Exercise echocardiography for improved assessment of diastolic filling dynamics

Abstract During exercise stress, heart rate (HR) increases to support cardiac output, which also reduces ventricular filling time. Although echocardiography is widely used to assess cardiac function, studies display conflicting data on the dynamic changes in the healthy trained and untrained heart d...

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Main Authors: Mads Fischer, Thomas Bonne, Magnus Bak Klaris, Emil Lenzing, Eric J. Stöhr, Jacob Bejder, Carsten Lundby, Nikolai B. Nordsborg, Lars Nybo
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Experimental Physiology
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Online Access:https://doi.org/10.1113/EP092177
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author Mads Fischer
Thomas Bonne
Magnus Bak Klaris
Emil Lenzing
Eric J. Stöhr
Jacob Bejder
Carsten Lundby
Nikolai B. Nordsborg
Lars Nybo
author_facet Mads Fischer
Thomas Bonne
Magnus Bak Klaris
Emil Lenzing
Eric J. Stöhr
Jacob Bejder
Carsten Lundby
Nikolai B. Nordsborg
Lars Nybo
author_sort Mads Fischer
collection DOAJ
description Abstract During exercise stress, heart rate (HR) increases to support cardiac output, which also reduces ventricular filling time. Although echocardiography is widely used to assess cardiac function, studies display conflicting data on the dynamic changes in the healthy trained and untrained heart during rest and acute exercise stress. To address these discrepancies, we tested a new echocardiography exercise protocol on two groups with significant differences in cardiorespiratory fitness. Ten untrained individuals with maximal oxygen uptake of 38 ± 8 ml/kg/min and 10 endurance‐trained athletes matched for body surface area but with higher maximal oxygen uptake (71 ± 5 ml/kg/min) were evaluated at rest, during semi‐recumbent cycling at 25 and 75 W and at a relative workload intensity eliciting a HR of 140 beats/min (HR140). Stroke volume was 36% higher in the trained at rest, and this difference increased during exercise to 42% at 25 W, 46% at 75 W and 63% at HR140 (all P < 0.05). In contrast, no group differences were found in markers of myocardial function (ventricular contraction and relaxation velocities) or other traditional echocardiographic measures of ventricular function at rest or exercise for a given HR. However, while similar at rest, diastolic and systolic function provided limited insight into differences between less fit and highly fit individuals. The new exercise echocardiography protocol improves the ability to uncover differences in dynamic changes in diastolic filling capacity that explain the previously reported higher end‐diastolic compliance in endurance‐trained athletes.
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spelling doaj-art-db3b6f2d525646098ae2b8cef05e51282025-08-20T01:58:11ZengWileyExperimental Physiology0958-06701469-445X2025-06-01110680982010.1113/EP092177Exercise echocardiography for improved assessment of diastolic filling dynamicsMads Fischer0Thomas Bonne1Magnus Bak Klaris2Emil Lenzing3Eric J. Stöhr4Jacob Bejder5Carsten Lundby6Nikolai B. Nordsborg7Lars Nybo8Department of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkInstitute of Sport Science Leibniz University Hannover Hannover GermanyDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkFaculty of Social and Health Sciences Section for Health and Exercise Physiology Campus Lillehammer Inland University of Applied Sciences Lillehammer NorwayDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkDepartment of Nutrition, Exercise and Sports University of Copenhagen Copenhagen DenmarkAbstract During exercise stress, heart rate (HR) increases to support cardiac output, which also reduces ventricular filling time. Although echocardiography is widely used to assess cardiac function, studies display conflicting data on the dynamic changes in the healthy trained and untrained heart during rest and acute exercise stress. To address these discrepancies, we tested a new echocardiography exercise protocol on two groups with significant differences in cardiorespiratory fitness. Ten untrained individuals with maximal oxygen uptake of 38 ± 8 ml/kg/min and 10 endurance‐trained athletes matched for body surface area but with higher maximal oxygen uptake (71 ± 5 ml/kg/min) were evaluated at rest, during semi‐recumbent cycling at 25 and 75 W and at a relative workload intensity eliciting a HR of 140 beats/min (HR140). Stroke volume was 36% higher in the trained at rest, and this difference increased during exercise to 42% at 25 W, 46% at 75 W and 63% at HR140 (all P < 0.05). In contrast, no group differences were found in markers of myocardial function (ventricular contraction and relaxation velocities) or other traditional echocardiographic measures of ventricular function at rest or exercise for a given HR. However, while similar at rest, diastolic and systolic function provided limited insight into differences between less fit and highly fit individuals. The new exercise echocardiography protocol improves the ability to uncover differences in dynamic changes in diastolic filling capacity that explain the previously reported higher end‐diastolic compliance in endurance‐trained athletes.https://doi.org/10.1113/EP092177cardiorespiratory fitnessechocardiographyenduranceexercisemaximal oxygen uptakemyocardial function
spellingShingle Mads Fischer
Thomas Bonne
Magnus Bak Klaris
Emil Lenzing
Eric J. Stöhr
Jacob Bejder
Carsten Lundby
Nikolai B. Nordsborg
Lars Nybo
Exercise echocardiography for improved assessment of diastolic filling dynamics
Experimental Physiology
cardiorespiratory fitness
echocardiography
endurance
exercise
maximal oxygen uptake
myocardial function
title Exercise echocardiography for improved assessment of diastolic filling dynamics
title_full Exercise echocardiography for improved assessment of diastolic filling dynamics
title_fullStr Exercise echocardiography for improved assessment of diastolic filling dynamics
title_full_unstemmed Exercise echocardiography for improved assessment of diastolic filling dynamics
title_short Exercise echocardiography for improved assessment of diastolic filling dynamics
title_sort exercise echocardiography for improved assessment of diastolic filling dynamics
topic cardiorespiratory fitness
echocardiography
endurance
exercise
maximal oxygen uptake
myocardial function
url https://doi.org/10.1113/EP092177
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