Geert Kleinnibbelink

Chapter 4 92 women, whilst greater LV adaptation may be present in women during dynamic exercise. 9, 10 Therefore, as an explorative aim, we evaluate the impact of sex on the impact of exercise in elite rowers on left- and right-sided cardiac structure, function and mechanics. METHODS Study population and study design In this prospective, longitudinal study, as part of the work-up to the 2012 Olympic Games, twenty-seven elite level rowers (male and female, all Caucasian) underwent baseline echocardiography prior to and post (9-months) a planned increase in training volume. Baseline echocardiograms were performed immediately after the 2011 World Rowing Championships (i.e. when all athletes were in a highly trained status), and 3 months before the 2012 Olympic Games. After the baseline echocardiograms, the rowers, both male and female, increased their training volume gradually from 24 hours to 30-35 hours per week (20% strength, 80% rowing training consisting of high-intensity interval and endurance training). Height and weight were obtained before echocardiography was performed (SECA scale and stadiometer, SECA GmbH, Hamburg, Germany). This study was conducted in accordance to with the ethical standards in sport and exercise science research and approved by the Radboud University Medical Center ethics committee. 11 Echocardiographic measurements The echocardiographic examinations were performed in the left lateral decubitus position by one highly experienced cardiologist (AvD) using a Vivid-Q ultrasound machine (GE Medical, Horton, Norway), equipped with a 1.5-4 MHz phased array transducer. Heart rate was calculated from a single lead ECG inherent to the ultrasound system. Images were stored in raw digital imaging and communication in medicine (DICOM) format and were exported to an offline workstation (EchoPac, version 113, GE Medical, Horton, Norway). Data-analysis, from three stored cycles, was performed by a single observer with experience in echocardiography (GK) using commercially available software (EchoPac, version 113, GE Medical, Horton, Norway). The echocardiograms were all coded so the observer was blinded for the timing (pre vs. post) and for sex (male vs. female).