THE EFFECT OF LEFT VENTRICULAR FALSE TENDON PHENOTYPES ON EXERCISE PERFORMANCE IN ATHLETES

Abstract

Aim: this paper aims to investigate the effect of left ventricular false tendon (LVFT) phenotypes on physical performance in athletes. Materials and methods. This study involved 69 athletes from cyclic and team sports, aged 16–26 years. All participants underwent transthoracic echocardiography (ECG) to determine LVFT topology and parameters of global and regional myocardial structure and function. Exercise testing was performed according to a maximal protocol with ECG and gas exchange analysis. Results. The most unfavorable topologies with respect to functional reserve utilization and physical performance are two transverse LVFTs or a network-like chordal architecture (more than three elements dif­fering in orientation). This phenomenon is due to a significant increase in myocardial mechanical inhomogeneity and reduced efficiency of functional reserve utilization during cardiac adaptation to physical load (increased systolic wall stress of the left ventricle and decreased maximal oxygen consumption). The most favorable LVFT phenotype for sports participation is characterized by single, thin, transverse, or small-angle LVFTs. Conclusions. LVFT phenotypes determine the heart’s ability to adapt to physical load through the corresponding effect of abnormalities on structural and functional inhomogeneity of the LV wall.