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

ABSTRACT

Purpose: 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:

• Speckle-tracking echocardiography
• athlete’s heart
• LV mass
• diastolic function
• rugby union

Acknowledgements

We gratefully thank all of the rugby players who participated in this study. We are also grateful to the staff (managers, coaches, doctors and supporting staffs) as well as Gilles Allou and Cédrick Vivant for their valuable assistance during the data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.