scholarly journals P317 Assessment of atrial function in elite soccer players

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F A Castro ◽  
M Lourenco ◽  
P V A Leite ◽  
O Azevedo ◽  
G Dias ◽  
...  

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.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Bewarder ◽  
S Kulenthiran ◽  
O Schaefer ◽  
L Lauder ◽  
C Ukena ◽  
...  

Abstract Background Professional cyclists frequently present with physiological adaptations to endurance exercise with an increase in left ventricular wall thickness and mass. Global longitudinal strain (GLS) is an early and sensitive echocardiographic method to detect left ventricular dysfunction. However, it is unclear whether GLS is able to differentiate between athlete's hearts or different pathological conditions of left ventricular hypertrophy. Methods A total of 87 professional athletes (37 professional cyclists, 29 professional soccer players, and 21 professional handball players) were compared to 125 patients with different forms of left ventricular hypertrophy (17 hypertrophic obstructive cardiomyopathy (HOCM), 36 hypertensive heart disease (HHD), 35 severe aortic valve stenosis (AVS); 37 untrained individuals served as controls. Examinations were performed between October 2018 to October 2019. All subjects underwent echocardiographic examination, including GLS. Results In all 212 participants/patients included a preserved ejection fraction >50% (mean 61±7%) was detected. Left ventricular mass index (LVMI) in professional cyclists (165.5±37.1 g/m2) was increased when compared to professional soccer players (97.3±12.4 g/m2, p<0.001), professional handball players (92.2±15.8 g/m2, p<0.001) and healthy controls (94.3±20.7 g/m2, p<0.001), as well as to patients with HHD (129.2±30.0 g/m2, p<0.001), or AVS (140.1±35.4 g/m2, p=0.064), but not to patients with HOCM (159.7±39.4 g/m2, p=0.64). Professional cyclists (−21.0±3.5%) achieved higher average GLS values than professional soccer (−18.4 ± %, p=0.004) or handball players (−18.4 ± %, p=0.021), healthy controls (−19.0±3.0%, p=0.008), HOCM (−15.0±6.5%, p<0.001), HHD (−13.8±5.9%, p<0.001), and AVS (−16.0±7.0%, p<0.001) (Figure 1). Conclusion In professional cyclists, higher LVMI and average GLS values were detected compared to professional soccer and handball players with lower excessive endurance exercise, as well as untrained healthy controls. Average GLS can help to differentiate between athletes' hearts in professional cyclists compared to pathologic patterns in different diseases characterized by left ventricular hypertrophy with elevated LVMI. Figure 1 Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saikrishna Ananthapadmanabhan ◽  
Giau Vo ◽  
Tuan Nguyen ◽  
Hany Dimitri ◽  
James Otton

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain


2021 ◽  
Vol 8 ◽  
Author(s):  
Wei Sun ◽  
Xuehua Shen ◽  
Jing Wang ◽  
Shuangshuang Zhu ◽  
Yanting Zhang ◽  
...  

Objective: This study aimed to: (1) evaluate the association between myocardial fibrosis (MF) quantified by extracellular volume fraction (ECV) and myocardial strain measured by two-dimensional (2D)- and three-dimensional speckle-tracking echocardiography (3D-STE) and (2) further investigate which strain parameter measured by 2D- and 3D-STE is the more robust predictor of MF in heart transplant (HT) recipients.Methods: A total of 40 patients with HT and 20 healthy controls were prospectively enrolled. Left ventricular (LV)-global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured by 2D- and 3D-STE. LV diffuse MF was defined by cardiovascular magnetic resonance (CMR)-ECV.Results: The HT recipients had a significantly higher native T1 and ECV than healthy controls (1043.8 ± 34.0 vs. 999.7 ± 19.7 ms, p &lt; 0.001; 26.6 ± 2.7 vs. 24.3 ± 1.8%, p = 0.02). The 3D- and 2D-STE-LVGLS and LVGCS were lower (p &lt; 0.005) in the HT recipients than in healthy controls. ECV showed a moderate correlation with 2D-LVGLS (r = 0.53, p = 0.002) and 3D-LVGLS (r = 0.60, p &lt; 0.001), but it was not correlated with 2D or 3D-LVGCS, or LVGRS. Furthermore, 3D-LVGLS and 2D-LVGLS had a similar correlation with CMR-ECV (r = 0.60 vs. 0.53, p = 0.670). A separate stepwise multivariate linear analysis showed that both the 2D-LVGLS (β = 0.39, p = 0.019) and 3D-LVGLS (β = 0.54, p &lt; 0.001) were independently associated with CMR-ECV.Conclusion: CMR marker of diffuse MF was present in asymptomatic patients with HT and appeared to be associated with decreased myocardial strain by echocardiography. Both the 2D- and 3D-LVGLS were independently correlated with diffuse LVMF, which may provide an alternative non-invasive tool for monitoring the development of adverse fibrotic remodeling during the follow-up of HT recipients.


2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii9-ii11
Author(s):  
O. Mirea ◽  
O. Mirea ◽  
A. Karuzas ◽  
E. Nestaas ◽  
BK. Lakatos ◽  
...  

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