An Ultrasound Speckle Tracking (Two-Dimensional Strain) Analysis of Myocardial Deformation in Professional Soccer Players Compared With Healthy Subjects and Hypertrophic Cardiomyopathy

Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.

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P317 Assessment of atrial function in elite soccer players

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.170 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

F A Castro ◽

M Lourenco ◽

P V A Leite ◽

O Azevedo ◽

G Dias ◽

...

Keyword(s):

Speckle Tracking ◽

Strain Analysis ◽

Left Ventricular ◽

Soccer Players ◽

Healthy Controls ◽

Professional Soccer ◽

Intensive Exercise ◽

Atrial Contraction ◽

Atrial Size ◽

2D Strain

Abstract Introduction Athlete´s heart is associated with physiological remodelling as a consequence of repetitive cardiac loading. Atrial dilation may occur in athletes, but atrial size is insufficient to provide mechanistic information about the atrium itself and an increase in atrial size is not intrinsically an expression of atrial dysfunction. Two dimensional (2D) LA strain analysis by speckle tracking emerges as a gold standard for evaluation of atrial myocardial function. Aim To compare LA function between elite soccer players and sedentary healthy controls through 2D-strain analysis by speckle tracking. Methods We included 44 consecutive male professional soccer players and 25 sedentary male healthy controls, matched by age and race. All subjects underwent transthoracic echocardiogram, including evaluation of LA diameter and volume and 2D-strain analysis by speckle tracking. Peak atrial longitudinal strain (PALS) was measured at the end of the reservoir phase and peak atrial contraction strain (PACS) was measured just before the start of the active atrial contractile phase. The average of PALS and PACS was obtained from the 12 LA segments at apical 4 and 2-chamber views. The LA contraction strain index (CSI) (ratio PACS/PALS x100) was also calculated. SPSS 20.0 was used for statistical analysis. Results Mean age was similar between athletes and controls (22.3 ± 4.2 vs 25.0 ± 2.4 p = 0.13) as well as body mass index (23.3 ± 5.8 vs 24.6 ± 2.7 Kg/m2, p = 0.24). Athletes had significantly higher LA volume (29.1 ± 6.9 vs. 21.1 ± 5.5, p < 0.001). No statistical differences were observed in LA diameter between the two groups (18.7 ± 2 vs 18.0 ±1.7, p = 0.163). Athletes had significantly lower PALS (36.3%±5.8 vs. 44.2%±8.9, p < 0.001), PACS (9.5%±2.8 vs 15.3%±4.8, p < 0.001) and LA CSI (26.3 ± 7.8 vs. 35.0 ± 9.3, p < 0.001) than controls. LA volume was correlated with PALS (p < 0.001 r = 0.99), but not with PACS or CSI (p = 0.089 and p = 0.142, respectively). Conclusion This study showed that in top-level athletes LA PALS and PACS are lower and PALS correlates with LA volume, suggesting that LA suffers not only a morphological but also a functional remodelling in response to intensive exercise. This can be mediated by increased LA workload imposed by the increased left ventricular work.

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