Acute impact of an endurance race on biventricular and biatrial myocardial strain in competitive male and female triathletes evaluated by feature-tracking CMR

Objectives Cardiac adaptation in endurance athletes is a well-known phenomenon, but the acute impact of strenuous exercise is rarely reported on. The aim of this study was to analyze the alterations in biventricular and biatrial function in triathletes after an endurance race using novel feature-tracking cardiac magnetic resonance (FT-CMR). Methods Fifty consecutive triathletes (45 +/- 10 years; 80% men) and twenty-eight controls were prospectively recruited, and underwent 1.5-T CMR. Biventricular and biatrial volumes, left ventricular ejection fraction (LVEF), FT-CMR analysis, and late gadolinium imaging (LGE) were performed. Global systolic longitudinal (GLS), circumferential (GCS), and radial strain (GRS) were assessed. CMR was performed at baseline and following an endurance race. High-sensitive troponin T and NT-proBNP were determined. The time interval between race completion and CMR was 2.3 +/- 1.1 h (range 1-5 h). Results Post-race troponin T (p < 0.0001) and NT-proBNP (p < 0.0001) were elevated. LVEF remained constant (62 +/- 6 vs. 63 +/- 7%, p = 0.607). Post-race LV GLS decreased by tendency (- 18 +/- 2 vs. - 17 +/- 2%, p = 0.054), whereas GCS (- 16 +/- 4 vs. - 18 +/- 4%, p < 0.05) and GRS increased (39 +/- 11 vs. 44 +/- 11%, p < 0.01). Post-race right ventricular GLS (- 19 +/- 3 vs. - 19 +/- 3%, p = 0.668) remained constant and GCS increased (- 7 +/- 2 vs. - 8 +/- 3%, p < 0.001). Post-race left atrial GLS (30 +/- 8 vs. 24 +/- 6%, p < 0.0001) decreased while right atrial GLS remained constant (25 +/- 6 vs. 24 +/- 6%, p = 0.519). Conclusions The different alterations of post-race biventricular and biatrial strain might constitute an intrinsic compensatory mechanism following an acute bout of endurance exercise. The combined use of strain parameters may allow a better characterization of ventricular and atrial function in endurance athletes.