Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load
The beneficial impact of regular physical activity on cardiovascular health is well established. However, the ideal amount of exercise required to provide these benefits is not well defined, with some recent reports showing no further cardiovascular benefits and even detrimental effects when perform...
| Autor: | |
|---|---|
| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2017 |
| País: | España |
| Institución: | CBUC, CESCA |
| Repositorio: | TDR. Tesis Doctorales en Red |
| OAI Identifier: | oai:www.tdx.cat:10803/585889 |
| Acceso en línea: | http://hdl.handle.net/10803/585889 |
| Access Level: | acceso abierto |
| Palabra clave: | Sistema cardiovascular Cardiovascular system Condició física Condición física Physical fitness Exercici Ejercicio físico Exercise Ventricles cardíacs Ventrículos cardíacos Ventricle of heart Gènere Género Gender Ciències de la Salut 61 |
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España |
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| dc.title.none.fl_str_mv |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| title |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| spellingShingle |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load Sanz de la Garza, María Sistema cardiovascular Cardiovascular system Condició física Condición física Physical fitness Exercici Ejercicio físico Exercise Ventricles cardíacs Ventrículos cardíacos Ventricle of heart Gènere Género Gender Ciències de la Salut 61 |
| title_short |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| title_full |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| title_fullStr |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| title_full_unstemmed |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| title_sort |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training load |
| dc.creator.none.fl_str_mv |
Sanz de la Garza, María |
| author |
Sanz de la Garza, María |
| author_facet |
Sanz de la Garza, María |
| author_role |
author |
| dc.contributor.none.fl_str_mv |
Sitges Carreño, Marta Universitat de Barcelona. Facultat de Medicina |
| dc.subject.none.fl_str_mv |
Sistema cardiovascular Cardiovascular system Condició física Condición física Physical fitness Exercici Ejercicio físico Exercise Ventricles cardíacs Ventrículos cardíacos Ventricle of heart Gènere Género Gender Ciències de la Salut 61 |
| topic |
Sistema cardiovascular Cardiovascular system Condició física Condición física Physical fitness Exercici Ejercicio físico Exercise Ventricles cardíacs Ventrículos cardíacos Ventricle of heart Gènere Género Gender Ciències de la Salut 61 |
| description |
The beneficial impact of regular physical activity on cardiovascular health is well established. However, the ideal amount of exercise required to provide these benefits is not well defined, with some recent reports showing no further cardiovascular benefits and even detrimental effects when performing exercise with high training loads, particularly for endurance sports disciplines. Indeed, during the last two decades, an increasing amount of data has related high endurance training loads with an increased susceptibility for atrial arrhythmias as well as with a detrimental right ventricle remodelling. In our study, we analysed structural and functional acute changes after an endurance race at three different distances and demonstrated a dose-response relationship between endurance exercise “doses” and acute impairment in right ventricular (RV) and atrial performance without left ventricle involvement. However, high interindividual variability was observed between participants performing the same amount of exercise. We identified different patterns of RV and atrial adaptation to exercise and highlighted RV diastolic dysfunction at rest as a potential early sign of RV maladaptation to exercise. Although we could not determine if these acute RV and atrial changes induced by a bout of endurance exercise would persist or are reversible, our experimental model of long-term endurance exercise showing impairment in RV performance promoted by very high endurance training loads suggested that, independently of individual factors, there is a threshold for safe exercise, determined by both intensity and duration, beyond which cardiac adaptation might be no longer benign but become deleterious. Additionally, we observed that the RV segments showed different adaptations to exercise, with the basal segment playing the major role in increasing stroke volume during exercise but also, due to its thinner wall and bigger cavity, being more vulnerable to the exercise-induced high wall stress, compared to the RV apex. Finally, we showed that long-term endurance training promoted a similar cardiac remodelling in both men and women. However, male athletes had larger right heart cavities and lower atrial and ventricular deformation values, compared to female athletes. These results imply that the right heart cavities of male athletes work under different conditions in maintaining RV and atrial stroke volume, with larger volumes and lower myocardial deformation. Thus, they are provided with an enhanced functional reserve during exercise but also work with increased atrial and RV wall stress. The mechanism underlying these gender-related differences in atrial and RV remodelling in response to exercise and the clinical significance of the findings warrant further investigation |
| publishDate |
2017 |
| dc.date.none.fl_str_mv |
2017 2018 2018 |
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info:eu-repo/semantics/doctoralThesis info:eu-repo/semantics/publishedVersion |
| format |
doctoralThesis |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10803/585889 |
| url |
http://hdl.handle.net/10803/585889 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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147 p. application/pdf application/pdf |
| dc.publisher.none.fl_str_mv |
Universitat de Barcelona |
| publisher.none.fl_str_mv |
Universitat de Barcelona |
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TDX (Tesis Doctorals en Xarxa) reponame:TDR. Tesis Doctorales en Red instname:CBUC, CESCA |
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CBUC, CESCA |
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TDR. Tesis Doctorales en Red |
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TDR. Tesis Doctorales en Red |
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|
| repository.mail.fl_str_mv |
|
| _version_ |
1869403621373771776 |
| spelling |
