Abstract

To determine whether regional wall motion abnormalities exist or contribute to left ventricular dysfunction, we obtained 2-dimensional echocardiograms in 12 athletes before (baseline), immediately after (race finish), and 1 d after (recovery) the Hawaii Ironman Triathlon (a 3.9-km swimming, 180.2-km bicycling, and 42.2-km running event). Left ventricular short-axis and apical four-chamber views were computer digitized and divided into 6 segments, and radial chord shortening and area ejection fraction were calculated. Global ejection fraction fell at race finish (51 vs 46) but recovered by 1 d (54, p<0.01 by repeated-measures analysis of variance). With the apical 4 chamber view, midseptal and apical-septal motion were reduced at race finish but returned to baseline during recovery (midseptal radial chord shortening: 21, 8, 22; apical-septal radial chord shortening: 27, 12, 25; midseptal area ejection fraction: 39, 30, 40; apical-septal area ejection fraction: 4 baseline, 33 race finish, 43 recovery; all p<0.01). In contrast, with the parasternal short-axis view, wall motion did not change at race finish but tended to be elevated during recovery and became significant for anteroseptal motion (radial chord shortening: 29, 30, 36; area ejection fraction: 49 baseline, 51 race finish, 58 recovery; both p<0.05). Lateral wall motion was unchanged. In all, the normal left ventricle may demonstrate heterogeneity of regional wall motion after prolonged exercise. Verf.-Referat (gekuerzt)