Conclusion
We have described in detail the augmentation of a variety of systolic
parameters during exercise in fit young adults demonstrating two
patterns of augmentation; linear for S’ and E’ and a plateau for EF and
GLS. The magnitude of the augmentation (14% for EF / 89% for S’ is in
line with previous research. The study describes the relationship
between longitudinal function (as expressed by S’) and
VO2 throughout exercise. Systolic velocity, which
represents early and mid-systolic function, is more important than whole
systolic parameters such as ejection fraction including GLS in
predicting exercise performance. The SES described for the first time
shows that the regressive relationship between S’ / VO2predicts peak exercise tolerance which proves that the relationship is
more than simply collinearity. It also offers a novel research
opportunity to evaluate disease states where this relationship may be
different. We abandon the past at our peril, and this data suggests a
move from velocity to strain may not be justified or helpful in
evaluating myocardial performance during exercise.
Acknowledgements
We thank the study participants for their time and taking part in the
study. We are also grateful to Virgin London Marathon for their support
in recruitment of participants. We are grateful to the entire marathon
study team performing investigations. In addition to the authors of this
manuscript, The Marathon Study group included the following staff from
St George’s University of London, University College London, Bart’s
Health Trust and other organizations.
Funding
The Marathon Study was funded by the British Heart Foundation
(FS/15/27/31465), Cardiac Risk in the Young, and the Barts
Cardiovascular Biomedical Research Centre. The study received support
from COSMED (Rome, Italy) through the provision of cardiopulmonary
exercise testing equipment and technical support.
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Table 1: Baseline characteristics