Tour de France and the Heart - Part 1

Have you ever watched the Tour de France? Maybe even the L’Alpe d’Huez stage? Where the participants torment their bodies to total exhaustion, climbing up the 21 steep turns to reach the top? Have you ever wondered how the cardiovascular system and the heart adapt to such extreme physical strain?

Well, echocardiography has the answer. Watch the following video from Dr. Sophie Demanez from Liege, Belgium. She is one of the leading specialists in sports cardiology and takes care of the Lotto Belisol cycling team. Together with the University of Rennes / France Dr. Demanez is engaged in studies to investigate the role of echocardiography in professional cyclers.

Dr. Sophie Demanez from Liege, Belgium

Indeed, echocardiography can pick up many of the changes that occur in training. As Dr. Demanez points out, it is very important to correctly interpret these findings. After all the heart of an athlete can look quite similar to a diseased heart. Importantly, even athletes may have relevant cardiac conditions that you need to pick up before you let them compete. New techniques, such as deformation imaging using speckle tracking analysis can really make a difference here. They help us to understand what happens to the heart when it is under extreme stress during a competition such as the Tour de France.

With all this information in mind, here is an echo from a famous Austrian extreme athlete. Can you pick up some of the features of an athlete's heart?

Short-axis view at rest

Does he truly have normal left ventricular function?

M-mode tracing; the IVS measures 12 mm

What about the thickness of the septum? Can you guess which form of exercise he does?

Four-chamber view

What about the size of the heart? Would you let him compete?

Post your suggestions and comments below. I will give you my interpretation next week and show you his speckle tracking images. I will then also tell you who this athlete is, what incredible physical abilities he has, and what happens to the heart when he really steps into the pedals.


PS: Don’t forget to watch the final stages of the Tour de France!

         Sophie Demanez          Thomas Binder