INFLUENCE OF TRIATHLON ON AORTIC STIFFNESS: THE ATLAS STUDY.

OBJECTIVE: Arterial stiffness is a strong predictor of future cardiovascular events and all-cause mortality. Endurance exercise is efficacious in reducing arterial stiffness. Triathlon, i.e., swimming, cycling and running over long to ultra-long distances in a row, is one of the most demanding endurance sports disciplines inducing major cardiovascular adaptations. However, acute and long-term effects of triathlon on arterial stiffness are still unknown. Therefore, we investigated arterial stiffness modification during a triathlon season.

DESIGN AND METHOD: The ATLAS study is a prospective interventional controlled and age matched study. We included thirty-four 19-39-years-old male long-distance triathletes (Tri) and twenty-nine healthy sex- and age-matched volunteers who were insufficiently active (Ctrl) according to World Health Organization recommendations. All participants attended three visits (V1, V2, V3) each separated by five months intervals, spread over the course of the race season. Each visit included an aortic stiffness evaluation by applanation tonometry.

RESULTS: After a race season, aortic pulse wave velocity (aoPWV) was significantly lower in the triathletes group (aoPWV tri = 6,11 ± 0,95 versus aoPWV ctrl = 7,17 ± 1,24 m/s with p = 0,0009). Triathletes had central systolic blood pressure (cSBP) and central pulse pressure (cPP) significantly higher than in control group (respectively, cSBP tri = 122,60 ± 11,43 versus cSBP ctrl = 116,64 ± 6,88 mmHg with p = 0,01, and cPP tri = 54,18 ± 10,04 versus cPP ctrl = 45, 44 ± 7,55 mmHg with p = 0,0002). Triathlon was correlated with a statistically significant positive impact on subendocardial viability ratio (SEVR) (SEVR tri = 162,89 ± 26,55 versus SEVR ctrl = 133,22 ± 26,99 with p = 0,00009). No statistically significant longitudinal variation of aoPWV was observed in triathletes during the race season.

CONCLUSIONS: These results suggest that triathlon has persistent beneficial effects on arterial stiffness, and even on myocardial perfusion. This improvement cardiovascular health for triathletes seems to reach its peak at the end of the sportive season.