CARDIAC REMODELING IN RUGBY AND FOOTBALL LINE PLAYERS IS ASSOCIATED WITH BOTH SUBCLINICAL SYSTOLIC AND DIASTOLIC DYSFUNCTION

Abstract

BackgroundAmerican style football player linemen are known to develop hypertension and concentric cardiac remodeling during training. It is unclear whether such cardiac remodeling is linked to hypertension or to the development of an athlete’s heart. The goal of this study was to demonstrate whether such cardiac remodeling was associated or not with subclinical cardiac dysfunction.MethodsForty-two line position athletes (25 male football players, 9 female rugby players and 8 male rugby players) were scanned using a Vivid q echo machine (General Electrics). For each participant, left ventricle mass, systolic function (ejection fraction (Simpson method), longitudinal strain imaging, intraventricular pressure gradient) and diastolic function (diastolic longitudinal strain rate and intraventricular vortex size) were assessed. The intracardiac pressure gradients were estimated by processing color M-mode Doppler data using the Euler equation of fluid dynamics and indexed (i) by the systolic arterial pressure of the participant. Vortex size was assessed by post-processing a 3-chamber color Doppler image using our own algorhythm in Matlab and expressed as (vortex surface x 100)/(LV surface). These echo data were compared to clinical characteristics: blood pressure, weight, medical history and past and current training.ResultsAmong female rugby players, only one was diagnosed with pre-hypertension while 85% of the male players had either pre- or confirmed hypertension (P = 0.0001). Increased LV mass was significantly associated with hypertension status (P=0.01) but unrelated to past or current training load. Decrease in both systolic and diastolic function were significantly associated with an increase in LV mass: longitudinal strain R=-0.4, P=0.01; intraventricular pressure gradient R=-0.6, P<0.001 (see figure); longitudinal diastolic strain rate R=-0.5, P=0.003 and vortex size R=-0.3, P=0.04Conclusion BackgroundAmerican style football player linemen are known to develop hypertension and concentric cardiac remodeling during training. It is unclear whether such cardiac remodeling is linked to hypertension or to the development of an athlete’s heart. The goal of this study was to demonstrate whether such cardiac remodeling was associated or not with subclinical cardiac dysfunction. American style football player linemen are known to develop hypertension and concentric cardiac remodeling during training. It is unclear whether such cardiac remodeling is linked to hypertension or to the development of an athlete’s heart. The goal of this study was to demonstrate whether such cardiac remodeling was associated or not with subclinical cardiac dysfunction. MethodsForty-two line position athletes (25 male football players, 9 female rugby players and 8 male rugby players) were scanned using a Vivid q echo machine (General Electrics). For each participant, left ventricle mass, systolic function (ejection fraction (Simpson method), longitudinal strain imaging, intraventricular pressure gradient) and diastolic function (diastolic longitudinal strain rate and intraventricular vortex size) were assessed. The intracardiac pressure gradients were estimated by processing color M-mode Doppler data using the Euler equation of fluid dynamics and indexed (i) by the systolic arterial pressure of the participant. Vortex size was assessed by post-processing a 3-chamber color Doppler image using our own algorhythm in Matlab and expressed as (vortex surface x 100)/(LV surface). These echo data were compared to clinical characteristics: blood pressure, weight, medical history and past and current training. Forty-two line position athletes (25 male football players, 9 female rugby players and 8 male rugby players) were scanned using a Vivid q echo machine (General Electrics). For each participant, left ventricle mass, systolic function (ejection fraction (Simpson method), longitudinal strain imaging, intraventricular pressure gradient) and diastolic function (diastolic longitudinal strain rate and intraventricular vortex size) were assessed. The intracardiac pressure gradients were estimated by processing color M-mode Doppler data using the Euler equation of fluid dynamics and indexed (i) by the systolic arterial pressure of the participant. Vortex size was assessed by post-processing a 3-chamber color Doppler image using our own algorhythm in Matlab and expressed as (vortex surface x 100)/(LV surface). These echo data were compared to clinical characteristics: blood pressure, weight, medical history and past and current training. ResultsAmong female rugby players, only one was diagnosed with pre-hypertension while 85% of the male players had either pre- or confirmed hypertension (P = 0.0001). Increased LV mass was significantly associated with hypertension status (P=0.01) but unrelated to past or current training load. Decrease in both systolic and diastolic function were significantly associated with an increase in LV mass: longitudinal strain R=-0.4, P=0.01; intraventricular pressure gradient R=-0.6, P<0.001 (see figure); longitudinal diastolic strain rate R=-0.5, P=0.003 and vortex size R=-0.3, P=0.04 Among female rugby players, only one was diagnosed with pre-hypertension while 85% of the male players had either pre- or confirmed hypertension (P = 0.0001). Increased LV mass was significantly associated with hypertension status (P=0.01) but unrelated to past or current training load. Decrease in both systolic and diastolic function were significantly associated with an increase in LV mass: longitudinal strain R=-0.4, P=0.01; intraventricular pressure gradient R=-0.6, P<0.001 (see figure); longitudinal diastolic strain rate R=-0.5, P=0.003 and vortex size R=-0.3, P=0.04 Conclusion