Left ventricular remodeling in rugby is a physiological adaptation to exercise: a pilot study conducted with high-level athletes

Nuno Dias Rato,Joanna Richards

doi:10.1007/s11332-021-00815-x

Abstract

PurposeLiterature examining left ventricular (LV) structural adaptations to combined strength and endurance training is inconsistent. Rugby is a sport that combines these two exercise modalities, both during training and match play. This study aimed to explore differences in LV structure between high-level rugby players and untrained controls. Body composition analysis was performed to determine the most appropriate indexing variable for LV mass (LVM) and understand if increases in LV represent either a training-related physiological adaptation or reflect the groups’ anthropometric differences.MethodsA cross-sectional design compared 10 rugby players and 10 untrained age-matched, male controls. Body composition was obtained by bioelectrical impedance. M-mode echocardiographic imaging was performed on the LV from the parasternal long axis view.ResultsSignificantly greater end-diastolic interventricular septum, LV internal diameter, posterior wall thickness, LVM and LVM/fat-free mass (FFM) (p < 0.05) were found in rugby players compared to age-matched controls. Moreover, Pearson’s correlation tests revealed FFM to be the body composition variable with the strongest correlation to LVM (r = 0.775, p < 0.001).ConclusionThe differences in LV structure between groups suggest that the combined endurance and strength training that rugby athletes are subjected to, induce a process of concentric and eccentric enlargement of the LV structure. Furthermore, the association found with FFM, suggests it to be the most appropriate body scaling variable to index to LVM and, thus, should be considered when describing increases in LVM. The present research suggests that increased LVM in the athletes group represents true physiological adaptations to training.

Highlights

The term “Athletes Heart” has been used to define the electrical, structural and functional myocardial adaptations promoted by frequent intensive physical training [1]
Athletes participating in endurance sports have previously been shown to undergo a process of eccentric hypertrophy of the cardiac muscle which is characterized by a greater left ventricle (LV) internal diameter (LVID) in diastole [8]
body surface area (BSA) and fat-free mass (FFM), LV mass (LVM) was still significantly greater (p < 0.05) in the athletesgroup compared to controls

Summary

Introduction

The term “Athletes Heart” has been used to define the electrical, structural and functional myocardial adaptations promoted by frequent intensive physical training [1]. These changes are known to affect the four cardiac chambers [2, 3]; changes in the left ventricle (LV) are more clearly and consistently described in the literature [3]. In strength-trained athletes, the increased LVM is mainly attributed to increased LV walls thickness, a process denominated concentric enlargement [8]. Pluim et al [3] proposed that the heart walls thicken with weight lifting to cope with the exaggerated blood pressure induced by this type of exercise

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