Influence of different dynamic sporting disciplines on right ventricular Structure and function in elite male athletes

Our objective was to assess the influence of different levels of exposure to dynamic training on right ventricular (RV) structure, function and mechanics in elite male athletes. We recruited 492 male elite athletes aged between 18 and 30 years old. Athletes were grouped according to their sporting discipline using the Mitchell Classification as Low Dynamic (LD), Moderate Dynamic (MD) or High Dynamic (HD). All participants underwent 2D, Doppler, tissue Doppler and strain (ε) echocardiography with a focused and comprehensive assessment of the right heart. Athletes involved in MD sports had the largest absolute RV chamber size and when scaled to body size RVOT PLAX, RVOT2, RVD1 and RVD3 were larger in HD compared to MD and LD athletes. There were no between group differences in conventional RV functional indices as well as global RV ε (LD: − 23.4 ± 3.1 vs. MD: − 22.7 ± 2.7 vs. HD: − 23.5 ± 2.6, %) and strain rate (P > 0.01). The base to apex ε gradient in the RV septum was lower in the MD athletes compared to HD and LD due to a lower apical septal ε which significantly correlated with absolute RV chamber size. After scaling for body size there was evidence of larger RV cavities in both MD and HD athletes compared to LD athletes. Global RV function, ε and strain rate were not different between groups. MD athletes had lower apical septal ε that contributed to a smaller base-to-apex ε gradient that is partially associated with larger absolute RV chamber dimensions.