title: Chronic adaptation of atrial structure and function in elite male athletes.
abstract: OBJECTIVE
  The aim of this study was to establish the degree of structural and functional adaptations in the left (LA) and right atria (RA) in elite male athletes engaged in 'high dynamic : high static' (HDHS) and 'low dynamic : high static' (LDHS) sporting disciplines compared with sedentary controls.
  
  
  RESULTS
  Eighteen male, elite HDHS athletes (13 boxers and 7 triathletes), 18 male, elite LDHS athletes (8 weightlifters and 10 Akido), and 20 male, age-matched sedentary controls were assessed using conventional 2D and myocardial speckle tracking (MST) echocardiography. Absolute LA and RA volumes [end systole (VOLes), pre A (VOLpreA), and end diastole (VOLed)] as well as the functional indices of reservoir (RESvol), conduit (CONvol), and booster volumes (BOOvol) were defined. MST allowed the assessment of atrial strain (ε) during the reservoir (RESε), conduit (CONε), and booster (BOOε) phases of the cardiac cycle. Both LA and RA sizes were significantly larger in HDHS compared with LDHS and controls (P < 0.05) across all structural and functional volume parameters with no significant difference between LDHS and controls (LAVOLes 35 ± 8, 26 ± 10, and 23 ± 5 mL/m(2); RAVOLes 37 ± 10, 26 ± 9, and 23 ± 5 mL/m(2), LARESvol 35 ± 9, 25 ± 11, and 23 ± 7 mL; RARESvol 41 ± 11, 34 ± 11, and 28 ± 7 mL for HDHS, LDHS, and controls, respectively). RA : LA ratios were >1 in all groups due to a comparatively larger RA volume (RAVOLes : LAVOLes 1.05 ± 0.26, 1.12 ± 0.55, and 1.04 ± 0.28 for HDHS, LDHS, and controls, respectively, P > 0.05). There was no significant between group differences for any ε parameter.
  
  
  CONCLUSIONS
  Bi-atrial hypertrophy is demonstrated in HDHS athletes and not in LDHS athletes, suggesting that the dynamic component to training is the primary driver for both LA and RA adaptation. Although functional data derived from volume shifts suggest augmented function in HDHS athletes, MST imaging demonstrated no difference in intrinsic atrial ε in any of the groups.
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK.
authors.forename: Gavin
authors.initials: G
authors.lastname: McClean
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: George
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Lord
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK.
authors.forename: Victor
authors.initials: V
authors.lastname: Utomi
authors.affiliation: Aintree University Hospitals NHS Trust and British Boxing Board of Control, London, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Jones
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK Countess of Chester Hospital, NHS Trust, Chester, UK.
authors.forename: John
authors.initials: J
authors.lastname: Somauroo
authors.affiliation: Department of Cardiology, Airedale General Hospital, Keighley, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fletcher
authors.affiliation: Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK d.l.oxborough@ljmu.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Oxborough
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D056352:Athletes; D015992:Body Mass Index; D059267:Cardiomegaly, Exercise-Induced; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
keywords: Athletes heart; Echocardiography; Left atrium; Right atrium; Strain imaging