Myocardial Adaptations to Competitive Swim Training

PURPOSESwim training is performed in the prone or supine position and obligates water immersion, factors that may augment cardiac volume loading more than other endurance sports. At present, prospective data defining the cardiac responses to swim training are lacking. We therefore studied myocardial...

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Published in:Medicine and science in sports and exercise 2019-10, Vol.51 (10), p.1987-1994
Main Authors: WASFY, MEAGAN M, WEINER, RORY B, WANG, FRANCIS, BERKSTRESSER, BRANT, DELUCA, JAMES, HUTTER, ADOLPH M, PICARD, MICHAEL H, BAGGISH, AARON L
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Competitive Behavior - physiology
Echocardiography, Doppler
Exercise Test - methods
Female
Hand Strength
Heart Ventricles - anatomy & histology
Heart Ventricles - diagnostic imaging
Humans
Longitudinal Studies
Male
Physical Conditioning, Human - physiology
Prospective Studies
Swimming - physiology
Ventricular Remodeling - physiology
Young Adult
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Summary:PURPOSESwim training is performed in the prone or supine position and obligates water immersion, factors that may augment cardiac volume loading more than other endurance sports. At present, prospective data defining the cardiac responses to swim training are lacking. We therefore studied myocardial adaptations among competitive swimmers to establish a causal relationship between swim training and left ventricular (LV) remodeling. METHODSCollegiate swimmers were studied before and after a 90-d period of training intensification. Transthoracic echocardiography was used to examine LV structural and functional adaptations under resting conditions and during an acute LV afterload challenge generated by isometric handgrip testing (IHGT). A sedentary control population was identically studied with IHGT. RESULTSIn response to a discrete period of swim training intensification, athletes (n = 17, 47% female, 19 ± 0.4 yr old) experienced eccentric LV remodeling, characterized by proportionally more chamber dilation than wall thickening, with attendant enhancements of resting LV systolic (LV twist) and diastolic (early and late phase tissue velocities) function. Compared with baseline and controls, athletes posttraining demonstrated greater systolic twist impairment during IHGT. However, training-induced LV dilation coupled with gains in diastolic function offsets this acquired systolic susceptibility to acute afterload, resulting in the relative preservation of stroke volume during IHGT. CONCLUSIONSwim training, a sport characterized by unique cardiac loading conditions, stimulates eccentric LV remodeling with the concomitant augmentation of systolic twist and diastolic relaxation. This volume-mediated cardiac remodeling appears to result in greater systolic susceptibility to acute afterload challenge. Further work is required to establish how training-induced changes in function translate to human performance and whether these are accompanied by physiologic trade-offs with relevance to common forms of heart disease.
ISSN:0195-9131
1530-0315
DOI:10.1249/MSS.0000000000002022