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Background: Neuromuscular function is considered as a determinant factor of endurance performance during adulthood. However, whether endurance training triggers further neuromuscular adaptations exceeding those of growth and maturation alone over the rapid adolescent growth period is yet to be determined. Objective: The present study investigated the concurrent role of growth, maturation, and endurance training on neuromuscular function through a 9‐month training period in adolescent triathletes. Methods: Thirty‐eight 13‐ to 15‐year‐old males (23 triathletes [~6 h/week endurance training] and 15 untrained [<2 h/week endurance activity]) were evaluated before and after a 9‐month triathlon training season. Maximal oxygen uptake (V̇O2max) and power at V̇O2max were assessed during incremental cycling. Knee extensor maximal voluntary isometric contraction torque (MVCISO) was measured and the voluntary activation level (VAL) was determined using the twitch interpolation technique. Knee extensor doublet peak torque (T100Hz) and normalized vastus lateralis (VL) electromyographic activity (EMG/M‐wave) were also determined. VL and rectus femoris (RF) muscle architecture was assessed using ultrasonography. Results: Absolute V̇O2max increased similarly in both groups but power at V̇O2max only significantly increased in triathletes (+13.8%). MVCISO (+14.4%), VL (+4.4%), and RF (+15.8%) muscle thicknesses and RF pennation angle (+22.1%) increased over the 9‐month period in both groups similarly (p < 0.01), although no changes were observed in T100Hz, VAL, or VL EMG/M‐wave. No changes were detected in any neuromuscular variables, except for coactivation. Conclusion: Endurance training did not induce detectible, additional neuromuscular adaptations. However, the training‐specific cycling power improvement in triathletes may reflect continued skill enhancement over the training period. [ABSTRACT FROM AUTHOR]

Left atrial (LA) function plays a pivotal role in cardiac performance by modulating left ventricular (LV) function. Impairments in LV function are commonly reported during hemodialysis (HD), but available data describing changes in LA function are limited. There is growing evidence of the cardioprotective effect of intradialytic exercise (IDE) on LV function, but studies analyzing its effect on LA function are scarce. Our aim was to evaluate whether IDE can limit the severity of HD-induced impairment in LA myocardial function. In this prospective, open-label, two-center randomized crossover trial, 56 stable individuals receiving HD participated in 2 HD sessions in random order: standard HD and a session incorporating 30 min of aerobic exercise. LA and LV global longitudinal strains (GLSs) were obtained before and at peak stress of HD (i.e., 30 min before the HD ending). IDE totally eradicated the decline in LA reservoir strain observed during HD (estimated difference: 3.1%, 95% confidence interval: 0.4/5.8, P = 0.02), whereas it did not affect the other components of LA mechanics. A similar result favoring IDE intervention was also demonstrated on GLS changes over the HD procedure (P < 0.001). Between-session differences of changes in GLS and LA reservoir strain were correlated (r = −0.32, P = 0.03). The cardioprotective effect of IDE disappeared in patients with LA enlargement (i.e., LA volume index >34 mL/m2). In conclusion, even a short duration of IDE at moderate intensity is effective in preventing HD-associated decline in LA reservoir function. Further research is needed to explore the long-term benefits of IDE on LA function. [ABSTRACT FROM AUTHOR]

