ABC | Volume 111, Nº6, December 2018

Original Article Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: Comparative Cross-Sectional Study Diego Vidaletti Silva, 1 Gustavo Waclawovsky, 1 Ana Beatriz Kramer, 1,2 Cinara Stein, 1 Bruna Eibel, 1 Guilherme Brasil Grezzana, 1 Maximiliano Isoppo Schaun, 1 Alexandre Machado Lehnen 1,2 Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC/FUC), 1 Porto Alegre, RS – Brazil Faculdade Sogipa de Educação Física, 2 Porto Alegre, RS – Brazil Mailing Address: Alexandre Machado Lehnen • Av. Princesa Isabel, 395. Postal Code 90620-001, Santana, Porto Alegre, RS – Brazil E-mail: amlehnen@gmail.com Manuscript received February 21, 2018, revised manuscript July 02, 2018, accepted July 02, 2018 DOI: 10.5935/abc.20180167 Abstract Background: Cardiac remodeling is a specific response to exercise training and time exposure. We hypothesized that athletes engaging for long periods in high-intensity strength training show heart and/or vascular damage. Objective: To compare cardiac characteristics (structure and function) and vascular function (flow-mediated dilation [FMD] and peripheral vascular resistance [PVR]) in powerlifters and long-distance runners. Methods: We evaluated 40 high-performance athletes (powerlifters [PG], n = 16; runners [RG], n = 24) and assessed heart structure and function (echocardiography), systolic and diastolic blood pressure (SBP/DBP), FMD, PVR, maximum force (squat, bench press, and deadlift), and maximal oxygen uptake (spirometry). A Student’s t Test for independent samples and Pearson’s linear correlation were used (p < 0.05). Results: PG showed higher SBP/DBP (p < 0.001); greater interventricular septum thickness (p < 0.001), posterior wall thickness (p < 0.001) and LV mass (p < 0.001). After adjusting LV mass by body surface area (BSA), no difference was observed. As for diastolic function, LV diastolic volume, wave E, wave e’, and E/e’ ratio were similar for both groups. However, LA volume (p = 0.016) and BSA-adjusted LA volume were lower in PG (p < 0.001). Systolic function (end‑systolic volume and ejection fraction), and FMD were similar in both groups. However, higher PVR in PG was observed (p = 0.014). We found a correlation between the main cardiovascular changes and total weight lifted in PG. Conclusions: Cardiovascular adaptations are dependent on training modality and the borderline structural cardiac changes are not accompanied by impaired function in powerlifters. However, a mild increase in blood pressure seems to be related to PVR rather than endothelial function. (Arq Bras Cardiol. 2018; 111(6):772-781) Keywords: Hypertrohy,Ventricular; Exercise; Exercise MovementTechniques; Blood Pressure; Resistance Training; Running/physiology. Introduction Exercise training induces cardiovascular adaptations secondary to changes in blood pressure as well as other hemodynamic and metabolic changes in response to physical exertion. These adaptive changes can induce left ventricular (LV) hypertrophy in the long run. 1 Some authors claim that borderline physiological and anatomical changes occur as part of an adaptive process of high-performance training and they have sparked off debate on their implications. 2 They postulate that volume overload generally increases LV pumping ability producing eccentric hypertrophy while, in contrast, pressure overload decreases ventricular cavity size producing concentric hypertrophy. Moreover, peripheral vascular resistance (PVR) is an important factor of cardiac overload by specifically modulating LV afterload. Furthermore, the endothelium is central to vasodilation by producing nitric oxide (NO), which is a vasodilator and has a direct effect on PVR. Therefore, it is important to highlight that after exercise there is a stimulation of NO production and eNOS phosphorylation, which contributes directly to a reduction in PVR. 3,4 Aerobic exercise increases shear stress leading to increased release and synthesis of NO and higher active muscle vasodilation. 5 LV pressure overload is reduced over time. 6 However, high-intensity resistance training such as weightlifting and powerlifting involves a number of very slow-speed contractions that produce transient mechanical compression of resistance vessels, increasing PVR and LV pressure overload during exercise. 7 It has been postulated that chronic increase in afterload induces the parallel addition of new sarcomeres in the myocardium leading to concentric ventricular hypertrophy. 8 Yet, this form of ventricular hypertrophy has not been demonstrated in strength training athletes, 9 and it is thus an inconsistent finding. Given the limited body of evidence in support of these cardiovascular adaptations as well as concerning endothelial function and PVR in strength athletes, this study aimed 772