Prolonged strenuous exercise alters the cardiovascular response to dobutamine stimulation in male athletes

Abstract

Prolonged strenuous exercise has been associated with transient impairment in left ventricular (LV) systolic and diastolic function that has been termed 'cardiac fatigue'. It has been postulated that cardiac beta-adrenoreceptor desensitization may play a central role; however, data are limited. Accordingly, we assessed the cardiovascular response to progressive dobutamine stimulation after prolonged strenuous exercise (2 km swim, 90 km bike, 21 km run). Nine experienced male athletes were studied: PRE (2-3 days before), POST (after) and REC (1-2 days later). The cardiovascular response to progressive continuous dobutamine stimulation (0, 5, 20, and 40 microg kg(-1) min(-1)) was assessed, including heart rate (HR), systolic blood pressure (SBP), LV cavity areas (two-dimensional echocardiography) and contractility (end-systolic elastance, SBP/end-systolic cavity area (ESCA)). POST there was limited evidence of myocardial necrosis (measured by troponin I), while catecholamines were elevated. HR was higher POST (mean +/-s.d.; PRE, 58 +/- 9; POST, 79 +/- 9; REC, 57 +/- 7 beats min(-1); P < 0.05), while SBP was lower (PRE, 127 +/- 15; POST, 116 +/- 9; REC, 121 +/- 12 mmHg; P < 0.05). A blunted HR, SBP and LV contractility (SBP/ESCA; PRE 29 +/- 6 versus POST 20 +/- 6 mmHg cm(-2); P < 0.05) response to dobutamine was demonstrated POST, with values returning towards baseline in REC. Following prolonged strenuous exercise, the chronotropic and inotropic response to dobutamine stimulation is blunted. This study supports the hypothesis that beta-receptor downregulation and/or desensitization may play a major role in prolonged-strenuous-exercise-mediated cardiac fatigue.