Left ventricular myocardial velocities and deformation indexes in top-level athletes.
BACKGROUND
The aim of this study was to define the range of left ventricular (LV) velocities and deformation indexes in highly trained athletes, analyzing potential differences induced by different long-term training protocols.


METHODS
Standard echocardiography, pulsed-wave tissue Doppler echocardiography, and two-dimensional strain echocardiography of the interventricular septum and lateral wall were performed in 370 endurance athletes and 280 power athletes. Using pulsed-wave tissue Doppler, the following parameters of myocardial function were assessed: systolic peak velocities (S(m)), early (E(m)) and late (A(m)) diastolic velocities, and the E(m)/A(m) ratio. By two-dimensional strain echocardiography, peaks of regional systolic strain and LV global longitudinal strain were calculated.


RESULTS
LV mass index and ejection fraction did not significantly differ between the two groups. However, power athletes showed an increased sum of wall thicknesses (P < .01) and relative wall thickness, while LV stroke volume and LV end-diastolic diameter (P < .001) were greater in endurance athletes. By pulsed-wave tissue Doppler analysis, E(m) and E(m)/A(m) at both the septal and lateral wall levels were higher in endurance athletes. By two-dimensional strain echocardiography, myocardial deformation indexes were comparable between the two groups. E(m)/A(m) ratios ≥ 1 were found in the overall population, while 90 % of athletes had an E(m) ≥ 16 cm/sec, S(m) ≥ 10 cm/sec, and global longitudinal strain ≤ -16%. Multivariate analyses evidenced independent positive association between Em peak velocity and LV end-diastolic volume (P < .001) and an independent correlation of global longitudinal strain with the sum of LV wall thicknesses (P < .005).


CONCLUSIONS
This study describes the full spectrum of systolic and diastolic myocardial velocities and deformation indexes in a large population of competitive athletes.
Second University of Naples, Monaldi Hospital Naples, Naples, Italy. antonellodandrea@libero.it
Antonello
A
D'Andrea
Rosangela
R
Cocchia
Lucia
L
Riegler
Raffaella
R
Scarafile
Gemma
G
Salerno
Rita
R
Gravino
Enrica
E
Golia
Enrica
E
Pezzullo
Rodolfo
R
Citro
Giuseppe
G
Limongelli
Giuseppe
G
Pacileo
Sergio
S
Cuomo
Pio
P
Caso
Maria Giovanna
MG
Russo
Eduardo
E
Bossone
Raffaele
R
Calabrò
D000293:Adolescent; D000328:Adult; D056352:Athletes; D001696:Biomechanical Phenomena; D001794:Blood Pressure / Q000502:physiology; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods*; D018619:Echocardiography, Doppler, Pulsed; D015444:Exercise / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006346:Heart Septum / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012016:Reference Values; D055070:Resistance Training; D012984:Software; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult