title: Patterns of left ventricular diastolic function in Olympic athletes.
abstract: BACKGROUND
  Whether morphologic left ventricular (LV) changes in elite athletes are associated with altered diastolic properties is undefined. The aim of this study was to investigate LV diastolic properties in a large population of Olympic athletes compared to untrained controls.
  
  
  METHODS
  A total of 1,145 Olympic athletes (61% men), and 154 controls, free of cardiovascular disease, underwent two-dimensional echocardiography, Doppler echocardiography, and Doppler tissue imaging.
  
  
  RESULTS
  Athletes had similar E velocities (87 ± 15 vs 89 ± 16 cm/sec, P = .134) but significantly decreased A velocities (47 ± 10 vs 56 ± 12 cm/sec, P < .001) compared with controls, with increased E/A ratios (1.93 ± 0.50 vs 1.63 ± 0.35, P < .001) and values ranging up to 4.8. Isovolumic relaxation (83 ± 13 vs 71 ± 16 msec, P < .001) and deceleration times (203 ± 40 vs 181 ± 36 msec, P < .001) were longer in athletes compared with controls. Doppler tissue imaging e' (13.8 ± 2.2 vs 16.2 ± 3.7 cm/sec, P < .001) and a' (7.2 ± 1.8 vs 8.5 ± 2.1 cm/sec, P < .001) were lower in athletes than in controls, but their ratio was not different between groups; E/e' ratios (6.37 ± 1.2 vs 5.72 ± 1.33, P < .001) were mildly higher in athletes. Subgroup analysis for type of sport showed that endurance athletes had the lowest A and a' velocities and the largest E/A ratios. Gender analysis revealed that men had significantly lower E and A velocities, as well as e', e'/a' ratios, and E/e' ratios (P < .01), compared with women.
  
  
  CONCLUSIONS
  This study provides normal values for Doppler echocardiographic and Doppler tissue imaging parameters describing diastolic function in elite athletes, which may be implemented as reference values in the clinical assessment of athlete's heart and prove useful in understanding the physiologic limits of cardiac adaptations in athletes.
authors.affiliation: Institute of Sports Medicine and Science, Rome, Italy. Electronic address: stefanocasellimd@gmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Caselli
authors.affiliation: Institute of Sports Medicine and Science, Rome, Italy.
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Di Paolo
authors.affiliation: Institute of Sports Medicine and Science, Rome, Italy.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Pisicchio
authors.affiliation: Cardiovascular Imaging and Hemodynamic Laboratory, Tufts University Medical Center, Boston, Massachusetts.
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.affiliation: Institute of Sports Medicine and Science, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D012016:Reference Values; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: Athletes; Diastolic function; Doppler; Echocardiography; LV hypertrophy