Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study

OBJECTIVE To compare coronary flow reserve in endurance athletes and healthy sedentary controls, using adenosine transthoracic echocardiography. METHODS 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m2) and 23 male controls (age 27.2 (6.1) years, BMI...

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Published in:British heart journal 2000-10, Vol.84 (4), p.383-389
Main Authors: Hildick-Smith, D J R, Johnson, P J, Wisbey, C R, Winter, E M, Shapiro, L M
Format: Article
Language:English
Subjects:
Adenosine
adenosine transthoracic echocardiography
Adult
athlete
Athletes
Biological and medical sciences
Blood Flow Velocity
Cardiovascular Medicine
Cardiovascular system
Case-Control Studies
Coronary Circulation - physiology
coronary flow reserve
Coronary vessels
Coronary Vessels - anatomy & histology
Echocardiography
Endothelium
Endothelium, Vascular - drug effects
Feasibility studies
Flow velocity
Hibernation
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical imaging
Medical sciences
Physical Endurance - physiology
Physiology
Sports - physiology
Ultrasonic investigative techniques
Vasodilator Agents
Veins & arteries
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creator Hildick-Smith, D J R
Johnson, P J
Wisbey, C R
Winter, E M
Shapiro, L M
description OBJECTIVE To compare coronary flow reserve in endurance athletes and healthy sedentary controls, using adenosine transthoracic echocardiography. METHODS 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m2) and 23 male controls (age 27.2 (6.1) years, BMI 23.9 (2.6) kg/m2) with no coronary risk factors underwent transthoracic echocardiographic assessment of distal left anterior descending coronary artery (LAD) diameter and flow, both at rest and during intravenous adenosine infusion (140 μg/kg/min). RESULTS Distal LAD diameter and flow were adequately assessed in 19 controls (83%) and 26 athletes (90%). Distal LAD diameter in athletes (2.04 (0.25) mm) was not significantly greater than in sedentary controls (1.97 (0.27) mm). Per cent increase in LAD diameter following 400 μg sublingual nitrate was greater in the athletes than in the controls, at 14.1 (7.2)%v 8.8 (5.7)% (p 
doi_str_mv 10.1136/heart.84.4.383
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METHODS 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m2) and 23 male controls (age 27.2 (6.1) years, BMI 23.9 (2.6) kg/m2) with no coronary risk factors underwent transthoracic echocardiographic assessment of distal left anterior descending coronary artery (LAD) diameter and flow, both at rest and during intravenous adenosine infusion (140 μg/kg/min). RESULTS Distal LAD diameter and flow were adequately assessed in 19 controls (83%) and 26 athletes (90%). Distal LAD diameter in athletes (2.04 (0.25) mm) was not significantly greater than in sedentary controls (1.97 (0.27) mm). Per cent increase in LAD diameter following 400 μg sublingual nitrate was greater in the athletes than in the controls, at 14.1 (7.2)%v 8.8 (5.7)% (p &lt; 0.01). Left ventricular mass index in athletes exceeded that of controls, at 130 (19) v 98 (14) g/m2(p &lt; 0.01). Resting flow among the athletes (10.6 (3.1) ml/min; 4.4 (1.2) ml/min/100 g left ventricular mass) was less than in the controls (14.3 (3.6) ml/min; 8.2 (2.2) ml/min/100 g left ventricular mass) (both p &lt; 0.01). Hyperaemic flow among the athletes (61.9 (17.8) ml/min) exceeded that of the controls (51.1 (14.6) ml/min; p = 0.02), but not when corrected for left ventricular mass (25.9 (5.6) v 28.5 (7.4) ml/min/100 g left ventricular mass; NS). Coronary flow reserve was therefore substantially greater in the athletes than in the controls, at 5.9 (1.0) v 3.7 (0.7) (p &lt; 0.01). CONCLUSIONS Coronary flow reserve in endurance athletes is supranormal and endothelium independent vasodilatation is enhanced. Myocardial hypertrophy per se does not necessarily impair coronary flow reserve. Adenosine transthoracic echocardiography is a promising technique for the investigation of coronary flow reserve.