Acute exercise-induced changes in cardiac function relates to right ventricular remodeling following 12-wk hypoxic exercise training.
Geert Kleinnibbelink, Arie P J van Dijk, Alessandro Fornasiero, Guilherme F Speretta, Christopher Johnson, Nicholas Sculthorpe, Keith P George, John D Somauroo, Dick H J Thijssen, David L Oxborough
Author Information
Geert Kleinnibbelink: Department of Physiology, Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. ORCID
Arie P J van Dijk: Department of Physiology, Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. ORCID
Alessandro Fornasiero: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Guilherme F Speretta: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom. ORCID
Christopher Johnson: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Nicholas Sculthorpe: Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Hamilton, United Kingdom. ORCID
Keith P George: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
John D Somauroo: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Dick H J Thijssen: Department of Physiology, Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
David L Oxborough: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Repeated ventricular exposure to alterations in workload may relate to subsequent cardiac remodeling. We examined whether baseline acute changes in right (RV) and left ventricular (LV) function relate to chronic cardiac adaptation to 12-wk exercise training. Twenty-one healthy individuals performed 12-wk high-intensity endurance running training under hypoxia (fraction of inspired oxygen: 14.5%). Resting transthoracic echocardiography was performed before and after the training program to assess ventricular structure, function, and mechanics (including strain-area/volume loops). In addition, we examined systolic cardiac function during recumbent exercise under hypoxia at baseline (heart rate of 110-120 beats/min, "stress echocardiography"). Fifteen individuals completed training (22.0 ± 2.4 yr, 10 males). Hypoxic exercise training increased RV size, including diameter and area (all < 0.05). With exception of an increase in RV fractional area change ( = 0.03), RV function did not change post-training (all > 0.05). Regarding the RV strain-area loop, lower systolic and diastolic slopes were found post-training ( < 0.05). No adaptation in LV structure, function, or mechanics was observed (all > 0.05). To answer our primary aim, we found that a greater increase in RV fractional area change during baseline stress echocardiography ( = -0.67, = 0.01) inversely correlated with adaptation in RV basal diameter following 12-wk training. In conclusion, 12-wk high-intensity running hypoxic exercise training induced right-sided structural remodeling, which was, in part, related to baseline increase in RV fractional area change to acute exercise. These data suggest that acute cardiac responses to exercise may relate to subsequent RV remodeling after exercise training in healthy individuals. During exercise, the right ventricle is exposed to a disproportionally higher wall stress than the left ventricle, which is further exaggerated under hypoxia. In this study, we showed that 12-wk high-intensity running hypoxic exercise training induced right-sided structural remodeling, which was, in part, related to baseline cardiac increase in RV fractional area change to acute exercise. These data suggest that acute RV responses to exercise are related to subsequent right ventricular remodeling in healthy individuals upon hypoxic training.
