Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia

Geert Kleinnibbelink; Arie P.J. van Dijk; Alessandro Fornasiero; Guilherme F. Speretta; Christopher Johnson; Maria T.E. Hopman; Nicholas Sculthorpe; Keith P. George; John D. Somauroo; Dick H.J. Thijssen; David L. Oxborough

doi:10.1016/j.echo.2020.12.003

Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia

Geert Kleinnibbelink
, Arie P.J. van Dijk
, Alessandro Fornasiero
, Guilherme F. Speretta
, Christopher Johnson
, Maria T.E. Hopman
, Nicholas Sculthorpe
, Keith P. George
, John D. Somauroo
, Dick H.J. Thijssen
, David L. Oxborough^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

35 Downloads (Pure)

Abstract

Background: Acute exercise promotes transient exercise-induced cardiac fatigue, which affects the right ventricle and to a lesser extent the left ventricle. Hypoxic exposure induces an additional increase in right ventricular (RV) afterload. Therefore, exercise in hypoxia may differently affect both ventricles. The aim of this study was to investigate the acute effects of a bout of high-intensity exercise under hypoxia versus normoxia in healthy individuals on right- and left-sided cardiac function and mechanics. Methods: Twenty-one healthy individuals (mean age, 22.2 ± 0.6 years; 14 men) performed 45-min high-intensity running exercise under hypoxia (fraction of inspired oxygen 14.5%) and normoxia (fraction of inspired oxygen 20.9%) in a randomized order. Pre- and post-exercise echocardiography, at rest and during low-to-moderate intensity recumbent exercise (“stress”), was performed to assess RV and left ventricular (LV) cardiac function and mechanics. RV structure, function, and mechanics were assessed using conventional two-dimensional, Doppler, tissue Doppler, speckle-tracking echocardiographic, and novel strain-area loops. Results: Indices of RV systolic function (RV fractional area change, Tricuspid annular plane systolic excursion, RV s′, and RV free wall strain) and LV function (LV ejection fraction and LV global longitudinal strain) were significantly reduced after high-intensity running exercise (P <.01). These exercise-induced changes were more pronounced when echocardiography was examined during stress compared with baseline. These responses in RV and LV indices were not altered under hypoxia (P >.05). Conclusions: There was no impact of hypoxia on the magnitude of exercise-induced cardiac fatigue in the right and left ventricles after a 45-min bout of high-intensity exercise. This finding suggests that any potential increase in loading conditions does not automatically exacerbate exercise-induced cardiac fatigue in this setting.

Original language	English
Pages (from-to)	511-521
Number of pages	11
Journal	Journal of the American Society of Echocardiography
Volume	34
Issue number	5
Early online date	14 Dec 2020
DOIs	https://doi.org/10.1016/j.echo.2020.12.003
Publication status	Published - 3 May 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

athlete's heart
exercise-induced cardiac fatigue
hypoxia
echocardiography
speckle-tracking echocardiography

Access to Document

10.1016/j.echo.2020.12.003Licence: CC BY

2020 11 30 Kleinnibbelink et al Cardiac finalFinal published version, 1.01 MBLicence: CC BY

Cite this

Kleinnibbelink, G., van Dijk, A. P. J., Fornasiero, A., Speretta, G. F., Johnson, C., Hopman, M. T. E., Sculthorpe, N., George, K. P., Somauroo, J. D., Thijssen, D. H. J., & Oxborough, D. L. (2021). Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia. Journal of the American Society of Echocardiography, 34(5), 511-521. https://doi.org/10.1016/j.echo.2020.12.003

@article{869aece35184411a9ca42a1e64f4763d,

title = "Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia",

abstract = "Background: Acute exercise promotes transient exercise-induced cardiac fatigue, which affects the right ventricle and to a lesser extent the left ventricle. Hypoxic exposure induces an additional increase in right ventricular (RV) afterload. Therefore, exercise in hypoxia may differently affect both ventricles. The aim of this study was to investigate the acute effects of a bout of high-intensity exercise under hypoxia versus normoxia in healthy individuals on right- and left-sided cardiac function and mechanics. Methods: Twenty-one healthy individuals (mean age, 22.2 ± 0.6 years; 14 men) performed 45-min high-intensity running exercise under hypoxia (fraction of inspired oxygen 14.5\%) and normoxia (fraction of inspired oxygen 20.9\%) in a randomized order. Pre- and post-exercise echocardiography, at rest and during low-to-moderate intensity recumbent exercise (“stress”), was performed to assess RV and left ventricular (LV) cardiac function and mechanics. RV structure, function, and mechanics were assessed using conventional two-dimensional, Doppler, tissue Doppler, speckle-tracking echocardiographic, and novel strain-area loops. Results: Indices of RV systolic function (RV fractional area change, Tricuspid annular plane systolic excursion, RV s′, and RV free wall strain) and LV function (LV ejection fraction and LV global longitudinal strain) were significantly reduced after high-intensity running exercise (P <.01). These exercise-induced changes were more pronounced when echocardiography was examined during stress compared with baseline. These responses in RV and LV indices were not altered under hypoxia (P >.05). Conclusions: There was no impact of hypoxia on the magnitude of exercise-induced cardiac fatigue in the right and left ventricles after a 45-min bout of high-intensity exercise. This finding suggests that any potential increase in loading conditions does not automatically exacerbate exercise-induced cardiac fatigue in this setting.",

keywords = "athlete's heart, exercise-induced cardiac fatigue, hypoxia, echocardiography, speckle-tracking echocardiography",

