Adaptation of Left Ventricular Twist Mechanics in Exercise-Trained Children Is Only Evident after the Adolescent Growth Spurt

• Published in: Journal of the American Society of Echocardiography Vol. 37; no. 5; pp. 538 - 549
• Main Authors: Perkins, Dean R., Talbot, Jack S., Lord, Rachel N., Dawkins, Tony G., Baggish, Aaron L., Zaidi, Abbas, Uzun, Orhan, Mackintosh, Kelly A., McNarry, Melitta A., Cooper, Stephen-Mark, Lloyd, Rhodri S., Oliver, Jon L., Shave, Rob E., Stembridge, Mike
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2024
• Subjects: Adaptation, Physiological - physiology; Adolescent; Cardiovascular; Child; Echocardiography; Echocardiography - methods; Exercise; Exercise - physiology; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Myocardium; Twist; Ventricular Function, Left - physiology; Ventricular Remodeling - physiology; Youth; Echocardiography; HRmax; Youth; ESV; LV; MWT; Twist; BSA; Exercise; ANOVA; EDV; LBM; Myocardium; V˙O2max; PHV; Left ventricular; Peak height velocity; V˙O 2max; Maximal oxygen consumption; Lean body mass; Body surface area; Maximum heart rate; Mean wall thickness; End-diastolic volume; End-systolic volume; Analysis of variance; HR max
• ISSN: 0894-7317; 1097-6795; 1097-6795
• DOI: 10.1016/j.echo.2023.11.024

The extent of structural cardiac remodeling in response to endurance training is maturity dependent. In adults, this structural adaptation is often associated with the adaptation of left ventricular (LV) twist mechanics. For example, an increase in LV twist often follows an expansion in end-diastolic volume, whereas a reduction in twist may follow a thickening of the LV walls. While structural cardiac remodeling has been shown to be more prominent post–peak height velocity (PHV), it remains to be determined how this maturation-dependent structural remodeling influences LV twist. Therefore, we aimed to (1) compare LV twist mechanics between trained and untrained children pre- and post-PHV and (2) investigate how LV structural variables relate to LV twist mechanics pre- and post-PHV. Left ventricular function and morphology were assessed (echocardiography) in endurance-trained and untrained boys (n = 38 and n = 28, respectively) and girls (n = 39 and n = 34, respectively). Participants were categorized as either pre- or post-PHV using maturity offset to estimate somatic maturation. Pre-PHV, there were no differences in LV twist or torsion between trained and untrained boys (twist: P = .630; torsion: P = .382) or girls (twist: P = .502; torsion: P = .316), and LV twist mechanics were not related with any LV structural variables (P > .05). Post-PHV, LV twist was lower in trained versus untrained boys (P = .004), with torsion lower in trained groups, irrespective of sex (boys: P < .001; girls: P = .017). Moreover, LV torsion was inversely related to LV mass (boys: r = −0.55, P = .001; girls: r = −0.46, P = .003) and end-diastolic volume (boys: r = −0.64, P < .001; girls: r = −0.36, P = .025) in both sexes. A difference in LV twist mechanics between endurance-trained and untrained cohorts is only apparent post-PHV, where structural and functional remodeling were related. •Pre-PHV training status does not alter LV twist mechanics.•Post-PHV, LV twist mechanics are lower in endurance-trained versus untrained children.•LV twist mechanics are related to structural remodeling but only post-PHV.