</description><identifier>ISSN: 1355-6037</identifier><identifier>ISSN: 0007-0769</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heart.84.4.383</identifier><identifier>PMID: 10995406</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Adenosine ; adenosine transthoracic echocardiography ; Adult ; athlete ; Athletes ; Biological and medical sciences ; Blood Flow Velocity ; Cardiovascular Medicine ; Cardiovascular system ; Case-Control Studies ; Coronary Circulation - physiology ; coronary flow reserve ; Coronary vessels ; Coronary Vessels - anatomy &amp; histology ; Echocardiography ; Endothelium ; Endothelium, Vascular - drug effects ; Feasibility studies ; Flow velocity ; Hibernation ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical imaging ; Medical sciences ; Physical Endurance - physiology ; Physiology ; Sports - physiology ; Ultrasonic investigative techniques ; Vasodilator Agents ; Veins &amp; arteries</subject><ispartof>British heart journal, 2000-10, Vol.84 (4), p.383-389</ispartof><rights>British Cardiac Society</rights><rights>2000 INIST-CNRS</rights><rights>Copyright: 2000 British Cardiac Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b581t-383be61f3af3fcf84ca6a775cb2614d8cbb68081fc87791c54d75ef199530c53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1729440/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1729440/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=1487170$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10995406$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hildick-Smith, D J R</creatorcontrib><creatorcontrib>Johnson, P J</creatorcontrib><creatorcontrib>Wisbey, C R</creatorcontrib><creatorcontrib>Winter, E M</creatorcontrib><creatorcontrib>Shapiro, L M</creatorcontrib><title>Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study</title><title>British heart journal</title><addtitle>Heart</addtitle><description>OBJECTIVE To compare coronary flow reserve in endurance athletes and healthy sedentary controls, using adenosine transthoracic echocardiography. METHODS 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m2) and 23 male controls (age 27.2 (6.1) years, BMI 23.9 (2.6) kg/m2) with no coronary risk factors underwent transthoracic echocardiographic assessment of distal left anterior descending coronary artery (LAD) diameter and flow, both at rest and during intravenous adenosine infusion (140 μg/kg/min). RESULTS Distal LAD diameter and flow were adequately assessed in 19 controls (83%) and 26 athletes (90%). Distal LAD diameter in athletes (2.04 (0.25) mm) was not significantly greater than in sedentary controls (1.97 (0.27) mm). Per cent increase in LAD diameter following 400 μg sublingual nitrate was greater in the athletes than in the controls, at 14.1 (7.2)%v 8.8 (5.7)% (p &lt; 0.01). Left ventricular mass index in athletes exceeded that of controls, at 130 (19) v 98 (14) g/m2(p &lt; 0.01). Resting flow among the athletes (10.6 (3.1) ml/min; 4.4 (1.2) ml/min/100 g left ventricular mass) was less than in the controls (14.3 (3.6) ml/min; 8.2 (2.2) ml/min/100 g left ventricular mass) (both p &lt; 0.01). Hyperaemic flow among the athletes (61.9 (17.8) ml/min) exceeded that of the controls (51.1 (14.6) ml/min; p = 0.02), but not when corrected for left ventricular mass (25.9 (5.6) v 28.5 (7.4) ml/min/100 g left ventricular mass; NS). Coronary flow reserve was therefore substantially greater in the athletes than in the controls, at 5.9 (1.0) v 3.7 (0.7) (p &lt; 0.01). CONCLUSIONS Coronary flow reserve in endurance athletes is supranormal and endothelium independent vasodilatation is enhanced. Myocardial hypertrophy per se does not necessarily impair coronary flow reserve. 