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Cited by 80Cardiovascular Effects of ExerciseCardiac Imaging and DiagnosticsCardiovascular and exercise physiology

Coronary flow reserve is supranormal in endurance athletes: an adenosine transthoracic echocardiographic study

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Hildick-Smith, D J R·2000·Heart
DOI 10.1136/heart.84.4.383PMC PMC1729440
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Abstract

OBJECTIVE: To compare coronary flow reserve in endurance athletes and healthy sedentary controls, using adenosine transthoracic echocardiography. METHODS: 29 male endurance athletes (mean (SD) age 27.3 (6.6) years, body mass index (BMI) 22.1 (1.9) kg/m(2)) and 23 male controls (age 27.2 (6.1) years, BMI 23.9 (2.6) kg/m(2)) with no coronary risk factors underwent transthoracic echocardiographic assessment of distal left anterior descending coronary artery (LAD) diameter and flow, both at rest and during intravenous adenosine infusion (140 microg/kg/min). RESULTS: Distal LAD diameter and flow were adequately assessed in 19 controls (83%) and 26 athletes (90%). Distal LAD diameter in athletes (2.04 (0.25) mm) was not significantly greater than in sedentary controls (1.97 (0.27) mm). Per cent increase in LAD diameter following 400 microg sublingual nitrate was greater in the athletes than in the controls, at 14.1 (7. 2)% v 8.8 (5.7)% (p < 0.01). Left ventricular mass index in athletes exceeded that of controls, at 130 (19) v 98 (14) g/m(2) (p < 0.01). Resting flow among the athletes (10.6 (3.1) ml/min; 4.4 (1.2) ml/min/100 g left ventricular mass) was less than in the controls (14.3 (3.6) ml/min; 8.2 (2.2) ml/min/100 g left ventricular mass) (both p < 0.01). Hyperaemic flow among the athletes (61.9 (17.8) ml/min) exceeded that of the controls (51.1 (14.6) ml/min; p = 0.02), but not when corrected for left ventricular mass (25.9 (5.6) v 28.5 (7.4) ml/min/100 g left ventricular mass; NS). Coronary flow reserve was therefore substantially greater in the athletes than in the controls, at 5.9 (1.0) v 3.7 (0.7) (p < 0.01). CONCLUSIONS: Coronary flow reserve in endurance athletes is supranormal and endothelium independent vasodilatation is enhanced. Myocardial hypertrophy per se does not necessarily impair coronary flow reserve. Adenosine transthoracic echocardiography is a promising technique for the investigation of coronary flow reserve.

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  • Beneficial vascular adaptations such as an improved coronary flow reserve may allow athletes to better deal with coronary stenoses and experience fewer symptoms and events than the general population with a similar plaque burden.

    “Therefore, beneficial vascular adaptations such as an improved coronary flow reserve 46, 47 may also allow athletes to better deal with coronary stenoses and experience fewer symptoms and events than the general population with a similar plaque burden.”

    From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [46]

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Cited by

Sorted by citations

Authors
Hildick-Smith, D. J. R.
Venue
Heart
Publisher
BMJ
Published
2000-10-01
Volume
84
Issue
4
Pages
383-389
ISSN
0007-0769 (ISSN-L)
DOI
10.1136/heart.84.4.383
PMC
PMC1729440
OpenAlex
W2049912746
Cited by
80
References
3
Citations by year
2026: 3 · 2025: 2 · 2024: 1 · 2023: 3 · 2021: 9 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 8
FWCI
2.23
Type
journal article
Language
en
Open access
Locations
  • Heart (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
coronary flow reserve, endurance athletes, adenosine, left anterior descending artery, coronary artery diameter, left ventricular mass, exercise training, cardiac hypertrophy, coronary microvascular function, sedentary controls, transthoracic echocardiography, myocardial perfusion imaging, coronary microvascular dysfunction, coronary reserve
MeSH terms
Adenosine, Adult, Blood Flow Velocity, Coronary Circulation, Coronary Vessels, Echocardiography, Endothelium, Vascular, Humans, Male, Physical Endurance, Sports, Vasodilator Agents, Case-Control Studies

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