Central hemodynamics in ultra-endurance athletes

Central hemodynamics such as ascending aortic blood pressure (BP), wave reflection and myocardial perfusion are clinically important in the context of cardiovascular health. Ultra-endurance athletes may be at greater risk of cardiovascular abnormalities due to chronically increased physiological stress placed on the cardiovascular system. This study was a cross-sectional investigation that compared central hemodynamics in ultra-endurance athletes and matched controls. Forty-four athletes (36 males; aged mean ± S.D., 34 ± 8 years) undergoing ultra-endurance training (16.3 ± 3.7 h/week) were compared to 44 matched recreationally active (1.2 ± 0.9 h/week) controls (36 males; aged 34 ± 8 years). Brachial BP was measured using an oscillometric device while central hemodynamics including ascending aortic BP, wave reflection (augmentation index, AIx), ejection duration, sub-endocardial perfusion (SEVR) and timing of the reflected wave (TR) were determined by applanation tonometry and pulse wave analysis. There were no significant (P > 0.05) differences between groups in AIx (athletes and controls; 6 ± 12% versus 6 ± 13%, respectively), TR (athletes and controls; 165 ± 22 ms versus 165 ± 19 ms, respectively), brachial (athletes and controls; 51 ± 9 mmHg versus 48 ± 12 mmHg, respectively) or central pulse pressure (33 ± 5 mmHg versus 31 ± 7 mmHg). However, athletes had significantly increased SEVR (226 ± 42% versus 198 ± 46%; P < 0.001) despite having a longer ejection duration (348 ± 19 ms versus 339 ± 18 ms; P < 0.05). Furthermore, the amount of exercise training volume was significantly related to central (r = -0.46; P = 0.002), but not brachial pulse pressure (r = -0.28; P > 0.05). Ultra-endurance athletes had increased sub-endocardial perfusion capacity and the quantity of exercise training was associated with central rather than peripheral hemodynamics.