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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
Rivista di Medicina, Traumatologia e Psicologia dello Sport
Indexed/Abstracted in: Chemical Abstracts, CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,111
The Journal of Sports Medicine and Physical Fitness 2016 May 03
Volumetric and functional assessment of the left atrium in young competitive athletes without left ventricular hypertrophy. Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Sport Study
Attila NEMES 1, Péter DOMSIK 1, Anita KALAPOS 1, Andrea OROSZ 2, Mónika OSZLÁNCZI 1, László TÖRÖK 3, 4, László BALOGH 5, János MÁRTON 4, Tamás FORSTER 1, Csaba LENGYEL 6 ✉
1 2nd Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary; 2 Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary; 3 Department of Traumatology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary; 4 Department of Sports Medicine, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary; 5 Intitute of Physical Education and Sports Science, Gyula Juhász Faculty of Education, University of Szeged, Szeged, Hungary; 6 1st Department of Medicine, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
BACKGROUND: Left atrial (LA) remodeling may be regarded as a physiologic adaptation to exercise conditioning. Three-dimensional speckle tracking echocardiography (3DSTE) is a new promising tool for volumetric and functional characterization of the LA. The present study was undertaken to assess adaptive changes in LA volumes and functional properties respecting cardiac cycle in young competitive athletes without left ventricular hypertrophy (LVH) by detailed 3DSTE assessment.
METHODS: The study group consisted of 20 young elite basketball and handball players (mean age: 28.1 ± 10.1 years, 8 males) without LVH, their results were compared to 23 age- and gender-matched non-sportive healthy controls (mean age: 31.7 ± 8.5 years, 11 men. All subjects had undergone standard transthoracic two-dimensional Doppler echocardiographic study with 3DSTE.
RESULTS: Increased systolic maximum (66.5 ± 13.6 ml vs. 38.5 ± 8.6 ml, p <0.0001) and diastolic pre-atrial contraction (36.7 ± 8.1 ml vs. 17.5 ± 5.8 ml, p <0.0001) and minimum (46.2 ± 10.1 ml vs. 26.2 ± 7.8 ml, p <0.0001) LA volumes could be demonstrated in athletes. Total (29.7 ± 9.0 ml vs. 20.7 ± 5.0 ml, p =0.0002) and passive LA stroke volumes (19.8 ± 8.7 ml vs. 12.4 ± 4.6 ml, p =0.0009) were increased, while total (44.2 ± 9.1 ml vs. 54.2 ± 9.4 ml, p =0.001) and active LA emptying fractions (20.6 ± 11.8% vs. 31.9 ± 8.7%, p =0.0008) proved to be decreased in athletes as compared to controls. Active LA stroke volume (9.9 ± 5.8 ml vs. 8.3 ± 3.3 ml, p =0.29) and passive LA emptying fraction (29.1 ± 10.6 ml vs. 32.6 ± 11.2 ml, p =0.31) did not differ between the groups. Only circumferential global (21.1 ± 7.7% vs. 27.6 ± 9.9%, p =0,02) and mean segmental (26.1 ± 7.1% vs. 35.7 ± 12.0%, p=0.003) peak LA strains proved to be significantly reduced in athletes as compared to controls.
CONCLUSIONS: 3DSTE-derived increased cyclic LA volumes and specific alterations in LA functional properties could be demonstrated in young competing athletes which is most likely a physiologic consequence of a global cardiac adaptation to intensive and chronic training.