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Analyse de l’entraînement et des conséquences fonctionnelles du remodelage cardio-vasculaire étudié en IRM chez le triathlète amateur longue distance

Abstract : Triathlon is a fast-growing endurance sport known for its high cardiovascular demand. This paper focuses on the impact that long distance triathlon (half-ironman and above) can have on the cardiovascular system. This writing proposes a descriptive study of the triathletes’ training and then an analysis of variations in aortic compliance and cardiac remodeling mesured by cardiovascular MRI during the race season.Thirty-four 19-39-year-old male long-distance triathletes (Tri) were included, as well as twenty-nine healthy sex- and age-matched volunteers who were insufficiently active (Ctrl) according to World Health Organization recommendations. Triathletes provided their training data through a dedicated diary. All volunteers completed three visits (V1, V2, V3) spread over the course of the race season. Each visit included an applanation tonometry and a cardiovascular MRI. This imaging modality allowed the measurement of aortic sections and right and left ventricular volumes.For the year 2018, triathletes reported training on average 10.5 ± 2.4 hours per week. During the six months prior to the reference race, the average weekly training parameters were: training load = 3244 ± 2225; monotony = 1.14 ± 0.44; strain = 4070 ± 4252; fitness = -3610 ± 3967. The compliance of the ascending aorta calculated with peripheral pulse pressure was significantly higher in the Tri group at V2 (3.85 ± 1.19.10-2 vs. 3.25 ± 0.88.10-2 cm²/mmHg; p = 0.032) and at V3 (3.85 ± 1.09.10-2 vs. 3.25 ± 0.92.10-2 cm²/mmHg; p = 0.027), with no longitudinal variation during the race season (p = 0.465). The majority of left and right ventricular volumes were significantly higher in the Tri group and for all three visits, but without significant longitudinal variation.These results are in favour of the existence of stable but long-standing cardiac adaptations. They are linked to regular and sufficiently sustained practice of an endurance sport such as triathlon and may be related to the notion of athlete's heart. Vascular adaptations are also suggested by these results, which may contribute to the emerging concept of the athlete's artery. Further longitudinal studies would be useful to assess the dynamics of this cardiovascular remodeling over an athlete's lifetime and its possible pathophysiological consequences.
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Submitted on : Monday, May 16, 2022 - 4:30:33 PM
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Anne-Charlotte Dupont. Analyse de l’entraînement et des conséquences fonctionnelles du remodelage cardio-vasculaire étudié en IRM chez le triathlète amateur longue distance. Cardiologie et système cardiovasculaire. Université de Lorraine, 2021. Français. ⟨NNT : 2021LORR0263⟩. ⟨tel-03669541⟩



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