The effect of exercise training on left ventricular function in young elite athletes

Abstract

BackgroundRegular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters (strain, rotation and twist). Aim of study is to assess the role of rotation and twist parameters for better characterize the heart performance in trained elite young athletes from different kind of sports. Eventually, verify early on any possible impact due to the regular sport activity not revealed by the standard parameters.Methods50 young athletes (16 cyclists, 17 soccer players, 17 basket players) regularly trained at least three times a week for at least 9 months a year and 10 young controls (mean age 18.5 ± 0.5 years) were evaluated either by to 2D echocardiography or by a Speckle Tracking (ST) multi-layer approach to calculate Left Ventricle (LV) endocardial and epicardial rotation, twist, circumferential strain (CS) and longitudinal strain (LS). Data were compared by ANOVA test.ResultsAll the found values were within the normal range. Left Ventricle Diastolic Diameter (LVDD 51.7 ± 2.6 mm), Cardiac Mass index (CMi 114.5 ± 18.5 g/m2), epi-CS, epi-LS, epicardial apex rotation and the Endo/Epi twist were significantly higher only in cyclists. In all the groups, a physiological difference of the Endo/Epi basal circumferential strain and twist values have been found. A weak but not significant relationship between the Endo and twist values and LVDD (r2 = 0.44, p = .005) and CMi was also reported in cyclists.ConclusionsProgressive increase of apical LV twist may represent an important component of myocardial remodelling. This aspect is particularly evident in the young cyclists group where the CMi and the LVDD are higher. ST multilayer approach completes the LV performance evaluation in young trained athletes showing values similar to adults.

The effect of incremental endurance exercise training on left ventricular mechanics: a prospective observational deformation imaging study

“…Our findings are consistent with these studies showing that long term IEET increases the LV strain without changing the EF. In a case-control study, De Luca et al (19) reported, using layer specific analysis, that epicardial strain was higher and endocardial strain was comparable in young cyclists in comparison with the control group. In contrast to this study, the present study, which featured longitudinal follow-up, did not include layer specific analysis.…”

“…Besides, 2D strain imaging may help in the understanding of the structural changes related to the athletes' heart. A study by De Luca et al (19) revealed that LV apical twist improved in young athletes after exercise training. However, Chan-Dewar et al (20) found LV twist comparable.…”

Comparative numerical study on left ventricular fluid dynamics after dilated cardiomyopathy

“…Several pathophysiologic mechanisms have been suggested, nevertheless there is paucity of clinical markers that can characterize a hemodynamic milieu predictive of the risk of cardiac remodeling either following infarction (Nijveldt et al, 2009;Wu et al, 2008) or excessive sport activity (De Luca et al, 2011;Mihl et al, 2008).…”

Особенности Предпатологических И Патологических Диагностических Критериев Состояния Миокарда Бывших И Действующих Спортсменов

“…Спортсменов рассматривают как отдельную группу людей, ведущих уникальный образ жизни и способных к экстраординарным физическим достижениям [1,2]. Однако, ресурсы человеческого организма не безграничны, даже если речь идет о профессиональных атлетах [3].…”

“…Предпатологические и патологические состояния миокарда, связанные с активной тренировочной и соревновательной деятельностью, проявляются как в процессе спортивной карьеры, так и после ее окончания [10]. Иногда отмечаются противоречивые данные в интерпретации особенностей физиологических и патологических изменений сердечной мышцы у лиц, занимающихся спортом [1,2]. Не выявленная или не верно интерпретированная на начальном этапе кардиологическая патология, в будущем может обернуться необратимыми изменениями, которые в свою очередь, негативно отражаются на спортивных результатах, а после окончания профессиональной карьеры существенно снижают уровень здоровья и качества жизни экс-спортсменов [4].…”