Determinants of myocardial mechanics in top-level endurance athletes: three-dimensional speckle tracking evaluation

Iudice, Francesco Lo; Petitto, M; Ferrone, Marco; Esposito, Roberta; Vaccaro, Andrea; Buonauro, Agostino; D’Andrea, Antonello; Trimarco, Bruno; Galderisi, Maurizio

doi:10.1093/ehjci/jew122

Cited by 16 publications

(15 citation statements)

References 34 publications

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“…GLS, GCS, global area strain, and GRS were assessed using 3DSTE. Athletes had significantly higher GLS (−22.1±4.4 vs −18.4±3.5%; P <.0001), GCS (−17.9±2.4 vs −16.0±3.2; P =.006), and global area strain (−35.5±6.7 vs −30.2±4.9; P <.0001), while GRS did not differ significantly compared with normal controls …”

Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 85%

“…On the basis of these studies, LVH in top‐level athletes is therefore characterized by increased myocardial function at rest, as expressed by better values of deformation on both 2D and real time 3DSTE as compared with sedentary normal subjects. Sinus bradycardia, LV mass, and afterload are independent determinants of this supernormal myocardial deformation …”

Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 97%

“…Finally, Lo Iudice et al. analyzed the determinants of systolic function in the performing heart using 3DSTE, a combination of STE and 3D volumetric assessment A total of 36 top‐level male endurance athletes and 36 age‐matched sedentary normal controls underwent standard and real time 3D echocardiography. GLS, GCS, global area strain, and GRS were assessed using 3DSTE.…”

Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 99%

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Left ventricular hypertrophy or storage disease? the incremental value of speckle tracking strain bull's‐eye

et al. 2017

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Left ventricular hypertrophy (LVH) develops in response to a variety of physical, genetic, and biochemical stimuli and represents the early stage of ventricular remodeling. In patients with LVH, subclinical left ventricular (LV) dysfunction despite normal ejection fraction (EF) may be present before the onset of symptoms, which portends a dismal prognosis. Strain measurement with two-dimensional speckle tracking echocardiography (STE) represents a highly reproducible and accurate alternative to LVEF determination. The present review focuses on current available evidence that supports the incremental value of STE in the diagnostic and prognostic workup of LVH. When assessing the components of LV contraction, STE has an incremental value in differentiating between primary and secondary LVH and in the differential diagnosis with storage diseases. In addition, STE provides unique information for the stratification of patients with LVH, enabling to detect intrinsic myocardial dysfunction before LVEF reduction.

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Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 85%

Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 97%

Section: Physiological Left Ventricular Hypertrophymentioning

confidence: 99%

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Left ventricular hypertrophy or storage disease? the incremental value of speckle tracking strain bull's‐eye

et al. 2017

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“…The increased LV contractility of athlete's heart is a well-known phenomenon; however, resting echocardiographic parameters (including strains) are not always able to explore this in every scenario, resulting in conflicting results in the literature [ 19 ]. Lo Iudice and colleagues found, however, increased LV longitudinal, circumferential, and area strains in male endurance athletes, with sinus bradycardia, increased LV mass, and afterload emerging as major determinants of these changes [ 20 ]. Notably, Monte et al found significantly lower strain values compared to sedentary controls in a set of predominantly male, strength-trained athletes [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The Female Athlete’s Heart: Comparison of Cardiac Changes Induced by Different Types of Exercise Training Using 3D Echocardiography

Doronina

Édes

Ujvári

et al. 2018

BioMed Research International

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We aimed to characterize female athlete's heart in elite competitors in the International Federation of Bodybuilding and Fitness (IFBB) Bikini Fitness category and compare them to athletes of a more dynamic sport discipline and healthy, sedentary volunteers using 3D echocardiography. Fifteen elite female fitness athletes were recruited and compared to 15 elite, age-matched female water polo athletes and 15 age-matched healthy, nontrained controls. Using 3D echocardiography, left ventricular (LV) and right ventricular (RV) end-diastolic volume index (EDVi) and LV mass index (LVMi) were measured. Fitness athletes presented similar LV and RV EDVi compared to healthy, sedentary volunteers. Water polo athletes, however, had higher LV and also RV EDVi (fitness versus water polo versus control; LVEDVi: 76 ± 13 versus 84 ± 8 versus 73 ± 8 ml/m2, ANOVA p = 0.045; RVEDVi: 61 ± 12 versus 86 ± 14 versus 55 ± 9 ml/m2, p < 0.0001). LVMi was significantly higher in the athlete groups; the hypertrophy, however, was even more prominent in water polo athletes (78 ± 13 versus 91 ± 10 versus 57 ± 10 g/m2, p < 0.0001). To the best of our knowledge, this is the first study to characterize female athlete's heart of IFBB Bikini Fitness competitors. The predominantly static exercise regime induced a mild, concentric-type LV hypertrophy, while in water polo athletes higher ventricular volumes and eccentric LV hypertrophy developed.

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“…Conversely, GRS did not differ significantly between endurance athletes and controls, it appears therefore not involved in the supernormal myocardial function process at rest. 101 Research Reports in Clinical Cardiology downloaded from https://www.dovepress.com/ by 44.224.250.200 on 02-Sep-2020 For personal use only.…”

Section: Athlete's Heartmentioning

confidence: 99%

Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

Sorrentino¹,

Esposito²,

Pezzullo³

et al. 2016

RRCC

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Three-dimensional speckle tracking echocardiography (3D STE) is a novel technique for the quantification of cardiac deformation based on tracking of ultrasonic speckles in gray scale full-volume 3D images. Developments in ultrasound technologies have made 3D speckle tracking widely available. Two-dimensional echocardiography has intrinsic limitations regarding estimation of left ventricular (LV) volumes, ejection fraction, and LV mechanics, due to its inherent foreshortening errors and dependency on geometric models. The development of 3D echocardiography has improved reproducibility and accuracy. Data regarding the feasibility, accuracy, and clinical applications of 3D STE are rapidly assembling. From the tracking results, 3D STE derives several parameters, including longitudinal, circumferential and radial strain, as well as a combined assessment of longitudinal and circumferential strain, termed area strain. 3D STE can also quantify LV rotational movements such as rotation, twist, and torsion. 3D STE provides a better insight on global and regional myocardial deformation. Main applications include detection of subclinical myocardial involvement in heart failure, arterial hypertension, dyssynchrony, and ischemic heart disease. Emerging areas of application include a large spectrum of heart-involving systemic conditions, such as prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and deeper physiological understanding of LV contraction mechanics in different types of athletes. Aim of this review is to discuss background, technical acquisition and processing aspects as well as recognized and developing clinical applications of this emerging ultrasound technology.

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Determinants of myocardial mechanics in top-level endurance athletes: three-dimensional speckle tracking evaluation

Abstract: AT have an increased myocardial function at rest when compared with NC, this being elicited mainly by subendocardial and mid-wall fibres. Sinus bradycardia, LV mass, and afterload are independent determinants of supernormal myocardial deformation at rest.

Cited by 16 publications

References 34 publications

Left ventricular hypertrophy or storage disease? the incremental value of speckle tracking strain bull's‐eye

Left ventricular hypertrophy or storage disease? the incremental value of speckle tracking strain bull's‐eye

The Female Athlete’s Heart: Comparison of Cardiac Changes Induced by Different Types of Exercise Training Using 3D Echocardiography

Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

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