Effect of recreational exercise and fitness on left ventricular torsion and wall mechanics study (FIT-TWIST/Health)

Abstract

Abstract Background Left ventricular (LV) remodeling is associated with elite athletics. This study aimed to assess the effects of recreational exercise on LV remodeling and mechanics in healthy adults. Methods A prospective cross-sectional study evaluated 38 healthy adult recreational exercise participants with a Bruce protocol treadmill exercise stress test, and 2D and speckle-tracking echocardiography. Fitness level was stratified by the achieved age- and sex-predicted metabolic equivalents (METS) as average/good (group A, N=20; METS=13.9) and high (group B, N=18; METS=18.2) groups. Results Mean age was 33 years, and 58% were female. Participants in Group B used more multi-modality (67 vs 20%; p=0.008) or running (50% vs 15%; p=0.04) exercise regimens, and had larger LV mass (66 vs 56 g/m2; p=0.05) and left atrial volume indices (28 vs 22 ml/m2; p=0.02), when compared with group A. However, all LV strain and torsion mechanics were similar between groups (Figure). Multivariate linear regression analysis revealed independent associations between global longitudinal strain (GLS) and transmitral E-wave (β=−0.57), maximum systolic blood pressure (β=0.32), and LV end-diastolic volume index (β=0.32) (model r=0.72; p<0.001). No correlation between METS achieved and LV parameters was observed. Conclusion Recreational exercise and fitness are associated with healthy LV geometry and mechanics in adults. Early diastolic LV filling, LV chamber size, and peak exercise blood pressure are correlated with GLS. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Florida Heart Research Foundation