Right Ventricular Structure and Function in Adolescent Athletes: A 3D Echocardiographic Study

Ujvári, Adrienn and Fábián, Alexandra and Lakatos, Bálint and Tokodi, Márton and Ladányi, Zsuzsanna and Sydó, Nóra and Csulak, Emese and Vágó, Hajnalka and Juhász, Vencel and Grebur, Kinga and Szűcs, Andrea and Zámodics, Márk and Babity, Máté and Kiss, Orsolya and Merkely, Béla and Kovács, Attila (2024) Right Ventricular Structure and Function in Adolescent Athletes: A 3D Echocardiographic Study. International Journal of Sports Medicine, 45 (06). pp. 473-480. ISSN 0172-4622

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Abstract

The aim of this study was to characterize the right ventricular (RV) contraction pattern and its associations with exercise capacity in a large cohort of adolescent athletes using resting three-dimensional echocardiography (3DE). We enrolled 215 adolescent athletes (16±1 years, 169 males, 12±6 hours of training/week) and compared them to 38 age and sex-matched healthy, sedentary adolescents. We measured the 3DE-derived biventricular ejection fractions (EF). We also determined the relative contributions of longitudinal EF (LEF/RVEF) and radial EF (REF/RVEF) to the RVEF. Same-day cardiopulmonary exercise testing was performed to calculate VO2/kg. Both LV and RVEFs were significantly lower (athletes vs. controls; LVEF: 57±4 vs 61±3, RVEF: 55±5 vs 60±5%, p<0.001). Interestingly, while the relative contribution of radial shortening to the global RV EF was also reduced (REF/RVEF: 0.40±0.10 vs 0.49±0.06, p<0.001), the contribution of the longitudinal contraction was significantly higher in athletes (LEF/RVEF: 0.45±0.08 vs 0.40±0.07, p<0.01). The supernormal longitudinal shortening correlated weakly with a higher VO2/kg (r=0.138, P=0.044). Similarly to the adult athlete’s heart, the cardiac adaptation of adolescent athletes comprises higher biventricular volumes and lower resting functional measures with supernormal RV longitudinal shortening. Characteristic exercise-induced structural and functional cardiac changes are already present in adolescence.

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