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Exercise cardiovascular magnetic resonance shows improved diastolic filling by atrioventricular area difference in athletes and controls

Edlund, Jonathan LU orcid ; Östenson, Bjorn LU orcid ; Heiberg, Einar LU orcid ; Arheden, Håkan LU and Steding-Ehrenborg, Katarina LU (2024) In Journal of Applied Physiology 137(6). p.1554-1562
Abstract

Hydraulic force, a novel mechanism shown to aid diastolic filling, can be calculated by assessing the geometrical relationship between the left ventricular and atrial short-axis areas (atrioventricular area difference, AVAD) (Maksuti E, Carlsson M, Arheden H, Kovács SJ, Broome M, Ugander M. Sci Rep 7: 43505-43510, 2017; Steding-Ehrenborg K, Hedstrom € E, Carlsson M, Maksuti E, Broome M, Ugander M, Magnusson M, Smith JG, Arheden H. J Appl Physiol (1985) 130: 993-1000, 2021). During exercise both ventricular and atrial volumes change due to altered loading conditions compared with rest, but it is unknown to what extent this affects AVAD. The aim of this study was to investigate whether AVAD differs when going from rest to exercise in... (More)

Hydraulic force, a novel mechanism shown to aid diastolic filling, can be calculated by assessing the geometrical relationship between the left ventricular and atrial short-axis areas (atrioventricular area difference, AVAD) (Maksuti E, Carlsson M, Arheden H, Kovács SJ, Broome M, Ugander M. Sci Rep 7: 43505-43510, 2017; Steding-Ehrenborg K, Hedstrom € E, Carlsson M, Maksuti E, Broome M, Ugander M, Magnusson M, Smith JG, Arheden H. J Appl Physiol (1985) 130: 993-1000, 2021). During exercise both ventricular and atrial volumes change due to altered loading conditions compared with rest, but it is unknown to what extent this affects AVAD. The aim of this study was to investigate whether AVAD differs when going from rest to exercise in sedentary controls and athletes. We included 13 sedentary controls and 20 endurance athletes to undergo cardiovascular magnetic resonance (CMR) imaging at rest and during moderate and vigorous exercise using a CMR-compatible ergometer. AVAD was calculated as the largest ventricular short-axis area minus the largest atrial short-axis area in end-diastole (ED) and end-systole (ES) as measured from CMR short-axis images. AVAD in ED increased during moderate exercise in both sedentary controls and athletes, thus aiding diastolic filling, but did not increase further during vigorous exercise. AVAD in ES was negative in both groups at rest and decreased further with increasing exercise intensity in sedentary controls, whereas athletes remained unchanged. In conclusion, results from AVAD in ED indicate the net hydraulic force to further augment diastolic filling during moderate exercise when compared with rest, providing new insights into the mechanism by which diastolic function increases during exercise. NEW & NOTEWORTHY This study is the first to assess hydraulic force during exercise, a novel mechanism shown to augment diastolic filling at rest. Our results indicate hydraulic force to further aid in diastolic filling during moderate exercise compared with rest in athletes and sedentary controls, providing new insights into the mechanism by which the left ventricle increases diastolic function during exercise.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrioventricular area difference, exercise cardiac magnetic resonance imaging, hydraulic force, left atrium, left ventricle
in
Journal of Applied Physiology
volume
137
issue
6
pages
9 pages
publisher
American Physiological Society
external identifiers
  • scopus:85211635957
  • pmid:39417822
ISSN
8750-7587
DOI
10.1152/japplphysiol.00446.2024
language
English
LU publication?
yes
id
42316e76-dd71-481a-9673-d4ccc0bbbfc7
date added to LUP
2025-01-20 15:10:37
date last changed
2025-07-08 04:44:31
@article{42316e76-dd71-481a-9673-d4ccc0bbbfc7,
  abstract     = {{<p>Hydraulic force, a novel mechanism shown to aid diastolic filling, can be calculated by assessing the geometrical relationship between the left ventricular and atrial short-axis areas (atrioventricular area difference, AVAD) (Maksuti E, Carlsson M, Arheden H, Kovács SJ, Broome M, Ugander M. Sci Rep 7: 43505-43510, 2017; Steding-Ehrenborg K, Hedstrom € E, Carlsson M, Maksuti E, Broome M, Ugander M, Magnusson M, Smith JG, Arheden H. J Appl Physiol (1985) 130: 993-1000, 2021). During exercise both ventricular and atrial volumes change due to altered loading conditions compared with rest, but it is unknown to what extent this affects AVAD. The aim of this study was to investigate whether AVAD differs when going from rest to exercise in sedentary controls and athletes. We included 13 sedentary controls and 20 endurance athletes to undergo cardiovascular magnetic resonance (CMR) imaging at rest and during moderate and vigorous exercise using a CMR-compatible ergometer. AVAD was calculated as the largest ventricular short-axis area minus the largest atrial short-axis area in end-diastole (ED) and end-systole (ES) as measured from CMR short-axis images. AVAD in ED increased during moderate exercise in both sedentary controls and athletes, thus aiding diastolic filling, but did not increase further during vigorous exercise. AVAD in ES was negative in both groups at rest and decreased further with increasing exercise intensity in sedentary controls, whereas athletes remained unchanged. In conclusion, results from AVAD in ED indicate the net hydraulic force to further augment diastolic filling during moderate exercise when compared with rest, providing new insights into the mechanism by which diastolic function increases during exercise. NEW &amp; NOTEWORTHY This study is the first to assess hydraulic force during exercise, a novel mechanism shown to augment diastolic filling at rest. Our results indicate hydraulic force to further aid in diastolic filling during moderate exercise compared with rest in athletes and sedentary controls, providing new insights into the mechanism by which the left ventricle increases diastolic function during exercise.</p>}},
  author       = {{Edlund, Jonathan and Östenson, Bjorn and Heiberg, Einar and Arheden, Håkan and Steding-Ehrenborg, Katarina}},
  issn         = {{8750-7587}},
  keywords     = {{atrioventricular area difference; exercise cardiac magnetic resonance imaging; hydraulic force; left atrium; left ventricle}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1554--1562}},
  publisher    = {{American Physiological Society}},
  series       = {{Journal of Applied Physiology}},
  title        = {{Exercise cardiovascular magnetic resonance shows improved diastolic filling by atrioventricular area difference in athletes and controls}},
  url          = {{http://dx.doi.org/10.1152/japplphysiol.00446.2024}},
  doi          = {{10.1152/japplphysiol.00446.2024}},
  volume       = {{137}},
  year         = {{2024}},
}