Systolic Right-Ventricular Function Impairment in Healthy Children After Endurance Stress

Excerpt

We read with interest the article, entitled The Munich Triathlon Heart Study: Ventricular Function, Myocardial Velocities, and Two-Dimensional Strain in Healthy Children Before and After Endurance Stress, by Hauser et al. [2]. In our opinion, this is an excellent article describing impaired systolic right-ventricular (RV) but not left-ventricular performance shortly after endurance stress in healthy children. The investigators clearly state that tissue Doppler parameters, such as tricuspid annular peak systolic velocity (S′) and M-mode parameter tricuspid annular plane systolic excursion (TAPSE), were able to detect impairment of systolic RV function after endurance stress [2]. They found that S’ and TAPSE were lower in the pediatric patient group measured shortly after endurance stress compared with echocardiographic testing before the triathlon. We may add that with an age distribution of the children from 7.9 to 16.4 years, different age-related normal values must be expected and should be taken into account. For the convenience of the readers of Pediatric Cardiology, we want to add that recently our group published normal TAPSE and S′ values with z-scores for healthy pediatric patients [4, 5]. In our opinion, investigators should correlate their measured TAPSE and S′ values indexed to age using z-scores based on normal published data (www.​parameterz.​org) in future studies [4, 5]. This has been shown in recent articles dealing with systolic RV function in the pediatric age group [1, 3]. The results of the remarkable study from Hauser et al. [2] clearly support the notion that the right ventricle is highly susceptible to endurance stress function impairment in children. As paediatricians, we want to thank the investigators for addressing the need for careful and systematic evaluation of the right ventricle in pediatric patients before and after endurance stress and look forward for more interesting studies from this group. …