Effect of Maximal Exercise on the Heart Rate, Blood Pressure and Level of Cardiac Remolding in Elite Athletes

Main Article Content

Hafeezullah Wazir ali
Abdullah Saleh Alanazi
Maj Gen Mohammad Aslam, Retd
Muhammad Mazhar Hussain

Abstract

Aim / Objective: The purpose of this study was to determine how intense exercise effect the blood pressure, heart rate and the extent upto, which the cardiac remolding may occur in elite athletes.


Location of Study: This study was conducted in the Department of Physiology, Army Medical College, along with the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi.


Methodology: There were 40 control participants and 40 elite endurance athletes. Clinical tests were performed on all the subjects to rule out an underlying medical condition or disease. Auscultatory method was used to measure the heart rate before exercise and immediately after exercise, Similarly the blood pressure was examined before and within 3 minutes after the physical activity. The left ventricular end-diastolic internal diameter (LVIDd), diastolic posterior wall thickness (PWTd), diastolic interventricular septal thickness (IVSTd), and left ventricular mass (LVM) were measured by echocardiography and determined using the Devereux formula. Before breakfast, the participants engaged in maximum physical activity on an electronic ergometer cycle until they were exhausted.


Results: It was observed that when compared to the control group, the heart rates and blood pressure of athletes were noticeably lower. In contrast, LVIDd, IVSTd, PWTd, and LVM were higher in athletes than in healthy controls...


Conclusion: The long term athletic training causes remodeling of the heart with increased dimensions of the left ventricle which reduces the heart rate and blood pressure in endurance trained athletes.


 

Article Details

How to Cite
Wazir ali, H., Alanazi, . A. S. ., Maj Gen Mohammad Aslam, Retd, & Hussain, M. M. (2024). Effect of Maximal Exercise on the Heart Rate, Blood Pressure and Level of Cardiac Remolding in Elite Athletes. International Journal of Medical Science and Clinical Research Studies, 4(05), 898–905. https://doi.org/10.47191/ijmscrs/v4-i05-22
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Articles

References

I. Darling EA. The effects of training-A study of the Harvard University Crews. Boston Med Surg J 1899; 141 (10): 229-233.

II. White PD. The pulse after a marathon race. Jama. 1918;71(13):1047–1048.

III. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med. 1975 Apr;82(4):521-4. doi: 10.7326/0003-4819-82-4-521. PMID: 1119766.

IV. Rubio-Arias JÁ, Andreu L, Martínez-Aranda LM, Martínez-Rodríguez A, Manonelles P, Ramos-Campo DJ. Effects of medium- and long-distance running on cardiac damage markers in amateur runners: a systematic review, meta-analysis, and metaregression. J Sport Health Sci. 2021 Mar; 10(2):192-200.

V. Zimmermann P, Wüstenfeld J, Zimmermann L, Schöffl V, Schöffl I. Physiological Aspects of World Elite Competitive German Winter Sport Athletes. Int J Environ Res Public Health. 2022 May 5;19(9):5620. doi: 10.3390/ijerph19095620. PMID: 35565006; PMCID: PMC9101905.

VI. Liu PY, Tsai KZ, Lima JAC, Lavie CJ, Lin GM. Athlete's Heart in Asian Military Males: The CHIEF Heart Study. Front Cardiovasc Med. 2021 Sep 29;8:725852. doi: 10.3389/fcvm.2021.725852. PMID: 34660727; PMCID: PMC8511640.

VII. Baggish AL. Focal Fibrosis in the Endurance Athlete's Heart: Running Scarred or Running Scared? JACC Cardiovasc Imaging. 2018 Sep;11(9):1271-1273. doi: 10.1016/j.jcmg.2017.09.015. Epub 2017 Dec 13. PMID: 29248664.

VIII. Lakatos BK, Molnár AÁ, Kiss O, Sydó N, Tokodi M, Solymossi B, Fábián A, Dohy Z, Vágó H, Babity M, Bognár C, Kovács A, Merkely B. Relationship between Cardiac Remodeling and Exercise Capacity in Elite Athletes: Incremental Value of Left Atrial Morphology and Function Assessed by Three-Dimensional Echocardiography. J Am Soc Echocardiogr. 2020 Jan;33(1):101-109.e1. doi: 10.1016/j.echo.2019.07.017.

