Abstract
Purpose
to assess the left ventricular (LV) remodeling with using transthoracic 3D Echo and MRI in young athletes.
Materials
for the period from October 2015 to April 2018, 88 athletes (61 men and 27 women) were examined. Mean age was 20.8 ± 3.9 years. Group A (professionals) – 65 athletes (4 or more training days a week, experience in sports for at least 7 years, the presence of at least the 1st sports category). Group B (Amateurs) – 23 athletes (3 or less training days a week). By types of loads were identified 4 groups: 1st - high-static, low-dynamic (climbing); 2nd - medium-static, medium-dynamic (volleyball, Rugby, sports dancing); 3rd - medium-static, high-dynamic (badminton, orienteering, hockey); 4th - high-static, high-dynamic (triathlon, water polo, rowing).
Methods
2D-, 3D-Echo was performed on Vivid E9 XDclear 4D (GE, USA). With the help of software package for processing 3D arrays (4D auto LVQ and 4D Strain and LV-mass) in automatic and semi-automatic mode was obtained end diastolic and end systolic volumes (EDV, ESV), ejection fraction (EF) and LV mass. The device was used for MRI - Avanto (Siemens) - 1.5 T, using: sensors for breathing and synchronization with ECG, standard surface coil Body Matrix. Visualization of the mobile myocardium was carried out by SSFP protocols in standard two-and four-chamber view, as well as on the short axis. In addition, the black-blood Protocol was performed in axial projection for visualization of mediastinal organs and chest. Evaluation of the results was performed on a workstation Syngo Via VB10B (Siemens) using a worker thread MR Cardiac analisis.
Results
There were significant differences in the types of loads (p < 0.001): 22% of men in Group B had 1st type, 2nd type - 78% of men and 93% of women in group B, 3rd type - 45% of men and 36% of women in group A, 4th type - 39% of men and 21% of women in group A. In the evaluation of LV remodeling and its relationship with the type of loads revealed significant differences (p < 0.01): 87.5% had LV remodeling (95.4% - aggregate type load 1, 2, 3), 6.8% - concentric remodeling (21.7% of all type 4), and 4.5% eccentric hypertrophy (8.7% of all type 4), 1.1 per cent of concentric hypertrophy (4.4% of all type 4). Consequently, most athletes with loads of type 4 had different types of LV remodeling. Comparing 3D Echo and MRI, high-grade positive correlations were obtained in indicators: EDV (R 0.82, p < 0.0001), ESV (R 0.80, p < 0.0001), LV mass (R 0.85, p < 0.0001), as well as moderate positive the index of EDV (R 0.54, p < 0.037) and unreliable for the EF.
Conclusions
three-dimensional visualization allows to carry out a reliable assessment of the volumetric parameters of the heart chambers, comparable with MRI data and to identify the signs and type of LV remodeling.
Requires further study of the performance of 3D Echo in athletes, given the lack of normative data on the modern stage.
Dinamika indeksa massy miokarda levogozheludochka u patsientov s arterial'noygipertoniey II-III stepeni na fone terapiiKo-renitekom i Gizaarom
