Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans

George, K; Oxborough, D; Forster, J; Whyte, G; Shave, R; Dawson, E; Stephenson, C; Dugdill, L; Edwards, B; Gaze, D

Abstract

We assessed segmental and global left ventricular (LV) diastolic function via tissue-Doppler
imaging (TDI) as well as Doppler flow variables before and after a marathon race to extend
our knowledge of exercise-induced changes in cardiac function. Twenty-nine subjects (age
18–62 year) volunteered to participate and were assessed pre- and post-race. Measurements of
longitudinal plane TDImyocardial diastolic velocities at five sites on the mitral annulus included
peak early myocardial tissue velocity (E), peak late (or atrial) myocardial tissue velocity (A)
and the ratio E/A. Standard pulsed-wave Doppler transmitral and pulmonary vein flow indices
were also recorded along with measurements of body mass, heart rate, blood pressures and
cardiac troponin T (cTnT), a biomarker of myocyte damage. Pre- to post-race changes in LV
diastolic function were analysed by repeated measures ANOVA. Delta scores for LV diastolic
function were correlated with each other and alterations in indices of LV loading. Diastolic
longitudinal segmental and mean TDI data were altered post-race such that the mean E/A ratio
was significantly depressed (1.51±0.34 to 1.16±0.35, P <0.05). Changes in segmental and
global TDI data were not related to an elevated post-race HR, a decreased post-race pre-load
or an elevated cTnT. The pulsed wave Doppler ratio of peak early transmitral flow velocity
(E)/peak late (or atrial) flow velocity (A) was also significantly reduced post-race (1.75±0.46 to
1.05±0.30, P <0.05); however, it was significantly correlated with post-race changes in heart
rate. The lack of change in E/E from pre- to post-race (3.4±0.8 and 3.3±0.7, respectively)
suggests that the depression in diastolic function is likely to be due to altered relaxation of the
left ventricle; however, the exact aetiology of this change remains to be determined.

Citation

George, K., Oxborough, D., Forster, J., Whyte, G., Shave, R., Dawson, E., …Gaze, D. (2005). Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans. Journal of Physiology, 569, 305-313. https://doi.org/10.1113/jphysiol.2005.095588

• Journal Article Type: Article
• Publication Date: Nov 1, 2005
• Deposit Date: Feb 26, 2010
• Journal: The Journal of Physiology
• Print ISSN: 0022-3751
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 569
• Pages: 305-313
• DOI: https://doi.org/10.1113/jphysiol.2005.095588
• Publisher URL: http://dx.doi.org/10.1113/jphysiol.2005.095588