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164 The effect of endurance exercise on right ventricular morphology in female master athletes
  1. Uchenna Ozo1,
  2. Stathis Papatheodorou2,
  3. Charlotte Mahoney3,
  4. Zephryn Fanton4,
  5. Paulo Bulleros4,
  6. Michael Papadakis4,
  7. Sanjay Sharma4
  1. 1Cardiology Clinical Academic Group, St. George’s University Hospitals NHS Foundation Trust, London, UK
  2. 2Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Greece
  3. 3St Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health
  4. 4St George’s Hospital, London


Objectives To investigate the effect of lifelong exercise on right heart size and function in a large group of female master athletes.

Background The benefits of moderate exercise are well known, however several studies have raised concerns about the association between excessive endurance exercise and adverse right ventricular (RV) cardiac remodelling.During exercise the RV undergoes a dramatic increase in preload leading to a 30-fold increase in RV wall stress. Critically, the reduction in pulmonary vascular resistance pales in comparison to that of systemic resistance leading to an exponential increase in pulmonary artery pressure. Subsequently, intensive endurance exercise has been associated with transient RV dilatation and systolic dysfunction. Furthermore, animal studies and several small cohorts of seemingly healthy predominately male endurance athletes have suggested that repetitive intensive exercise leads to an increased prevalence of right ventricular dysfunction. Few large studies have specifically assessed right heart morphology and function in lifelong female master athletes (>40 years old).

Methods 173 apparently healthy and asymptomatic female master athletes (mean age 55.1 ± 7.4 years) underwent echocardiography using conventional planes as recommended by the British Society of Echocardiography. Athletes exercised >6 hours a week for at least 10 consecutive years. The results were compared to 43 sedentary age matched controls who exercised less than 3 hours per week (table 1).

Results Female master athletes demonstrated significantly increased absolute and indexed right ventricular dimensions compared to sedentary controls, with the greatest increases in basal and longitudinal measurements. Athletes also demonstrated a significantly larger right atrial area. Athletes had increased longitudinal RV systolic function based on TAPSE. There was no significant difference in RV fractional area change between athletes and controls. None of the study group revealed regional wall motional abnormalities or dyskinetic RV segments (table 2).

Abstract 164 Table 1

Demographics of female athetes and controls

Abstract 164 Table 2

Right heart dimensions and function assessed by 2D echocardiography in female master athletes compared to healthy sedentary controls

Conclusions Female master athletes continue to demonstrate echocardiographic features of cardiac adaptation into their later years. Chronic endurance exercise is associated with increased right heart size, but no obvious evidence features of arrhythmogenic right ventricular cardiomyopathy. Larger studies including cardiac magnetic resonance scanning for fibrosis and cardiac monitoring are required to identify potential subclinical features of adverse RV remodelling.

Conflict of Interest None

  • Sports Cardiology
  • Master Athletes
  • Athlete’s Heart

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