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Other studies have identified three major exercise-induced pulmonary changes: bronchoconstriction, dynamic hyperinflation and pulmonary oedema with reduced alveolar\u2013capillary membrane diffusing capacity. This study investigated whether athletes with one of these pulmonary dysfunctions following a very long-distance triathlon exhibit similar cardiac alterations as those without dysfunctions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty trained male triathletes (age 39\u2009\u00b1\u20099\u00a0years) underwent baseline and post-race assessments, including echocardiography (with standard, 2D-strain and myocardial work assessments), spirometry and double-diffusion technique to evaluate alveolar\u2013capillary membrane diffusing capacity for carbon monoxide (DM\n                      <jats:sub>CO<\/jats:sub>\n                      ). Cardiac function in athletes with exercise-induced bronchoconstriction (&gt;\u200910% decrease FEV\n                      <jats:sub>1<\/jats:sub>\n                      ), dynamic hyperinflation (&gt;\u200910% decrease inspiratory capacity) or impaired diffusion capacity (&gt;\u200920% decrease DM\n                      <jats:sub>CO<\/jats:sub>\n                      \/alveolar volume) were compared with those without these dysfunctions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The race lasted 14\u00a0h 20\u00a0min\u2009\u00b1\u20091\u00a0h 26\u00a0min. Both systolic and diastolic cardiac functions declined post-race. Post-race, 18% of athletes had bronchoconstriction, 58% dynamic hyperinflation and 40% impaired diffusing capacity. Right and left ventricular standard and 2D-strain parameters were similar before the race in all subgroups and changed similarly post-race, except E\/E\u2032, which decreased in the bronchoconstriction subgroup and increased in those with diffusion impairment. Global constructive work decreased by\u2009~\u200919% post-race (2302\u2009\u00b1\u2009226 versus 1869\u2009\u00b1\u2009328\u00a0mmHg%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), more pronounced in athletes with diffusion impairment compared with others (\u2212\u200926\u2009\u00b1\u200913 versus\u2009\u2212\u200915\u2009\u00b1\u20099%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and positively correlated with DM\n                      <jats:sub>CO<\/jats:sub>\n                      \/alveolar volume reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After a very long-distance triathlon, bronchoconstriction and hyperinflation were not associated with significant cardiac changes, whereas impaired alveolar\u2013capillary membrane diffusing capacity was associated with a more significant decline in myocardial function. These findings highlight the complex relationship between pulmonary gas exchange abnormalities and cardiac fatigue following prolonged strenuous exercise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40279-024-02128-8","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T15:01:44Z","timestamp":1729090904000},"page":"739-751","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cardiac Fatigue in Male Athletes with Exercise-Induced Pulmonary Impairments After a Very Long-Distance Triathlon"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-2097","authenticated-orcid":false,"given":"Christophe","family":"H\u00e9don","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fares","family":"Gouzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Padovani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris","family":"Schuster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Maufrais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Cade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Cransac","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaspard","family":"Bui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Morcillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronia","family":"Ayoub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9r\u00f4me","family":"Thireau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Izem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyril","family":"Reboul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Walther","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurice","family":"Hayot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Nottin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Cazorla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"2128_CR1","doi-asserted-by":"publisher","first-page":"679","DOI":"10.2165\/00007256-200131090-00004","volume":"31","author":"C Hausswirth","year":"2001","unstructured":"Hausswirth C, Leh\u00e9naff D. 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All patients enrolled in the study provided written consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"All patients enrolled in the study provided written consent.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code Availability"}},{"value":"The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data Availability"}},{"value":"O.C. and C.H. are the guarantors of this study and are responsible for all content of the manuscript. All authors made substantial contributions to acquisition or interpretation of data, critically reviewed every draft for important intellectual content, and agree to be accountable for all aspects of the work. Additionally, O.C. and C.H. contributed to the conception or design of the study. O.C., S.N., F.G. and C.H. were responsible for data analysis, interpretation of the data, and writing of the manuscript. All authors have read and approved the final version of the manuscript.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author Contributions"}}]}}