Echocardiographic evidence of the cardiac stress of competing in ultra-endurance exercise

Numerous studies have utilised echocardiography to assess cardiac function pre and post prolonged endurance exercise to investigate the phenomena termed EICF. A large, but inconsistent, body of evidence has demonstrated LV systolic and diastolic EICF using global (2D and Doppler) echocardiographic imaging. More recent developments in imaging technology have afforded regional as well as multi-plane motion assessment of the LV exercise response using tissue Doppler and myocardial deformation analysis. These new tools have provided additional descriptive insight with respect to EICF and have begun to point to possible mechanism(s). Further these imaging modes have been applied to the assessment of LA and RV functional responses to prolonged exercise. Understanding the interplay between the RV, LA and LV and their impact on loading conditions during and in recovery from prolonged endurance exercise is likely to be vital in on-going attempts to elucidate mechanism(s) associated with EICF.