author = "Geert Kleinnibbelink and \{van Dijk\}, \{Arie P.J.\} and Alessandro Fornasiero and Speretta, \{Guilherme F.\} and Christopher Johnson and Hopman, \{Maria T.E.\} and Nicholas Sculthorpe and George, \{Keith P.\} and Somauroo, \{John D.\} and Thijssen, \{Dick H.J.\} and Oxborough, \{David L.\}",

note = "Copyright {\textcopyright} 2020. Published by Elsevier Inc.",

year = "2021",

month = may,

day = "3",

doi = "10.1016/j.echo.2020.12.003",

language = "English",

volume = "34",

pages = "511--521",

journal = "Journal of the American Society of Echocardiography",

issn = "0894-7317",

publisher = "Elsevier Inc.",

number = "5",

}

Kleinnibbelink, G, van Dijk, APJ, Fornasiero, A, Speretta, GF, Johnson, C, Hopman, MTE, Sculthorpe, N, George, KP, Somauroo, JD, Thijssen, DHJ & Oxborough, DL 2021, 'Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia', Journal of the American Society of Echocardiography, vol. 34, no. 5, pp. 511-521. https://doi.org/10.1016/j.echo.2020.12.003

TY - JOUR

T1 - Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia

AU - Kleinnibbelink, Geert

AU - van Dijk, Arie P.J.

AU - Fornasiero, Alessandro

AU - Speretta, Guilherme F.

AU - Johnson, Christopher

AU - Hopman, Maria T.E.

AU - Sculthorpe, Nicholas

AU - George, Keith P.

AU - Somauroo, John D.

AU - Thijssen, Dick H.J.

AU - Oxborough, David L.

PY - 2021/5/3

Y1 - 2021/5/3

N2 - Background: Acute exercise promotes transient exercise-induced cardiac fatigue, which affects the right ventricle and to a lesser extent the left ventricle. Hypoxic exposure induces an additional increase in right ventricular (RV) afterload. Therefore, exercise in hypoxia may differently affect both ventricles. The aim of this study was to investigate the acute effects of a bout of high-intensity exercise under hypoxia versus normoxia in healthy individuals on right- and left-sided cardiac function and mechanics. Methods: Twenty-one healthy individuals (mean age, 22.2 ± 0.6 years; 14 men) performed 45-min high-intensity running exercise under hypoxia (fraction of inspired oxygen 14.5%) and normoxia (fraction of inspired oxygen 20.9%) in a randomized order. Pre- and post-exercise echocardiography, at rest and during low-to-moderate intensity recumbent exercise (“stress”), was performed to assess RV and left ventricular (LV) cardiac function and mechanics. RV structure, function, and mechanics were assessed using conventional two-dimensional, Doppler, tissue Doppler, speckle-tracking echocardiographic, and novel strain-area loops. Results: Indices of RV systolic function (RV fractional area change, Tricuspid annular plane systolic excursion, RV s′, and RV free wall strain) and LV function (LV ejection fraction and LV global longitudinal strain) were significantly reduced after high-intensity running exercise (P <.01). These exercise-induced changes were more pronounced when echocardiography was examined during stress compared with baseline. These responses in RV and LV indices were not altered under hypoxia (P >.05). Conclusions: There was no impact of hypoxia on the magnitude of exercise-induced cardiac fatigue in the right and left ventricles after a 45-min bout of high-intensity exercise. This finding suggests that any potential increase in loading conditions does not automatically exacerbate exercise-induced cardiac fatigue in this setting.

AB - Background: Acute exercise promotes transient exercise-induced cardiac fatigue, which affects the right ventricle and to a lesser extent the left ventricle. Hypoxic exposure induces an additional increase in right ventricular (RV) afterload. Therefore, exercise in hypoxia may differently affect both ventricles. The aim of this study was to investigate the acute effects of a bout of high-intensity exercise under hypoxia versus normoxia in healthy individuals on right- and left-sided cardiac function and mechanics. Methods: Twenty-one healthy individuals (mean age, 22.2 ± 0.6 years; 14 men) performed 45-min high-intensity running exercise under hypoxia (fraction of inspired oxygen 14.5%) and normoxia (fraction of inspired oxygen 20.9%) in a randomized order. Pre- and post-exercise echocardiography, at rest and during low-to-moderate intensity recumbent exercise (“stress”), was performed to assess RV and left ventricular (LV) cardiac function and mechanics. RV structure, function, and mechanics were assessed using conventional two-dimensional, Doppler, tissue Doppler, speckle-tracking echocardiographic, and novel strain-area loops. Results: Indices of RV systolic function (RV fractional area change, Tricuspid annular plane systolic excursion, RV s′, and RV free wall strain) and LV function (LV ejection fraction and LV global longitudinal strain) were significantly reduced after high-intensity running exercise (P <.01). These exercise-induced changes were more pronounced when echocardiography was examined during stress compared with baseline. These responses in RV and LV indices were not altered under hypoxia (P >.05). Conclusions: There was no impact of hypoxia on the magnitude of exercise-induced cardiac fatigue in the right and left ventricles after a 45-min bout of high-intensity exercise. This finding suggests that any potential increase in loading conditions does not automatically exacerbate exercise-induced cardiac fatigue in this setting.

KW - athlete's heart

KW - exercise-induced cardiac fatigue

KW - hypoxia

KW - echocardiography

KW - speckle-tracking echocardiography

U2 - 10.1016/j.echo.2020.12.003

DO - 10.1016/j.echo.2020.12.003

M3 - Article

C2 - 33333146

SN - 0894-7317

VL - 34

SP - 511

EP - 521

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

IS - 5

ER -

Exercise-induced cardiac fatigue after a 45-minute bout of high-intensity running exercise is not altered under hypoxia

Abstract

UN SDGs

Keywords

Access to Document

Fingerprint

Cite this