Adaptation of Left Ventricular Twist Mechanics in Exercise-Trained Children Is Only Evident after the Adolescent Growth Spurt

Dean R Perkins; Jack S Talbot; Rachel N Lord; Tony G Dawkins; Aaron L Baggish; Abbas Zaidi; Orhan Uzun; Kelly A Mackintosh; Melitta A McNarry; Stephen-Mark Cooper; Rhodri S Lloyd; Jon L Oliver; Rob E Shave; Mike Stembridge

doi:10.1016/j.echo.2023.11.024

Adaptation of Left Ventricular Twist Mechanics in Exercise-Trained Children Is Only Evident after the Adolescent Growth Spurt

J Am Soc Echocardiogr. 2023 Dec 11:S0894-7317(23)00647-8. doi: 10.1016/j.echo.2023.11.024. Online ahead of print.

Authors

Affiliations

¹ Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom.
² Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom; Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.
³ Institute of Sports Science, University of Lausanne, Lausanne, Switzerland.
⁴ Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom.
⁵ Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom.
⁶ Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom; Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand; Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand.
⁷ Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom; Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand.
⁸ Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.
⁹ Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom. Electronic address: mstembridge@cardiffmet.ac.uk.

PMID: 38056578
DOI: 10.1016/j.echo.2023.11.024

Abstract

Background: The extent of structural cardiac remodeling in response to endurance training is maturity dependent. In adults, this structural adaptation is often associated with the adaptation of left ventricular (LV) twist mechanics. For example, an increase in LV twist often follows an expansion in end-diastolic volume, whereas a reduction in twist may follow a thickening of the LV walls. While structural cardiac remodeling has been shown to be more prominent post-peak height velocity (PHV), it remains to be determined how this maturation-dependent structural remodeling influences LV twist. Therefore, we aimed to (1) compare LV twist mechanics between trained and untrained children pre- and post-PHV and (2) investigate how LV structural variables relate to LV twist mechanics pre- and post-PHV.

Methods: Left ventricular function and morphology were assessed (echocardiography) in endurance-trained and untrained boys (n = 38 and n = 28, respectively) and girls (n = 39 and n = 34, respectively). Participants were categorized as either pre- or post-PHV using maturity offset to estimate somatic maturation.

Results: Pre-PHV, there were no differences in LV twist or torsion between trained and untrained boys (twist: P = .630; torsion: P = .382) or girls (twist: P = .502; torsion: P = .316), and LV twist mechanics were not related with any LV structural variables (P > .05). Post-PHV, LV twist was lower in trained versus untrained boys (P = .004), with torsion lower in trained groups, irrespective of sex (boys: P < .001; girls: P = .017). Moreover, LV torsion was inversely related to LV mass (boys: r = -0.55, P = .001; girls: r = -0.46, P = .003) and end-diastolic volume (boys: r = -0.64, P < .001; girls: r = -0.36, P = .025) in both sexes.

Conclusions: A difference in LV twist mechanics between endurance-trained and untrained cohorts is only apparent post-PHV, where structural and functional remodeling were related.

Keywords: Echocardiography; Exercise; Myocardium; Twist; Youth.