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NON-INVASIVE ASSESSMENT OF THE PULMONARY AND SYSTEMIC VASCULAR DISTENSIBILITY AT EXERCISE IN SEDENTARY VS. ATHLETIC SUBJECTS

par Carpentier, Marine ;Motoji, Yoshiki ;Selvais, Nicolas ;Rabineau, Jérémy ;Tordeur, Cyril ;Forton, Kevin ;Chaumont, Martin ;Faoro, Vitalie ; [et al.]
Référence European Congress of Sport Science (ECSS) (05-07/07/2023: Paris, France)
Publication Non publié, 2023-07-07

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Résumé :

INTRODUCTIONPhysical activity improves cardio-vascular health condition. However, it remains uncertain how much training affects the vascular distensibility (α) of the pulmonary circulation, especially regarding to the systemic vascular distensibility. This is of particular interest as the right ventricle (RV) function is under heavy stress during exercise (1) at high cardiac output (Q) and a more distensible circulation would smoothen the RV afterload. We therefore compared the RV and pulmonary circulation response at exercise among athletes and sedentary subjects, with the exercise systemic vascular response. METHODS17 professional football players (24±3 years) matched (age and body mass index) with 17 sedentary volunteers, performed an incremental cyclo-ergometric exercise echocardiography for RV and pulmonary circulation evaluation. Gas exchanges and systemic arterial blood pressure were measured continuously during exercise. Q was calculated from the left ventricular outflow tract flow velocity-time integral, mean pulmonary arterial pressure (mPAP) was calculated from the peak tricuspid regurgitation velocity and right atrial pressure. The coupling of RV function to the pulmonary circulation was evaluated by the tricuspid annular plane systolic excursion (TAPSE) to systolic PAP (PAPs) ratio. Pulmonary and systemic vascular distensibility, αpulm and αsys, were determined from multi-point mPAP/atrial pressure vs Q relationships, established by Linehan equation (2).RESULTSWhile athletes displayed smoothened chronotropic (HR) (p<0.001) and enhanced inotropic (p=0.006) response to exercise as compared to sedentary subjects, the exercise-induced increase in PAPm or the decrease in TAPSE/PAPs did not differ between the two groups. However, αpulm was higher in athletes than in sedentary people (1.37±0.41 vs 0.88±0.42%/mmHg, p=0.002) and correlated, at identical exercise intensity, with the TAPSE/PAPs ratio (football players: p=0.006, r=0.63, sedentary: p<0.001, r=0.79). αsys was correlated to αpulm (p<0.05, r=0.33) suggesting a global vascular adaptation. While αsys was not different between the two groups, it was positively correlated to cardio-respiratory fitness indexes such as the VO2peak (p=0.02, r=0.37) and the stroke volume at maximal common effort (p=0.02, r=0.37). CONCLUSIONRegarding the fact that RV study values do not differ between our groups, we could conclude that both groups tolerate adequately the effort, without a major effect of frequent training on RV function. However, football players present a higher αpulm, moreover correlated with TAPSE/PAPs ratio among football players and sedentary subjects, suggesting that a better αpulm could allow to have a better RV-arterial coupling, an ideal advantage for aerobic training. αpulm is also correlated with αsys suggesting that the vascular effects of regular training apply on both circulations. Furthermore, αsys seems to be linked to aerobic capacity, showing a better αsys at higher VO2.1. La Gerche (2014) 2. Linehan (1985)