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