Background: Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in childhood lymphoma survivors (CLS). Methods: Thirty‐one young adults including CLS and age‐matched healthy controls were enrolled. All underwent echocardiography including an evaluation of left ventricular (LV) morphology and regional function. We assessed LV longitudinal (differentiating sub‐endocardial and sub‐epicardial layers), circumferential strains and twist, global and regional MW index (MWI). LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain, from myocardial wasted work (MWW) and myocardial work efficiency (MWE). Results: The longitudinal strains both at the level of the sub‐endocardium and sub‐epicardium were reduced in CLS compared to controls. The global MWI was also decreased (1668 ± 266 vs 1870 ± 264%.mmHg in CLS patients and controls, respectively, p < 0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. MWW and MWE remained unchanged compared to controls. Conclusion: Our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in MW and an increase in LV mechanical dispersion. The apex is specifically altered, but its clinical significance remains uncertain. MW as a complement to strain seems interesting in cancer survivors to detect myocardial dysfunction at early stage and adapt their follow‐up. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the acute effects of a long-duration adventure race on knee extensor (KE) fatigue and the knee functional ratio in adolescent athletes. Methods: Twenty trained male adolescents (aged 14–17 y) performed an adventure race of 68.5 km. Maximal voluntary isometric contraction (MVIC) KE and knee flexor torques were measured before and immediately after the race. Central and peripheral components of neuromuscular fatigue were quantified from the maximal voluntary activation level and the doublet peak torque (Tw100), respectively. The peak eccentric knee flexor torque to concentric KE torque ratio was also measured to determine functional ratio. Results: The race completion time was 05:38 (00:20) hours. Significant reductions in MVICKE (−14.7%, P <.001) and MVICKF (−17.0%, P <.01) were observed after the race. Voluntary activation level decreased by 8.3% (P <.001) while Tw100 remained unchanged. Peak eccentric knee flexor torque decreased 16.0% (P <.001) while peak concentric KE torque did not change. This resulted in a significant reduction in functional ratio (−12.0%, P <.01). Conclusion: The adventure race induced a moderate fatigue, which was mainly explained by central factors without significant peripheral fatigue. However, particular attention should be paid to the knee muscular imbalance incurred by the race, which could increase the risk of ligament injury in adolescent athletes. [ABSTRACT FROM AUTHOR]

We investigated the acute cardiac consequences of a long-duration (>5 h) adventure race in adolescent athletes from evaluations of left ventricular (LV) strains and myocardial work. Twenty trained male adolescents (i.e. 8 ± 4 h·week−1 of endurance sports) aged 14–17 years participated in a competitive long-duration adventure race. Blood samples were collected before, immediately and 24 h after the race to determine the time course of troponin I (cTnI) considered a myocardial damage biomarker. Resting echocardiography was conducted before and after the race to assess myocardial regional strains, LV twisting mechanics and myocardial work using speckle tracking echocardiography. The mean completion time of the race was 05:38 ± 00:20 h, with a mean heart rate (HR) of 83 ± 5% of maximal HR. cTnI concentration significantly increased in 16/20 participants after the race (pre: 0.001 ± 0.002 vs. post: 0.244 ± 0.203 ng·dL−1, p <.001) and returned to baseline within 24 h. Stroke volume, ejection fraction and global longitudinal strains remained unchanged after the race, while LV twist and global myocardial work significantly decreased (8.6 ± 3.3 vs. 6.3 ± 3.3 deg and 2080 ± 250 vs. 1781 ± 334 mmHg%, p <.05). Diastolic function, indexes of myocardial relaxation and LV untwisting rate (−91.0 ± 19.0 vs. −56.4 ± 29.1 deg·s−1, p <.001) were affected after the race. We demonstrated that in trained adolescents, a high-intensity endurance exercise of several hours induced an increase of the cTnI concentration associated with an alteration of myocardial function. Highlights This is the first study to explore the acute cardiac consequences of a very-long duration and high-intensity race in trained adolescents The cardiac evaluations before and immediately after the race were conducted using up-to-date advances in echocardiography, including not only regional left ventricular strains, rotations and twists, but also global myocardial work to consider changes in loading conditions that occur after such exercises. We observed exercise-induced cardiac fatigue in the adolescents, characterized by a drop in myocardial work, associated with an increase of cardiac troponin I in 16/20 participants. The cardiac alterations were principally observed at the apical level of the heart: the apical strains and rotations were decreased and delayed. Consequently, left ventricular twist and twisting rates were also delayed, which probably affected the diastolic function after the race. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to assess left ventricular (LV) morphological and regional functional adaptations in backs and forwards elite rugby union (RU) players. Methods: Thirty-nine elite male RU players and twenty sedentary controls have been examined using resting echocardiography. RU players were divided into two groups, forwards (n = 22) and backs (n = 17). Evaluations included tissue Doppler and 2D speckle-tracking analysis to assess LV strains and twisting mechanics. Results: The elite RU players exhibited an LV remodelling characterized by an increase in LV mass indexed to body surface area (82.2 ± 13.2 vs. 99.9 ± 16.1 and 119.7 ± 13.4 g.m−2, in controls, backs and forwards; P <.001). Compared to backs, forwards exhibited lower global longitudinal strain (19.9 ± 2.5 vs. 18.0 ± 1.6%; P <.05), lower early diastolic velocity (16.5 ± 1.8 vs. 15.0 ± 2.3 cm.s−1; P <.05) and lower diastolic longitudinal strain rate (1.80 ± 0.34 vs. 1.54 ± 0.26 s−1; P <.01), especially at the apex. LV twist and untwisting velocities were similar in RU players compared to controls, but with lower apical (−46.2 ± 22.1 vs. −28.2 ± 21.7 deg.s−1; P <.01) and higher basal rotational velocities (33.9 ± 20.9 vs. 48.4 ± 20.7 deg.s−1; P <.05). Conclusion: RU players exhibited an increase in LV mass which was more pronounced in forwards. In forwards, LV global longitudinal strain was depressed, LV filling pressures were decreased, and LV relaxation depressed at the apex. Highlights Elite RU players exhibited LV hypertrophy, especially in forwards players. LV regional function suggested a drop in LV relaxation and an increase in LV filling pressures in RU players, with higher alterations in forwards. LV remodelling was associated with regional alterations in torsional mechanics: higher rotations and rotational diastolic velocities at the basal level of LV but lower rotation and rotational diastolic velocities at the apex were observed in RU players. [ABSTRACT FROM AUTHOR]

