Right Heart and Pulmonary Hemodynamic Response to Prolonged Exercise in Middle-Aged Endurance Athletes

Chronic endurance exercise has shown to contribute to disproportionate right ventricular (RV) remodeling in athletes, and prolonged strenuous exercise has been associated with acute changes in RV function post-exercise, which are transient. RV function has been closely coupled to pulmonary arterial (PA) hemodynamics, and PA pressures appear to increase progressively with exercise intensity. There is however a paucity of directly-measured pulmonary hemodynamic data to support this observation. We characterized the PA hemodynamic and RV functional responses to acute, step-incremental (n=16) and sustained steady-state aerobic exercise (n=5) in healthy, middle-aged endurance athletes. All subjects underwent simultaneous right heart catheterization and echocardiography. PA pressures increased after initiation of exercise, then stabilized, without further change during acute and prolonged exercise. Accordingly, indices of RV function did not decline during prolonged exercise, altogether arguing against the notion that sustained elevations in pulmonary pressures may compromise RV systolic performance during prolonged aerobic exercise.M.Sc