IX. García-Manso JM, Martínez-Patiño MJ, de la Paz Arencibia L, Valverde-Esteve T. Tactical behavior of high-level male marathon runners. Scand J Med Sci Sports. 2021 Mar; 31(3):521-528.

X. Albaeni A, Davis JW, Ahmad M. Echocardiographic evaluation of the Athlete's heart. Echocardiography. 2021 Jun;38(6):1002-1016. doi: 10.1111/echo.15066. Epub 2021 May 10. PMID: 33971043.

XI. Christou GA, O'Driscoll JM. The impact of demographic, anthropometric and athletic characteristics on left atrial size in athletes. Clin Cardiol. 2020 Aug;43(8):834-842. doi: 10.1002/clc.23368.

XII. Schleich KT, Smoot MK, Ernst ME. Hypertension in Athletes and Active Populations. Curr Hypertens Rep. 2016 Nov;18(11):77. doi: 10.1007/s11906-016-0685-y. PMID: 27739019.

XIII. Ozemek C, Tiwari S, Sabbahi A, Carbone S, Lavie CJ. Impact of therapeutic lifestyle changes in resistant hypertension. Prog Cardiovasc Dis. 2020 Jan-Feb;63(1):4-9. doi: 10.1016/j.pcad.2019.11.012. Epub 2019 Nov 20. PMID: 31756356; PMCID: PMC7257910.

XIV. Schweiger V, Niederseer D, Schmied C, Attenhofer-Jost C, Caselli S. Athletes and Hypertension. Curr Cardiol Rep. 2021;23(12):176. Published 2021 Oct 16. doi:10.1007/s11886-021-01608-x

XV. Varga-Pintér B, Horváth P, Kneffel Z, Major Z, Osváth P, Pavlik G. Resting blood pressure values of adult athletes. Kidney Blood Press Res. 2011;34(6):387-95. doi: 10.1159/000327850. Epub 2011 Jun 11. PMID: 21677435.

XVI. Shah AB, Zilinski J, Brown MG, Neary JH, Weiner RB, Hutter AM, Apple FS, Picard MH, Januzzi JL, Baggish AL. Endurance Exercise Training Attenuates Natriuretic Peptide Release During Maximal Effort Exercise: Biochemical Correlates of the "Athlete's Heart". J Appl Physiol. 2018 Oct 11.125: 1702–1709.

XVII. Gielen S, Schuler G, Adams V. Cardiovascular effects of exercise training: molecular mechanisms. Circulation. 2010 Sep 21;122(12):1221-38. doi: 10.1161/CIRCULATIONAHA.110.939959. PMID: 20855669.

XVIII. Kovacs R, Baggish AL. Cardiovascular adaptation in athletes. Trends Cardiovasc Med 2016;26:46–52

XIX. Baggish AL, Battle RW, Beaver TA, Border WL, Douglas PS, Kramer CM, Martinez MW, Mercandetti JH, Phelan D, Singh TK, Weiner RB, Williamson E. Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes: A Report from the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Computed Tomography and the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2020 May;33(5):523-549. doi: 10.1016/j.echo.2020.02.009.

XX. Małek ŁA, Czajkowska A, Mróz A, Witek K, Barczuk-Falęcka M, Nowicki D, Postuła M, Werys K. Left ventricular hypertrophy in middle-aged endurance athletes: is it blood pressure related? Blood Press Monit. 2019 Jun;24(3):110-113. doi: 10.1097/MBP.0000000000000377.

PMID: 30969227.

XXI. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986 Feb 15;57(6):450-8. doi: 10.1016/0002-9149(86)90771-x. PMID: 2936235.

XXII. Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001 Oct 2;104(14):1694-740. doi: 10.1161/hc3901.095960. PMID: 11581152.

XXIII. Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes. J Athl Train. 2021 May 1;56(5):484-490. doi: 10.4085/78-20. PMID: 33150370; PMCID: PMC8130770.

XXIV. Deus LA, Sousa CV, Rosa TS, Filho JMS, Santos PA, Barbosa LD, Silva Aguiar S, Souza LHR, Simões HG. Heart rate variability in middle-aged sprint and endurance athletes. Physiol Behav. 2019 Jun 1;205:39-43. doi: 10.1016/j.physbeh.2018.10.018. Epub 2018 Oct 30. PMID: 30389479.

