Background: Professional athletes have variety of changes on heart structure. The aim of this study was to determine the differences of left ventricle (LV) structure in wheelchair athletes versus non-athlete wheelchair population.

Methods: This is a cross-sectional study enrolling athlete and non-athlete wheelchair population. The target population was combined of three different groups: basketball players, weight lifters and non-athlete people. At first, the entire participants fulfilled a questionnaire which included demographic information (age, sex, weight, height, past medical history and etc.). Then the LV structure was evaluated by echocardiography.

Results: Thirty-two wheelchair people including12 basketball players, 12 weight lifters and 8 non-athletes were enrolled. The mean age was52.34±4.66 years old (min=45y max=60y).The mean height was 177.56±7.69cm (min=160cm, max=192cm).The mean weight was 82.5± 9.85kg (min=60kg, max=100kg).The main important result in this study was IVSD (inter ventricular septal thickness in diastole) differences between3groups which was statistically significant (p<0.05).IVSD was higher in wheelchair basketball players in comparison with non-athletes.

Conclusion: Although our results showed that except IVSD, all the other echo measurements were not significantly different among athletic and non-athletic wheelchair people but other studies with larger sample volume size may lead to significant results.

Athletes-Athletic Wheelchair

Nowadays the whole general conception of being a professional athlete has been changed since you will find great professional athletes among para-Olympic competitors whom are hardly supposed to be less active in comparison to non-athlete normal population. Actually the left ventricle (LV)is the main key in the whole story. It adapts to long-term intensive training which eventually results in increased wall thickness, LV mass and cavity diameter [1-4]. The gap of distinguishing the change of an athlete LV structure from a pathologic kind is currently fulfilled with echocardiography [5-7]. Whether it is an isotonic exercise or an isometric kind, it has its own impact on LV structure [5,8-11]. The researchers’ efforts have been attempted to compare different sports regarding their impact on LV structure in which weight lifting, basketball and body-building are more favored [12-20]. In the present study we compared the LV structures in wheelchair athletes including weight lifters, basketball players and non-athlete wheelchair population to acquire a better understanding of differences and impacts on LV structure made by long-term isotonic or isometric exercises.

This is a cross-sectional study enrolling wheelchair population. The target population was combined of three different groups: basketball players, weightlifters and non-athlete people who are were unable to walk. Before enrollment, the aim of project and its scientific aspects were completely explained for the participants. The participants who signed an informed consent were entered in the study. In the athlete group (basketball players and weightlifters) there was at least 4 years professional training. At first, the entire participant fulfilled a questionnaire which included demographic information (age, sex, weight, height, past medical history and etc.).Then the left ventricle (LV) structure was evaluated by Doppler Echocardiography device (vivid 7, GE). The main variables assessed by Doppler Echocardiography were left ventricle posterior wall thickness in systole (LVPWS), left ventricle posterior wall thickness in diastole (LVPWD), inter ventricular septum thickness in systole (IVSS), inter ventricular septum thickness in diastole (IVSD), left ventricle end systole diameter (LVESD),left ventricle end diastole diameter (LVEDD), left ventricle mass(LVM),ejection fraction (EF),Blood Pressure and Heart Rate were all’s controlled. All the assessments were measured in a clean, quiet and peaceful place by medical experts. Before undergoing Echocardiography, the people were asked to be comfortably seated on the bed. All the measurement were rechecked and documented for further analysis by expert statisticians.

Shapiro-Wilk test was used for the normality of the data. If the data were normal, ANOVA test was used and for comparing the groups in two to two the ANOVA Toki test was used. If the data were not normal Kruskal-Wallis test was used and for comparing two to two groups Man-Whitney was used. The whole statistical analysis was performed by expert’s usingSPSSv18 and EXCEL2007 Microsoft Company. The p-value less than 0.05was considered statistically significant.

Thirty-two wheel chair peopleincluding12basketball players, 12 weightlifters and8 non-athletes were enrolled. The mean age was 52.34±4.66yearsold (min=45y, max=60y). The mean heightwas177.56±7.69cm (min=160cm, max=192cm). The mean weightwas82.5±9.85kg (min=60kg, max=100kg). The main important result in this study was about IV SD differences between 3groupswhichwasstatistically significant (p=0.045) Kruskal-Wallis test. IV SD in basketball players were significantly higher than nonathletes (p=0.017) Man-Whitney test. However, it was not significant when comparing to weightlifters (p>0.05), Table 1&2. Regarding IVSD, there was not a significant difference between weight lifters and non-athletes (p=0.14).There was also another interesting point in the results. All the other measurements including LVESD (by ANOVA test), LVEDD (Kruskal-Wallis),IVSS (Kruskal-Wallis), LVPWS (Kruskal-Wallis), LVPWD( ANOVA) and LVM (ANOVA)did not show any significant differences when comparing 3 groups with each other.

*Kruskal-Wallis **Anova
Table1: Describe the dependent variables

Table 2: The cardiovascular disease parameters were relatively the same between groups

Our results show that although based on previous expectations, echo parameters of IVSD,LVEDD,…should be higher in athletes comparing to non-athletes, all the measured parameters (except IVSD)did not show any significant differences between 3 groups. However, our study is a unique project due to its special target population which is “wheel chair subject”. Hence the results of this study could not be generalized to normal population (the people who can walk freely), it should not be forgotten that it has its own features. Here there are “recent” articles discussing similar issues: In a Turkish study in 2005 researchers showed that myocardial performance index and aortic elastic properties are not different in athletes compared with sedentary subjects [21]. A year later in 2006, there was a study that showed regular basketball training leads to moderate cardiac hyper trophy due to thickening of myocardial walls [22]. In 2008in Lithuania, researchers showed that relative LV diameter was higher in long distance runners comparing to basketball players, cyclists, and power athletes. Being a Basket ballplayer, road cyclist, power athlete, and swimmer was associated with increased LV concentricity in comparison with paddling or distance running [23]. Another Turkish study in2013-2014showed that regular and intensive Sports results in an increase in LV wall thickness. According to the type of exercise, these changes could be different [24]. But some characters should be noticed in our study, first of all, for all the parameters including IVSD, LVESD, LVEDD, IVSS, LVPWS, LVPWD and LVM, the numbers in athlete group (basketball players and weigh tlifters) were higher than non-athlete group. However, they were not “statistically” significant. It shows that may be with larger sample size and different region or different sports these differences could be statistically significant. This study does not discuss about “life quality “of wheel chair people which could be so much different between athlete and non-athlete group. We just described the LV parameters by echocardiography comparing between 3groups and the results of this study should be cautiously used avoiding any misunderstandings.

Although our results showed that except IVSD, all the other echo measurements were not significantly different among athletic and non- athletic wheelchair people but may be another study with larger sample size and different population leads to significant results.

The authors declare that they have no competing interests.

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