BackgroundARVC/D is characterized by progressive dilatation and fibro-fatty substitution of the right ventricular (RV) myocardium. Although morphologic abnormalities of the RV are a defining feature of ARVC/D, long term changes in RV size or function have not been clearly defined. PurposeThe right ventricular (RV) complex shape and position in the chest have resulted in a paucity of information regarding its structure and function during exercise. Meanwhile the role of RV is of increasing interest in both disease and athletic performance. The aim of this study was to quantitate the response of the analogues of RV function to dynamic exercise. Methods: Fifteen healthy individuals, (38.6 ± 13.1 years, 53% women) recruited from the health eHeart study, underwent a rest and graded supine bicycle exercise echocardiogram. Tricuspid annular plane systolic excursion (TAPSE), pulmonary velocity time integral (PVTI), longitudinal strain based on speckle tracking from the base, mid and apex of RV free wall and septum were analyzed and RV global strain (GS) was calculated. RV 3D volume (3DV), end diastolic (RVEDV), end systolic volume (RVESV) and ejection fraction (RVEF) were measured. Imaging and off line analyses were performed using a GE Vivid E9 system and EchoPAC software. ResultsInterpretable images for RV 3DV and strain were obtained in all subjects at each achieved exercise level. The mean maximal heart rate was 165.2bpm ± 13.1. RVESV decreased with marginal significance: 21.2ml ± 9.2 to 16.7ml ± 6.3; p= 0.05. The RVEDV decreased from 40.1ml ± 15.4 to 36.5 ± 15.6 9, p=ns. The RVGS was also not significantly changed (-19.9% ± 7.1 to -21% ± 7.1; p=ns). TAPSE and PVTI increased significantly with increasing exercise (24.8 mm ±3.4 to 28.4mm ± 3.3; p=0.02 resp. 18.2cm± 2.6 to 21.9 cm ± 3.2; p=0.01). ConclusionsAspects of healthy right ventricular physiology during exercise are presented and indicated that TAPSE and RVESV are major contributors to exercise performance. The magnitude of these changes may serve as reference values for investigation of pathologic states.