Left ventricular function and mechanics in backs and forwards elite rugby union players

Charly Fornasier-Santos; Omar Izem; Falah Aboukhoudir; Thomas Rupp; Paul Stridgeon; Grégoire P Millet; Stéphane Nottin

doi:10.1080/17461391.2022.2092778

Left ventricular function and mechanics in backs and forwards elite rugby union players

Eur J Sport Sci. 2023 Jun;23(6):904-913. doi: 10.1080/17461391.2022.2092778. Epub 2022 Jul 8.

Authors

Charly Fornasier-Santos^{1

2}, Omar Izem¹, Falah Aboukhoudir^{1

3}, Thomas Rupp⁴, Paul Stridgeon², Grégoire P Millet⁵, Stéphane Nottin¹

Affiliations

¹ Pharm-Ecology Cardiovascular Laboratory EA4278, Avignon University, Avignon, France.
² Rugby Club Toulonnais, Toulon, France.
³ Service de cardiologie, centre hospitalier d'Avignon, Avignon, France.
⁴ Inter-University Laboratory of Human Movement Science, University of Savoie Mont-Blanc, Chambéry, France.
⁵ Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.

PMID: 35734942
DOI: 10.1080/17461391.2022.2092778

Abstract

ABSTRACTPurpose: The aim of the present study was to assess left ventricular (LV) morphological and regional functional adaptations in backs and forwards elite rugby union (RU) players.

Methods: Thirty-nine elite male RU players and twenty sedentary controls have been examined using resting echocardiography. RU players were divided into two groups, forwards (n = 22) and backs (n = 17). Evaluations included tissue Doppler and 2D speckle-tracking analysis to assess LV strains and twisting mechanics.

Results: The elite RU players exhibited an LV remodelling characterized by an increase in LV mass indexed to body surface area (82.2 ± 13.2 vs. 99.9 ± 16.1 and 119.7 ± 13.4 g.m^-2, in controls, backs and forwards; P < .001). Compared to backs, forwards exhibited lower global longitudinal strain (19.9 ± 2.5 vs. 18.0 ± 1.6%; P < .05), lower early diastolic velocity (16.5 ± 1.8 vs. 15.0 ± 2.3 cm.s^-1; P < .05) and lower diastolic longitudinal strain rate (1.80 ± 0.34 vs. 1.54 ± 0.26 s^-1; P < .01), especially at the apex. LV twist and untwisting velocities were similar in RU players compared to controls, but with lower apical (-46.2 ± 22.1 vs. -28.2 ± 21.7 deg.s^-1; P < .01) and higher basal rotational velocities (33.9 ± 20.9 vs. 48.4 ± 20.7 deg.s^-1; P < .05).

Conclusion: RU players exhibited an increase in LV mass which was more pronounced in forwards. In forwards, LV global longitudinal strain was depressed, LV filling pressures were decreased, and LV relaxation depressed at the apex.Highlights Elite RU players exhibited LV hypertrophy, especially in forwards players.LV regional function suggested a drop in LV relaxation and an increase in LV filling pressures in RU players, with higher alterations in forwards.LV remodelling was associated with regional alterations in torsional mechanics: higher rotations and rotational diastolic velocities at the basal level of LV but lower rotation and rotational diastolic velocities at the apex were observed in RU players.

Keywords: LV mass; Speckle-tracking echocardiography; athlete’s heart; diastolic function; rugby union.

MeSH terms

Echocardiography
Heart Ventricles / diagnostic imaging
Humans
Hypertrophy, Left Ventricular
Male
Rugby*
Ventricular Function, Left*
Ventricular Remodeling