Central hemodynamics in ultra-endurance athletes

Summary 

Central hemodynamics such as ascending aortic blood pressure (BP), wave reflection and myocardial perfusion are clinically important in the context of cardiovascular health. Ultra-endurance athletes may be at greater risk of cardiovascular abnormalities due to chronically increased physiological stress placed on the cardiovascular system. This study was a cross-sectional investigation that compared central hemodynamics in ultra-endurance athletes and matched controls. Forty-four athletes (36 males; aged mean±S.D., 34±8 years) undergoing ultra-endurance training (16.3±3.7h/week) were compared to 44 matched recreationally active (1.2±0.9h/week) controls (36 males; aged 34±8 years). Brachial BP was measured using an oscillometric device while central hemodynamics including ascending aortic BP, wave reflection (augmentation index, AIx), ejection duration, sub-endocardial perfusion (SEVR) and timing of the reflected wave (T_R) were determined by applanation tonometry and pulse wave analysis. There were no significant (P>0.05) differences between groups in AIx (athletes and controls; 6±12% versus 6±13%, respectively), T_R (athletes and controls; 165±22ms versus 165±19ms, respectively), brachial (athletes and controls; 51±9mmHg versus 48±12mmHg, respectively) or central pulse pressure (33±5mmHg versus 31±7mmHg). However, athletes had significantly increased SEVR (226±42% versus 198±46%; P<0.001) despite having a longer ejection duration (348±19ms versus 339±18ms; P<0.05). Furthermore, the amount of exercise training volume was significantly related to central (r=−0.46; P=0.002), but not brachial pulse pressure (r=−0.28; P>0.05). Ultra-endurance athletes had increased sub-endocardial perfusion capacity and the quantity of exercise training was associated with central rather than peripheral hemodynamics.

Keywords: Central pulse pressure, Endurance exercise, Training adaptations, Triathlon