Effects of sustained training on left ventricular structure and function in top level rowers

The effects of vigorous training on left ventricular structure and function were evaluated in 15 top level rowers using electrocardiography, Doppler echocardiography and radionuclide angiography. All subjects were studied after 1 month of deconditioning and again after 5 months of vigorous training. After training there was an increase in the ventricular hypertrophy voltage criteria proposed by Sokolow-Lyon and by Friedman but not in that proposed by Casale; T wave amplitude in leads V5 and V6 increased in nine subjects, was unchanged in one and decreased in five; the mean values were also unchanged. Training induced a significant increase in left ventricular end-diastolic and end-systolic diameter and in left ventricular mass index, while peak systolic stress and mean wall stress index decreased. No change was detected after training in the mean values of Doppler echocardiographic and radionuclide angiographic data; nevertheless a significant relationship was found between changes in T wave height in V5 or V6 and in peak filling rate, and between changes in T wave height and ejection fraction. Our study confirms that the effect of vigorous training on left ventricular mass and dimensions does not include changes in mean values of systolic and diastolic function. The relationship between change in T wave amplitude and in peak filling rate values suggests that some metabolic or neurohumoral derangement occurs in the subset of athletes with T wave flattening, that is responsible for the slight reduction in peak filling rate and ejection fraction.