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Theses

Adaptations cardiaques à l’exercice aigu, chronique et épuisant de longue durée : mise en évidence du rôle clé du mécanisme de torsion - détorsion dans le remplissage ventriculaire gauche

Abstract : During systole, contraction of cardiomyocytes induces left ventricular (LV) strains. Moreover, the helical orientation of myofibers induces LV torsion consequently to LV basal and apical rotations. LV torsion stores energy in elastic component that is released very early in diastole and constitutes a key factor of LV filling. The aims of this thesis were to characterize LV mechanicals adaptations focussing on the role of LV torsion 1) during a progressive exercise test in healthy sedentary subjects, 2) induced by aerobic training at rest and during a progressive exercise test and, 3) concomitant with cardiac dysfunctions after prolonged and strenuous exercise. We used a novel echocardiographic tool, based on Speckle Tracking (STE), in order to evaluate LV function at rest and/or during a progressive exercise test. Our results underlined the key role of LV torsion in systolic – diastolic coupling during exercise. Moreover, our results showed an alteration of LV mechanical adaptation paralleling the enhancement of diastolic function during effort in aerobic trained subjects. At last, transient LV dysfunction after prolonged and strenuous exercise was associated with decreased and delayed LV torsion, probably limiting the early drop of LV intraventricular pressures and thus LV filling. All together, these results underlined the usefulness to evaluate LV mechanics at rest and during effort by STE, and point out the key role of twisting – untwisting mechanism in improved or depressed LV diastolic function
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Grégory Doucende. Adaptations cardiaques à l’exercice aigu, chronique et épuisant de longue durée : mise en évidence du rôle clé du mécanisme de torsion - détorsion dans le remplissage ventriculaire gauche. Médecine humaine et pathologie. Université d'Avignon, 2010. Français. ⟨NNT : 2010AVIG0703⟩. ⟨tel-00630056⟩

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