title: Comprehensive assessment of biventricular function and aortic stiffness in athletes with different forms of training by three-dimensional echocardiography and strain imaging.
abstract: OBJECTIVE
  Previous studies have shown distinct models of cardiac adaptations to the training in master athletes and different effects of endurance and strength-training on cardiovascular function. We attempted to assess left-ventricular (LV) function, aortic (Ao) function, and right-ventricular (RV) function in athletes with different forms of training by using three-dimensional (3D) echocardiography, tissue Doppler imaging (TDI) and speckle-tracking imaging (STI).
  
  
  RESULTS
  We examined 35 male marathon runners (endurance-trained athletes, ETA), 35 powerlifting athletes (strength-trained athletes, STA), 35 martial arts athletes (mixed-trained athletes, MTA), and 35 sedentary untrained healthy men (controls, CTR). Two-dimensional and three-dimensional echocardiography were performed for the assessment of LV and RV systolic/diastolic function. LV and RV longitudinal strain (LS) and LV torsion (LVtor) were determined using STI (EchoPAC BT11, GE-Ultrasound). Maximum velocity of systolic wall expansion peaks (AoSvel) was determined using TDI. ETA experienced LV eccentric hypertrophy with increased 3D LV end-diastolic volume and mass and significant increase in peak systolic apical rotation and LVtor. In all groups of athletes, RV-LS was reduced at rest and improved after exercise. AoSvel was significantly increased in ETA and MTA and significantly decreased in STA compared with CTR. There were good correlations between LV remodelling and aortic stiffness values. Multivariate analysis showed aortic wall velocities to be independently related to LV mass index.
  
  
  CONCLUSIONS
  In strength-trained, endurance-trained, and mixed-trained athletes, ventricular and vascular response assessed by 3DE, TDI, and STI underlies different adaptations of LV, RV, and aortic indexes.
authors.affiliation: Sapienza University, Cardiac Dept., Via Lima 35, 00198 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitarelli
authors.forename: Lidia
authors.initials: L
authors.lastname: Capotosto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Placanica
authors.forename: Fiorella
authors.initials: F
authors.lastname: Caranci
authors.forename: Mario
authors.initials: M
authors.lastname: Pergolini
authors.forename: Francesco
authors.initials: F
authors.lastname: Zardo
authors.forename: Francesco
authors.initials: F
authors.lastname: Martino
authors.forename: Stefania
authors.initials: S
authors.lastname: De Chiara
authors.forename: Massimo
authors.initials: M
authors.lastname: Vitarelli
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001011:Aorta / Q000502:physiology*; D056352:Athletes / Q000706:statistics & numerical data; D016022:Case-Control Studies; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D016552:Ergometry / Q000379:methods; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D016139:Martial Arts / Q000502:physiology; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology; D010807:Physical Endurance; D012016:Reference Values; D012420:Running / Q000502:physiology; D013177:Sports / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D059289:Vascular Stiffness / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*; D014891:Weight Lifting / Q000502:physiology; D055815:Young Adult
keywords: Aortic function; Athlete's heart; Echocardiography; Speckle tracking imaging; Three-dimensional echocardiography; Tissue Doppler imaging; Ventricular function