Atrial Performance During an Endurance Race

Study Questions:

What is the effect of endurance exercise on atrial function?


This study examined 55 men participating in an endurance race, with patient stratified by short (group S; 14 cm), medium (group M; 35 km), and long-distance (group L; 56 km) races, and compared atrial and ventricular function using speckle-tracking. Echocardiography with strain was performed 24 hours before the race, and within an hour of completion, with comparisons in atrial and ventricular function based on strain imaging.


There were baseline differences in groups, with patients running for longer distances reporting more frequent and higher-intensity training, as well as larger baseline left atrial (LA), right atrial (RA), and right ventricular (RV) size. In comparison to baseline function, RA reservoir function (sum of absolute values of negative and positive strain peaks and positive strain rate) did not change in group S, with a decrease in group M (-12.5) and a larger decrease in group L (-15.4) (p < 0.05). RA contractile function increased in group S (14.8), did not change in group M (0.7), and decreased in group L (-9.3) (p < 0.05). RV global longitudinal strain increased in group S (5.1), and decreased in group M (-7.6) and L (-8.7) (p < 0.05). The decrease in RA reservoir after running correlated with the lower RV global longitudinal strain (0.44, p < 0.05).


Increased duration of endurance running is associated with an acute impairment of RA function, which appears associated with impaired systolic function of the RV.


This study observes acute changes in RA function related to exercise duration, and suggests that longer duration of endurance exercise was associated with decreased acute RA function. A decrease in RV systolic function was also observed with increased race duration, and there was a modest correlation between RA and RV function, suggesting a potential relationship. There were baseline differences between groups in exercise training and right-sided chamber size, which limits the ability to draw specific conclusions from these findings. Whether these findings are related to observed differences in chamber size and rates of atrial arrhythmias in endurance athletes remains to be determined.

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Sports and Exercise Cardiology, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Echocardiography/Ultrasound, Exercise, Sports & Exercise and Imaging

Keywords: Arrhythmias, Cardiac, Athletes, Atrial Function, Right, Diagnostic Imaging, Echocardiography, Exercise, Heart Failure, Physical Endurance, Running, Systole, Ventricular Function, Right

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