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Grant support

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this work was partially funded by grants from AGAUR (M. Sanz-de la Garza, MD, PhD), Plan Nacional I. D., Del Programa Estatal de Fomento De La Investigacion Cientifica y Tecnica de Excelencia, Subprograma De Generacion Del Conocimiento, Ministerio de Economia y Competitividad 2013 (grant number DEP2013-44923-P).

Analysis of institutional authors

Domenech-Ximenos BAuthorPrat-González SAuthorCrispi, FAuthorPerea, RjAuthorGarcia-Alvarez, AAuthorSitges, MMain author
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Article

Exercise-induced cardio-pulmonary remodelling in endurance athletes: Not only the heart adapts

Publicated to:European Journal Of Preventive Cardiology. 27 (6): 651-659 - 2020-04-01 27(6), DOI: 10.1177/2047487319868545

Authors: Domenech-Ximenos, Blanca; Sanz-de la Garza, Maria; Prat-Gonzalez, Susanna; Sepulveda-Martinez, Alvaro; Crispi, Fatima; Perea, Rosario J; Garcia-Alvarez, Ana; Sitges, Marta

Affiliations

Barcelona Univ, Barcelona Ctr Maternal Foetal & Neonatal Med, Hosp Clin, CIBER ER, Barcelona, Spain - Author
Barcelona Univ, Hosp St Joan Deu, CIBER ER, Barcelona, Spain - Author
Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Barcelona, Spain - Author
Hosp Clin Barcelona, Radiol Dept, Barcelona, Spain - Author
Hosp Univ Dr Josep Trueta, Radiol Dept, Girona, Spain - Author
Inst Invest Biomed August Pi i Sunyer IDIBAPS, Hosp Clin, Cardiovasc Inst, Barcelona, Spain - Author
Univ Chile, Hosp Clin, Dept Obstet & Gynaecol, Foetal Med Unit, Santiago, Chile - Author
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Abstract

The cumulative effects of intensive endurance exercise may induce a broad spectrum of right ventricular remodelling. The mechanisms underlying these variable responses have been scarcely explored, but may involve differential pulmonary vasculature adaptation. Our aim was to evaluate right ventricular and pulmonary circulation in highly trained endurance athletes.Ninety-three highly trained endurance athletes (>12?h training/week at least during the last five years; age: 36?±?6 years; 52.7% male) and 72 age- and gender-matched controls underwent resting cardiovascular magnetic resonance imaging to assess cardiac dimensions and function, as well as pulmonary artery dimensions and flow. Pulmonary vascular resistance (PVR) was estimated based on left ventricular ejection fraction and pulmonary artery flow mean velocity. Resting and exercise Doppler echocardiography was also performed in athletes to estimate pulmonary artery pressure.Athletes showed larger biventricular and biatrial sizes, slightly reduced systolic biventricular function, increased pulmonary artery dimensions and reduced pulmonary artery flow velocity as compared with controls in both genders (p?4.2?WU) were found in seven of the 93 (9.3%) athletes: those exhibiting an enlarged pulmonary artery (indexed area cm2/m2: 4.8?±?0.6 vs. 3.9?±?0.6, p?

Keywords
american-collegeassociationcardiac mricmriechocardiographyhypertensionmassphysical-activitypulmonary vascular resistancespulmonary vascular-resistancesportstriathletesAdaptation, physiologicalAdultAmerican-collegeArterial pressureAssociationAthletesBlood flow velocityCardiac mriCardiomegaly, exercise-inducedCase-control studiesCmriEchocardiographyEndurance exerciseFemaleHumansHypertensionMaleMassPhysical conditioning, humanPhysical endurancePhysical-activityPulmonary circulationPulmonary vascular resistancesPulmonary vascular-resistanceRight-ventricular dysfunctionSportsTime factorsTriathletesVascular remodelingVentricular function, leftVentricular function, rightVentricular remodeling

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal European Journal Of Preventive Cardiology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 18/142, thus managing to position itself as a Q1 (Primer Cuartil), in the category Cardiac & Cardiovascular Systems.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.2. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 1.42 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 6.87 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-06, the following number of citations:

  • WoS: 17
  • Scopus: 20
  • Europe PMC: 7
  • OpenCitations: 14
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-06:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 43.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 43 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 4.85.
  • The number of mentions on the social network X (formerly Twitter): 9 (Altmetric).
Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Chile.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Domenech Ximenos, Blanca) and Last Author (Sitges Carreño, Marta).

the author responsible for correspondence tasks has been Garza MS.