Adaptation du myocarde à l'effort (effet de l'âge et de l'activité sportive chez le sujet sain)

Objectif : Décrire l'adaptation à l'effort du myocarde du sujet sain sous l'effet de l'âge et de l'exercice physique. Méthode : Il s'agit d'une étude prospective mono-centrique en échocardiographie avec étude au repos et à l'effort des paramètres de fonction systolique et diastolique ventriculaire. Résultats : 38 seniors sportifs, 15 seniors sédentaires, 18 jeunes sportifs et 27 jeunes sédentaires ont pu être inclus pour l'analyse. La masse ventriculaire gauche et les volumes ventriculaires sont plus élevés chez les jeunes sportifs (p<0,01) que chez les seniors sportifs eux même supérieurs aux deux autres groupes. Pendant l'effort, le strain global longitudinal est meilleur chez les jeunes sportifs (p<0,05). Concernant la relaxation, les ondes e' septale et latérale sont plus élevées au repos et à l'effort chez les jeunes (p<0,01). Conclusion : Des adaptations myocardiques à la pratique sportive existent, en particulier à l'effort. Elles s'atténuent avec l'âge.RENNES1-BU Santé (352382103) / SudocSudocFranceF

Exercise adaptation of the left ventricular myocardium in men over 50 years of age.

International audienceBackground .- The cardiac consequences of extensive athletic activity in men over the age of 50 years are unknown. Aims .- We intend to describe the remodelling that occur due to intensive athletic activity in men≥50 years of age. Methods .- We conducted a prospective analysis of 21 athletes≥50 years of age. Fifteen sedentary healthy controls and ten patients diagnosed with a left ventricular hypertrophy who were all over the age of 50. All subjects underwent a resting and a sub-maximal exercise echocardiography in order to measure left ventricular systolic and diastolic functions. Results .- Left ventricular (LV) volumes, which were similar at rest in the three groups, were higher in the athletes during exercise (P <0.01). Systolic ejection volumes and longitudinal global left ventricular strains were greater at rest in healthy subjects (athletes and controls) in comparison to those in LVH-patients (P <0.01). During exercise, the increase in longitudinal strain was higher in athletes than in the two other groups (P <0.05). Concerning left ventricular relaxation, septal e'- and lateral e'-waves were higher both at rest and during exercise in the group of healthy subjects in comparison to those in patients (P <0.05). Conclusion .- Distinguishing physiology from pathology is challenging at rest, particularly in the elderly. However, exercise stress echocardiography helps. Only the changes in shape and in the longitudinal LV systolic function during exercise are significantly different between athletes and controls or LVH-subjects

Comparison of the heart function adaptation in trained and sedentary men after 50 and before 35 years of age.

International audienceThe effects of aging and of sustained athletic activity on the heart in men aged >50 years are unknown. The aim of this study was to assess the adaptation of the heart in athletic and sedentary men aged 8 hours of bicycling per week in the athletic groups. Left ventricular mass was greater in the Y(ATH) than in the S(ATH) group (p <0.01) and greater in the S(ATH) than in the S(SED) group (p <0.001). Likewise, left ventricular volumes were greater in the athletic than in the sedentary groups (p <0.05), although they were smaller in the seniors than in youth (p <0.01). Left ventricular stroke volume was greater in the athletic than in the sedentary groups (p <0.001); global longitudinal strain during exercise was -20.0 ± 2.4% in the S(ATH) group and -22.1 ± 2.1% in the Y(ATH) group, compared to -19.2 ± 3.4% in the S(SED) group and -20.2 ± 2.4% in the Y(SED) group (p <0.05, athletic vs sedentary). The e' velocities recorded at the septal and lateral mitral annulus were higher at rest and during exercise (p <0.01) in the youth than in the senior groups. In conclusion, systolic and diastolic myocardial adaptation to regular exercise was significantly more prominent in young than in senior volunteers