{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:16:59Z","timestamp":1790651819495,"version":"4.1.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Echocardiographic signs of exercise-induced cardiac fatigue (EICF) have been described after strenuous endurance exercise. Nevertheless, few data are available on the effects of repeated strenuous exercise, especially when associated with other constraints as sleep deprivation or mental stress which occur during military selection boot camps. Furthermore, we aimed to study the influence of experience and training level on potential EICF signs.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Two groups of trained soldiers were included, elite soldiers from the French Navy Special Forces (elite; <jats:italic>n<\/jats:italic> = 20) and non-elite officer cadets from a French military academy (non-elite; <jats:italic>n<\/jats:italic> = 38). All underwent echocardiography before and immediately after exposure to several days of uninterrupted intense exercise during their selection boot camps. Changes in myocardial morphology and function of the 4 cardiac chambers were assessed.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Exercise-induced decrease in right and left atrial and ventricular functions were demonstrated with 2D-strain parameters in both groups. Indeed, both atrial reservoir strain, RV and LV longitudinal strain and LV global constructive work were altered. Increase in LV mechanical dispersion assessed by 2D-strain and alteration of conventional parameters of diastolic function (increase in E\/e' and decrease in e') were solely observed in the non-elite group. Conventional parameters of LV and RV systolic function (LVEF, RVFAC, TAPSE, s mitral, and tricuspid waves) were not modified.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Alterations of myocardial functions are observed in soldiers after uninterrupted prolonged intense exercise performed during selection boot camps. These alterations occur both in elite and non-elite soldiers. 2D-strain is more sensitive to detect EICF than conventional echocardiographic parameters.<\/jats:p>","DOI":"10.3389\/fcvm.2021.785869","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T04:47:35Z","timestamp":1639975655000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Exercise-Induced Cardiac Fatigue in Soldiers Assessed by Echocardiography"],"prefix":"10.3389","volume":"8","author":[{"given":"Marion","family":"Charton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e4elle","family":"Kervio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Matelot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Lachard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Galli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwan","family":"Donal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Carr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol\u00e8ne","family":"Le Douairon Lahaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Schnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1161\/01.CIR.76.6.1206","article-title":"Cardiac fatigue after prolonged exercise","volume":"76","author":"Douglas","year":"1987","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1093\/eurheartj\/ehr397","article-title":"Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes","volume":"33","author":"La Gerche","year":"2011","journal-title":"Eur Heart J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1161\/CIRCIMAGING.110.961938","article-title":"Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise","volume":"4","author":"Oxborough","year":"2011","journal-title":"Circ Cardiovasc Imaging."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1111\/j.1540-8175.2010.01251.x","article-title":"\u201cExercise-induced cardiac fatigue\u201d, a review of the echocardiographic literature","volume":"27","author":"Oxborough","year":"2010","journal-title":"Echocardiography."},{"key":"B5","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1249\/01.mss.0000239395.93578.60","article-title":"Impact of repeated prolonged exercise bouts on cardiac function and biomarkers","volume":"39","author":"Middleton","year":"2007","journal-title":"Med Sci Sports Exerc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1007\/s00421-018-3906-z","article-title":"Left ventricular function and mechanics following prolonged endurance exercise: an update and meta-analysis with insights from novel techniques","volume":"118","author":"Lord","year":"2018","journal-title":"Eur J Appl Physiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1136\/hrt.2006.101063","article-title":"Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise","volume":"94","author":"La Gerche","year":"2008","journal-title":"Heart."},{"key":"B8","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1152\/ajpheart.00917.2014","article-title":"Altered ventricular mechanics after 60 min of high-intensity endurance exercise: insights from exercise speckle-tracking echocardiography","volume":"308","author":"Stewart","year":"2015","journal-title":"Am J Physiol Heart Circ Physiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s10554-018-1502-2","article-title":"Left atrial functional response after a marathon in healthy amateur volunteers","volume":"35","author":"Hirata","year":"2019","journal-title":"Int J Cardiovasc Imaging."},{"key":"B10","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1093\/eurheartj\/ehs016","article-title":"A novel clinical method for quantification of regional left ventricular pressure\u2013strain loop area: a non-invasive index of myocardial work","volume":"33","author":"Russell","year":"2012","journal-title":"Eur Heart J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1152\/ajpheart.00191.2013","article-title":"Assessment of wasted myocardial work: a novel method to quantify energy loss due to uncoordinated left ventricular contractions","volume":"305","author":"Russell","year":"2013","journal-title":"Am J Physiol Heart Circ Physiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1161\/CIRCEP.118.007224","article-title":"Left ventricular remodeling results in homogenization of myocardial work distribution","volume":"12","author":"Duchenne","year":"2019","journal-title":"Circulation."