XXV. Huang J, Liao J, Fang Y, Deng H, Yin H, Shen B, Hu M. Six-Week Exercise Training With Dietary Restriction Improves Central Hemodynamics Associated With Altered Gut Microbiota in Adolescents With Obesity. Front Endocrinol (Lausanne). 2020 Dec 7;11:569085. doi: 10.3389/fendo.2020.569085. PMID: 33365012; PMCID: PMC7750456.

XXVI. Lee BA, Kim YJ. Effect of regular endurance exercises on management of cardiovascular health in middle-aged men. J Exerc Rehabil. 2022 Feb 24;18(1):50-56. doi: 10.12965/jer.2142674.337. PMID: 35356140; PMCID: PMC8934609.

XXVII. Santoro A, Alvino F, Antonelli G, Caputo M, Padeletti M, Lisi M, Mondillo S. Endurance and Strength Athlete's Heart: Analysis of Myocardial Deformation by Speckle Tracking Echocardiography. J Cardiovasc Ultrasound. 2014 Dec;22(4):196-204. doi: 10.4250/jcu.2014.22.4.196. Epub 2014 Dec 26. PMID: 25580194; PMCID: PMC4286641.

XXVIII. Yahia M. An electrocardiographic and echocardiographic assessment of football athletes. J Cardiol Curr Res. 2019;12(1):36‒39.

XXIX. Churchill TW, Petek BJ, Wasfy MM, Guseh JS, Weiner RB, Singh TK, Schmied C, O'Malley H, Chiampas G, Baggish AL. Cardiac Structure and Function in Elite Female and Male Soccer Players. JAMA Cardiol. 2021 Mar 1;6(3):316-325. doi: 10.1001/jamacardio.2020.6088. PMID: 33263734; PMCID: PMC7711565.

XXX. Engvall JE, Aneq MÅ, Nylander E, Brudin L, Maret E. Moderately trained male football players, compared to sedentary male adults, exhibit anatomical but not functional cardiac remodelling, a cross-sectional study. Cardiovasc Ultrasound. 2021 Nov 11;19(1):36. doi: 10.1186/s12947-021-00263-0. PMID: 34758817; PMCID: PMC8582134.

XXXI. D'Andrea A, Mele D, Palermi S, Rizzo M, Campana M, Di Giannuario G, Gimelli A, Khoury G, Moreo A; a nome dell’Area Cardioimaging dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO). Le “zone grigie” degli adattamenti cardiovascolari all’esercizio fisico: come orientarsi nella valutazione ecocardiografica del cuore d’atleta [Grey zones in cardiovascular adaptations to physical exercise: how to navigate in the echocardiographic evaluation of the athlete's heart]. G Ital Cardiol (Rome). 2020 Jun;21(6):457-468. Italian. doi: 10.1714/3359.33330. PMID: 32425192.

XXXII. Beaumont AJ, Grace FM, Richards JC, Campbell AK, Sculthorpe NF. Aerobic Training Protects Cardiac Function During Advancing Age: A Meta-Analysis of Four Decades of Controlled Studies. Sports Med. 2019 Feb;49(2):199-219. doi: 10.1007/s40279-018-1004-3. PMID: 30374946; PMCID: PMC6513799.

XXXIII. Pelliccia A, Caselli S, Sharma S, Basso C, Bax JJ, Corrado D, D'Andrea A, D'Ascenzi F, Di Paolo FM, Edvardsen T, Gati S, Galderisi M, Heidbuchel H, Nchimi A, Nieman K, Papadakis M, Pisicchio C, Schmied C, Popescu BA, Habib G, Grobbee D, Lancellotti P; Internal reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur Heart J. 2018 Jun 1;39(21):1949-1969.

XXXIV. De Bosscher R, Dausin C, Janssens K, Bogaert J, Elliott A, Ghekiere O, Van De Heyning CM, Sanders P, Kalman J, Fatkin D, Herbots L, Willems R, Heidbuchel H, La Gerche A, Claessen G; Pro@Heart Consortium. Rationale and design of the PROspective ATHletic Heart (Pro@Heart) study: long-term assessment of the determinants of cardiac remodelling and its clinical consequences in endurance athletes. BMJ Open Sport Exerc Med. 2022 Mar 18;8(1):e001309. doi: 10.1136/bmjsem-2022-001309. PMID: 35368514; PMCID: PMC8935177.