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Athlete's heart in children: exercise-induced right ventricular remodelling in preadolescent athletes.

Session Sports cardiology: adaption or disease

Speaker Assistant Professor Flavio D'Ascenzi

Event : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Sports Cardiology
  • Session type : Moderated Posters

Authors : F D'ascenzi (Siena,IT), M Solari (Siena,IT), A Malandrino (Siena,IT), F Anselmi (Siena,IT), F Valentini (Siena,IT), M Focardi (Siena,IT), M Bonifazi (Siena,IT), S Mondillo (Siena,IT)

F. D'Ascenzi1 , M. Solari1 , A. Malandrino1 , F. Anselmi1 , F. Valentini1 , M. Focardi1 , M. Bonifazi2 , S. Mondillo1 , 1University of Siena, Department of Medical Biotechnologies, Division of Cardiology - Siena - Italy , 2University of Siena, Department of Medicine, Surgery, and NeuroScience - Siena - Italy ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 831

Background: Little is known about the cardiac response of the growing heart to endurance exercise and data from preadolescent athletes are largely missing.

Purpose: The aim of this study was to assess the effect of a 5-month intensive training program on RV morphology and function in preadolescent athletes.

Methods: 57 male competitive swimmers (mean age 10.8±0.2 years) were evaluated by echocardiography just before and after 5 months of intensive training and compared to 37 age- and sex-matched non-athlete subjects evaluated at the same baseline time and after 5 months of natural growth. All subjects were asymptomatic and with negative family history for cardiomyopathies.

Results: At baseline there were no differences between athletes and controls for height, weight, and BSA (p=0.11, p=0.94, p=0.45, respectively). Athletes had a lower resting heart rate as compared to controls (72±9 vs. 77±12 bpm, p<0.05) and a further decrease was observed after training (67±9 bpm, p<0.0001). At baseline no differences were found between athletes and controls for indexed RV outflow tract (RVOT) (18.5±2.7 vs. 16.8±5.0 mm/m2, p=0.18) and RV basal end-diastolic diameter (EDD) (24.9±4.1 vs. 23.6±3.0 mm/m2, p=0.15). After 5 months, indexed RVOT1 and RV basal EDD significantly increased in athletes (20.2±2.9 mm/m2 and 25.4±3.3 mm/m2, p<0.0001 vs. baseline) while no differences were observed in controls (p=0.84 and p=0.25). Neither athletes nor controls exhibited changes in RV fractional area change, although the former had a lower value as compared to the latter (42.9±7.5 vs. 48.6±8.2%, p=0.007). The s' value did not differ between athletes and controls, neither at baseline nor after 5 months (p=0.75 and p=0.79). RV global longitudinal strain did not differ between athletes and controls at baseline (-29.2±5.8 vs. -31.6±7.0%, p=0.063) and did not change after 5 months, neither in athletes nor in controls (p=0.28 and p=0.33, respectively).

Conclusions: RV physiologic remodelling occurs in the early phases of the sports career, as shown by the additive growth of RV size observed in preadolescent subject engaged in endurance training. RV enlargement occurs in absence of loss of function. Therefore, in children engaged in endurance sports the increase in RV dimensions associated with normal RV function should be considered as early physiological expression of the athlete's heart.

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