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1093\/ehjci\/jex191","article-title":"Role of myocardial constructive work in the identification of responders to CRT","volume":"19","author":"Galli","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B14","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B15","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"Nagueh","year":"2016","journal-title":"J Am Soc Echocardiogr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.echo.2014.11.003","article-title":"Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"28","author":"Voigt","year":"2015","journal-title":"J Am Soc Echocardiogr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.echo.2016.11.013","article-title":"Mechanical dispersion by strain echocardiography: a novel tool to diagnose hypertrophic cardiomyopathy in athletes","volume":"30","author":"Schnell","year":"2017","journal-title":"J Am Soc Echocardiogr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1093\/ehjci\/jey042","article-title":"Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"19","author":"Badano","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B19","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/echo.14210","article-title":"Myocardial constructive work is impaired in hypertrophic cardiomyopathy and predicts left ventricular fibrosis","volume":"36","author":"Galli","year":"2018","journal-title":"Echocardiography."},{"key":"B20","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.echo.2017.10.009","article-title":"Value of myocardial work estimation in the prediction of response to cardiac resynchronization Therapy","volume":"31","author":"Galli","year":"2018","journal-title":"J Am Soc Echocardiogr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1161\/CIRCULATIONAHA.106.613562","article-title":"The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death","volume":"114","author":"Maron","year":"2006","journal-title":"Circulation."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1007\/s00421-011-2184-9","article-title":"Maximal oxygen consumption is best predicted by measures of cardiac size rather than function in healthy adults","volume":"112","author":"La Gerche","year":"2011","journal-title":"Eur J Appl Physiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1093\/eurheartj\/ehp040","article-title":"Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes","volume":"30","author":"Teske","year":"2008","journal-title":"Eur Heart J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1016\/j.jcmg.2016.03.016","article-title":"Acute, exercise dose-dependent impairment in atrial performance during an endurance race","volume":"9","author":"Sanz-de la Garza","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1007\/s00421-019-04085-x","article-title":"Cardiac performance after an endurance open water swimming race","volume":"119","author":"Martinez","year":"2019","journal-title":"Eur J Appl Physiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.echo.2009.04.009","article-title":"Myocardial function in older male amateur marathon runners: assessment by tissue doppler echocardiography, speckle tracking, and cardiac biomarkers","volume":"22","author":"Knebel","year":"2009","journal-title":"J Am Soc Echocardiogr."},{"key":"B27","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.jcmg.2016.08.014","article-title":"strain for categorization of LV diastolic dysfunction","volume":"10","author":"Singh","year":"2017","journal-title":"Cardiovasc Imaging."},{"key":"B28","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1093\/ehjci\/jex225","article-title":"Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes","volume":"19","author":"Hubert","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B29","doi-asserted-by":"publisher","first-page":"2245","DOI":"10.1016\/j.jcmg.2018.06.031","article-title":"Multimodality imaging for best dealing with patients in atrial arrhythmias","volume":"12","author":"Donal","year":"2019","journal-title":"Cardiovasc Imaging."},{"key":"B30","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s00421-009-1264-6","article-title":"Evidence of increased electro-mechanical delay in the left and right ventricle after prolonged exercise","volume":"108","author":"Chan-Dewar","year":"2009","journal-title":"Eur J Appl Physiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jcmg.2009.11.012","article-title":"Mechanical dispersion assessed by myocardial strain in patients after myocardial infarction for risk prediction of ventricular arrhythmia","volume":"3","author":"Haugaa","year":"2010","journal-title":"Cardiovasc Imaging."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1016\/j.echo.2007.04.032","article-title":"Effect of preload augmentation on pulsed wave and tissue doppler echocardiographic indices of diastolic function after a marathon","volume":"20","author":"Hart","year":"2007","journal-title":"J Am Soc Echocardiogr."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1152\/japplphysiol.01151.2009","article-title":"Acute cardiac effects of marathon running","volume":"108","author":"Trivax","year":"2010","journal-title":"J Appl Physiol."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.785869\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T04:47:39Z","timestamp":1639975659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.785869\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":33,"alternative-id":["10.3389\/fcvm.2021.785869"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.785869","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]},"article-number":"785869"}}