Abstract 4036: Tricuspid Regurgitation Velocities in 515 Either Endurance or Power Competitive Athletes
Background. Doppler evaluation of tricuspid valve regurgitation velocity (TRV) can be used to estimate pulmonary artery systolic pressure. Previous invasive studies have demonstrated higher pressures in athletes. However, the full range of TRV in athletes has been incompletely defined.
Aims. To investigate the physiological adaptation of pulmonary pressure in response to different long-term training protocols, and to define reference values of TRV in competitive athletes.
Methods. The study population included 320 endurance-trained athletes (ATE) and 195 strength-trained athletes (ATS) (380 males; mean age 24.3±15.6 years; range: 18 – 40). All the subjects underwent conventional echocardiographic evaluation. Left ventricular (LV) stroke volume was calculated as LV outflow tract area × outflow tract time velocity integral. With continuous-wave Doppler, the maximum peak TRV recorded from any view was measured.
Results. LV mass index and ejection fraction did not significantly differ between the 2 groups. Conversely, ATS showed increased sum of wall thickness (septum + LV posterior wall), LV circumferential end-systolic stress and relative wall thickness, while LV stroke volume, LV end-diastolic diameter and peak TRV were significantly higher in ATE. In particular, a TRV value >2.5 m/s was observed in 65 athletes (12.5%). By multiple linear regression analyses, in the overall population of athletes age (p <0.01), duration of training (p<0.001) and LV stroke volume (p<0.005) were the only independent predictors of peak TRV.
Conclusions. This study defines the upper physiologic limits of TRV in athletes. The range of TRV is higher than generally recognized and in part is due to the duration of training. A mild increase of TRV is most pronounced in endurance athletes with larger LV stroke volume and should be interpreted as normal when evaluating athletes suspected for sports eligibility.