.40）^b	-27.90±3.81^b	-25.70（-23.80，-28.95）^{b c}	-26.90（-25.95，-29.25）^b
对照组	30	-24.68±3.24	-	-	-29.41±3.44	-	-
统计值		F=4.062	H=10.605	H=14.410	F=5.161	H=9.754	H=17.552
P值		0.009	0.005	0.001	0.002	0.008	＜0.001

组别	例数	右心室整体纵向应变（%）			右心室游离壁纵向应变（%）
组别	例数	运动前（ $x ¯$ ±s）	运动后1 h［M（P₂₅，P₇₅）］	运动后第4天［M（P₂₅，P₇₅）］	运动前（ $x ¯$ ±s）	运动后1 h［M（P₂₅，P₇₅）］	运动后第4天［M（P₂₅，P₇₅）］
ST组	23	-25.91±3.20	-24.60（-21.80，-26.90）	-24.98（-22.80，-28.80）	-31.34±3.65^a	-28.90（-26.40，-32.60）^c	-30.50（-28.60，-34.00）
MET组	32	-23.82±2.89^b	-22.00（-21.00，-23.80）^{b c}	-22.75（-21.93，-24.90）^b	-28.86±3.74^b	-26.00（-24.65，-29.70）^{b c}	-27.80（-26.33，-30.65）^b
LT组	33	-23.15±3.03^{a b}	-21.30（-20.65，-22.40）^{b c}	-22.20（-21.10，-23.40）^b	-27.90±3.81^b	-25.70（-23.80，-28.95）^{b c}	-26.90（-25.95，-29.25）^b
对照组	30	-24.68±3.24	-	-	-29.41±3.44	-	-
统计值		F=4.062	H=10.605	H=14.410	F=5.161	H=9.754	H=17.552
P值		0.009	0.005	0.001	0.002	0.008	＜0.001

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