Remodelagem cardíaca induzida pelo exercício físico em atletas de nível competitivo e militares de forças especiais

Abstract

IntroductionExercise‐induced cardiac remodeling is frequent in athletes. This adaptation is structurally manifested by an increase in cardiac dimensions and mass. Soldiers are also subject to intense physical exercise, although with different characteristics. ObjectiveTo compare exercise‐induced cardiac remodeling in competitive athletes and in soldiers on a special forces training course. MethodsWe studied 17 soldiers (all male and Caucasian, mean age 21±3 years) who completed a special forces course and 17 basketball players (47.3% male, 64.7% Caucasian, mean age 21±3 years). Assessment included a transthoracic echocardiogram and analysis of myocardial mechanics. This assessment was performed at the beginning and end of the military course and the sports season, respectively. ResultsCardiac remodeling was observed in both groups. The soldiers presented a predominantly eccentric pattern, with increased left ventricular (LV) size (49.7±3.2 vs. 52.8±3.4 mm; p<0.01), increased LV mass (93.1±7.7 vs. 100.2±11.4 g/m2; p<0.01) and decreased relative wall thickness (0.40±0.1 vs. 0.36±0.1; p=0.05). The basketball players showed a concentric pattern, with decreased LV size (52.0±4.7 vs. 50.4±4.7 mm; p=0.05), and increased relative wall thickness (0.33±0.1 vs. 0.36±0.1; p=0.05). Although there was no significant difference in LV myocardial strain in the groups separately, when compared there was a significant decrease (‐20.2±1.6% vs. ‐19.4±2.1%; p=0.03). ConclusionCardiac remodeling was frequent, with an eccentric pattern in soldiers and a concentric pattern in basketball players. Myocardial deformation may represent a physiological adaptation to physical exercise.