The present study investigated the acute effects of a mixed-modality, long-duration adventure race on pulmonary function in adolescent athletes. Twenty male adolescents aged 14 to 17 years volunteered to participate in a wilderness adventure race of 68.5-km. Expiratory function was evaluated before, immediately after, and 24 h after race completion. Measurements included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF). Maximal inspiratory and expiratory mouth static pressures (MIP and MEP, respectively) were also measured using a portable hand-held mouth pressure meter across the same time points. The mean completion time of the race was 05:38±00:20 hours. A significant post-race decrease in FVC was observed immediately after the race (−5.2%, p=0.01). However, no significant changes were observed for FEV1 , PEF and the FEV1 /FVC and FEV1 /PEF ratios. In addition, estimates of respiratory muscle strength (MIP and MEP) were unaffected by the race. The long-duration adventure race induced no marked reduction in expiratory pulmonary function and this response was associated with no apparent respiratory muscle fatigue. Therefore, the pulmonary system of trained adolescent athletes was sufficiently robust to sustain the mixed-modality, long-duration adventure race of ~ 5–6 h. [ABSTRACT FROM AUTHOR]

We questioned whether changes in high-intensity locomotor and micro-movements patterns between the first and second part of each half depend on playing position in the 2014–2015 European rugby union championship winning team. Thirty-three rugby players were grouped according to five playing positions. Players were equipped with micro-electromechanical system including a GPS sampling at 10 Hz and high temporal resolution micro-sensors during 17 Top14 and 7 European games. High-speed movements (HSM), high-intensity accelerations (HIA), repeated high-intensity efforts (RHIE), and high-intensity micro-movements (HIMM) were subsequently compared between four 20-min game periods. No significant group × time interactions were observed for any locomotor variables (p > 0.283). Irrespectively of playing position, the number of HSM (p = 0.019), decreased from 0–20 min to 60–80 min as well as from 40–60 to 60–80 min (p < 0.001) with HIA (p = 0.020) and RHIE (p < 0.001). Significant group × time interaction was found for HIMM (p = 0.03) with a significant decrease observed in back row forwards from 0–20 to 60–80 min periods (−17.5%; ES = 0.6; p = 0.031). In elite rugby union, fatigue-induced changes during the last 20 min are independent from playing positions in high-intensity locomotor patterns in contrary to HIMM. Training drills that include specific RHIE (high-speed and HIA efforts) may be useful to postpone match-related fatigue. [ABSTRACT FROM AUTHOR]