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Johnson, P J ; Wisbey, C R ; Winter, E M ; Shapiro, L M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b581t-383be61f3af3fcf84ca6a775cb2614d8cbb68081fc87791c54d75ef199530c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adenosine</topic><topic>adenosine transthoracic echocardiography</topic><topic>Adult</topic><topic>athlete</topic><topic>Athletes</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Cardiovascular Medicine</topic><topic>Cardiovascular system</topic><topic>Case-Control Studies</topic><topic>Coronary Circulation - physiology</topic><topic>coronary flow reserve</topic><topic>Coronary vessels</topic><topic>Coronary Vessels - anatomy &amp; histology</topic><topic>Echocardiography</topic><topic>Endothelium</topic><topic>Endothelium, Vascular - drug effects</topic><topic>Feasibility studies</topic><topic>Flow velocity</topic><topic>Hibernation</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Physical Endurance - physiology</topic><topic>Physiology</topic><topic>Sports - physiology</topic><topic>Ultrasonic investigative techniques</topic><topic>Vasodilator Agents</topic><topic>Veins &amp; 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Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hildick-Smith, D J R</au><au>Johnson, P J</au><au>Wisbey, C R</au><au>Winter, E M</au><au>Shapiro, L M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study</atitle><jtitle>British heart journal</jtitle><addtitle>Heart</addtitle><date>2000-10-01</date><risdate>2000</risdate><volume>84</volume><issue>4</issue><spage>383</spage><epage>389</epage><pages>383-389</pages><issn>1355-6037</issn><issn>0007-0769</issn><eissn>1468-201X</eissn><abstract>OBJECTIVE To compare coronary flow reserve in endurance athletes and healthy sedentary controls, using adenosine transthoracic echocardiography. METHODS 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m2) and 23 male controls (age 27.2 (6.1) years, BMI 23.9 (2.6) kg/m2) with no coronary risk factors underwent transthoracic echocardiographic assessment of distal left anterior descending coronary artery (LAD) diameter and flow, both at rest and during intravenous adenosine infusion (140 μg/kg/min). RESULTS Distal LAD diameter and flow were adequately assessed in 19 controls (83%) and 26 athletes (90%). Distal LAD diameter in athletes (2.04 (0.25) mm) was not significantly greater than in sedentary controls (1.97 (0.27) mm). Per cent increase in LAD diameter following 400 μg sublingual nitrate was greater in the athletes than in the controls, at 14.1 (7.2)%v 8.8 (5.7)% (p &lt; 0.01). Left ventricular mass index in athletes exceeded that of controls, at 130 (19) v 98 (14) g/m2(p &lt; 0.01). Resting flow among the athletes (10.6 (3.1) ml/min; 4.4 (1.2) ml/min/100 g left ventricular mass) was less than in the controls (14.3 (3.6) ml/min; 8.2 (2.2) ml/min/100 g left ventricular mass) (both p &lt; 0.01). Hyperaemic flow among the athletes (61.9 (17.8) ml/min) exceeded that of the controls (51.1 (14.6) ml/min; p = 0.02), but not when corrected for left ventricular mass (25.9 (5.6) v 28.5 (7.4) ml/min/100 g left ventricular mass; NS). Coronary flow reserve was therefore substantially greater in the athletes than in the controls, at 5.9 (1.0) v 3.7 (0.7) (p &lt; 0.01). CONCLUSIONS Coronary flow reserve in endurance athletes is supranormal and endothelium independent vasodilatation is enhanced. Myocardial hypertrophy per se does not necessarily impair coronary flow reserve. Adenosine transthoracic echocardiography is a promising technique for the investigation of coronary flow reserve.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>10995406</pmid><doi>10.1136/heart.84.4.383</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Adenosine
adenosine transthoracic echocardiography
Adult
athlete
Athletes
Biological and medical sciences
Blood Flow Velocity
Cardiovascular Medicine
Cardiovascular system
Case-Control Studies
Coronary Circulation - physiology
coronary flow reserve
Coronary vessels
Coronary Vessels - anatomy & histology
Echocardiography
Endothelium
Endothelium, Vascular - drug effects
Feasibility studies
Flow velocity
Hibernation
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical imaging
Medical sciences
Physical Endurance - physiology
Physiology
Sports - physiology
Ultrasonic investigative techniques
Vasodilator Agents
Veins & arteries
title Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study
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