Characterization of the spectrum of cardiac adaptation to endurance exercise: Impact of gender and training loadSanz de la Garza, MaríaSistema cardiovascularCardiovascular systemCondició físicaCondición físicaPhysical fitnessExerciciEjercicio físicoExerciseVentricles cardíacsVentrículos cardíacosVentricle of heartGènereGéneroGenderCiències de la Salut61The beneficial impact of regular physical activity on cardiovascular health is well established. However, the ideal amount of exercise required to provide these benefits is not well defined, with some recent reports showing no further cardiovascular benefits and even detrimental effects when performing exercise with high training loads, particularly for endurance sports disciplines. Indeed, during the last two decades, an increasing amount of data has related high endurance training loads with an increased susceptibility for atrial arrhythmias as well as with a detrimental right ventricle remodelling. In our study, we analysed structural and functional acute changes after an endurance race at three different distances and demonstrated a dose-response relationship between endurance exercise “doses” and acute impairment in right ventricular (RV) and atrial performance without left ventricle involvement. However, high interindividual variability was observed between participants performing the same amount of exercise. We identified different patterns of RV and atrial adaptation to exercise and highlighted RV diastolic dysfunction at rest as a potential early sign of RV maladaptation to exercise. Although we could not determine if these acute RV and atrial changes induced by a bout of endurance exercise would persist or are reversible, our experimental model of long-term endurance exercise showing impairment in RV performance promoted by very high endurance training loads suggested that, independently of individual factors, there is a threshold for safe exercise, determined by both intensity and duration, beyond which cardiac adaptation might be no longer benign but become deleterious. Additionally, we observed that the RV segments showed different adaptations to exercise, with the basal segment playing the major role in increasing stroke volume during exercise but also, due to its thinner wall and bigger cavity, being more vulnerable to the exercise-induced high wall stress, compared to the RV apex. Finally, we showed that long-term endurance training promoted a similar cardiac remodelling in both men and women. However, male athletes had larger right heart cavities and lower atrial and ventricular deformation values, compared to female athletes. These results imply that the right heart cavities of male athletes work under different conditions in maintaining RV and atrial stroke volume, with larger volumes and lower myocardial deformation. Thus, they are provided with an enhanced functional reserve during exercise but also work with increased atrial and RV wall stress. The mechanism underlying these gender-related differences in atrial and RV remodelling in response to exercise and the clinical significance of the findings warrant further investigationLos efectos beneficiosos de la actividad física regular sobre la salud cardiovascular son incuestionables. Sin embargo, la cantidad óptima de ejercicio para proporcionar estos beneficios no está aún bien establecida, sugiriéndose que altas cargas de entrenamiento podrían llegar incluso a tener efectos deletéreos. De hecho, varias publicaciones han relacionado el entrenamiento de resistencia con una mayor susceptibilidad a arritmias auriculares y con un remodelado patológico del ventrículo derecho (VD). En el presente estudio, analizamos los cambios agudos experimentados por el corazón tras la realización de una carrera de resistencia con tres distancias distintas y demostramos una relación dosis- respuesta entre el empeoramiento en el funcionamiento del VD y las aurículas y la carga de ejercicio realizada. Sin embargo, objetivamos una gran variabilidad inter-individual entre participantes que ejecutaron la misma carga de ejercicio. Identificamos distintos patrones de adaptación del VD y las aurículas al ejercicio de resistencia y señalamos como la disfunción diastólica del VD en reposo podría ser un signo incipiente de mala adaptación al ejercicio. Aunque no pudimos determinar la persistencia o temporalidad de estos cambios, nuestro modelo experimental demostró un empeoramiento de la funcionalidad del VD inducida por el entrenamiento de resistencia, sugiriendo que, independientemente de factores individuales, hay un verdadero límite para la práctica deportiva segura, determinado por la intensidad y la duración, a partir del cual la adaptación cardíaca al ejercicio podría pasar de fisiológica a patológica. Por otra parte, observamos que los segmentos del VD muestran diferentes adaptaciones al ejercicio, siendo el basal el que juega un mayor papel en el aumento del volumen latido durante el ejercicio, pero también el más vulnerable al estrés de pared inducido por el ejercicio. Finalmente, objetivamos que el entrenamiento de resistencia indujo un remodelado cardiaco similar en ambos géneros. Sin embargo, los varones mostraron cavidades derechos mayores y menores valores de deformación miocárdica tanto a nivel ventricular como auricular que las mujeres. Estos hallazgos sugieren que las cavidades cardiacas derechas de los hombres deportistas, trabajan en condiciones diferentes para mantener el volumen latido, con volúmenes mayores y menor deformación; lo cual implica una reserva funcional aumentada durante la práctica de ejercicio pero también un mayor estrés de pared auricular y ventricular.Universitat de BarcelonaSitges Carreño, MartaUniversitat de Barcelona. Facultat de Medicina201820182017info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion147 p.application/pdfapplication/pdfhttp://hdl.handle.net/10803/585889TDX (Tesis Doctorals en Xarxa)reponame:TDR. Tesis Doctorales en Redinstname:CBUC, CESCAInglésADVERTIMENT. L'accés als continguts d'aquesta tesi doctoral i la seva utilització ha de respectar els drets de la persona autora. Pot ser utilitzada per a consulta o estudi personal, així com en activitats o materials d'investigació i docència en els termes establerts a l'art. 32 del Text Refós de la Llei de Propietat Intel·lectual (RDL 1/1996). Per altres utilitzacions es requereix l'autorització prèvia i expressa de la persona autora. En qualsevol cas, en la utilització dels seus continguts caldrà indicar de forma clara el nom i cognoms de la persona autora i el títol de la tesi doctoral. No s'autoritza la seva reproducció o altres formes d'explotació efectuades amb finalitats de lucre ni la seva comunicació pública des d'un lloc aliè al servei TDX. Tampoc s'autoritza la presentació del seu contingut en una finestra o marc aliè a TDX (framing). Aquesta reserva de drets afecta tant als continguts de la tesi com als seus resums i índexs.info:eu-repo/semantics/openAccessoai:www.tdx.cat:10803/5858892026-06-14T12:46:07Z |
| score |
15,301603 |