Geert Kleinnibbelink

Acute Cardiac Responses vs. Cardiac Remodelling 3 77 9 0 23 21 19 17 15 13 11 -5 -10 -15 -20 -25 25 Left ventricular volume (ml) Left ventricular longitudinal strain (%) Right ventricular longitudinal strain (%) Right ventricular area (cm 2 ) 20 90 80 70 60 50 40 30 -5 -10 -15 -20 -25 100 110 A) B) Pre-training systolic Post-training systolic Pre-training diastolic Post-training diastolic Pre-training systolic Post-training systolic Pre-training diastolic Post-training diastolic Figure 3 . A) mean RV strain-area loops and B) mean LV strain-volume loops prior to (‘Pre Systolic’: black lines, ‘Pre Diastolic’: black dotted lines) and post (‘Post Systolic’: red lines, ‘Post Diastolic’: red dotted lines) 12-week hypoxic high-intensity running exercise training program. Error bars represent means ± SE. Acute exercise-induced changes in cardiac responses versus structural adaptation Prior to training, all systolic indices for RV function (RVFWS, TDI s’, RVFAC, TAPSE) significantly increased with acute exercise (all p < 0.05) ( Table 3 ). The RV strain-area loop characteristics did not significantly change with acute exercise (all p > 0.05) ( Table 3 ). The change in RVFAC with acute exercise showed a significant inverse correlation with changes in basal diameter post-training (r=-0.66, p=0.01) ( Figure 4 ). The inverse relation indicates that a lesser increase in RVFAC with acute exercise is associated with greater RV structural adaptation to training. Changes in RVFWS, TDI s’ and TAPSE with acute exercise did not correlate with RV structural indices (data in Supplemental 2). As strain-area loop characteristics did not significantly change with acute exercise, we did not perform correlations analysis on these data. Intra-observer variability . ICC were as follows: RV free wall strain 0.96 (0.84-0.99), Sslope 0.92 (0.70-0.98), ESslope 0.84 (0.48-0.96), EDslope 0.94 (0.79-0.99), LDslope 0.95 (0.80- 0.99), Uncoupling 0.87 (0.56-0.97), Uncoupling_ED 0.86 (0.52-0.96), Uncoupling_LD 0.88 (0.58-0.97), RVEDA 0.96 (0.87-0.99), RVESA 0.94 (0.78-0.99), RVFAC 0.92 (0.72-0.98), RV basal diameter 0.91 (0.68-0.98), RV mid-cavity diameter 0.80 (0.38-0.95), RVOT PLAX 0.75 (0.27-0.93), RA area 0.99 (0.97-0.99), IVSd 0.67 (0.12-91), PWd 0.74 (0.25-0.93), LVIDd 0.79 (0.35-0.94).