title: Endurance and Strength Athlete's Heart: Analysis of Myocardial Deformation by Speckle Tracking Echocardiography.
abstract: BACKGROUND
  Intensive training induces two morphological myocardial typologies of athlete's heart. Endurance training (ET) induces eccentric remodeling, bradycardia and better diastolic filling. Strength training (ST) determines concentric chamber remodelling maintaining a normal heart rate (HR). Aim of the study was to compare ET and ST athletes' heart using speckle tracking echocardiography (STE).
  
  
  METHODS
  33 professional ET, 36 ST athletes, and 17 healthy controls (CT) were enrolled. All subjects underwent standard transthoracic echocardiography at rest and STE.
  
  
  RESULTS
  In ET group, HR was lower than ST group and CT group (p < 0.001; p < 0.01). ET group had higher E/A ratio than ST group and CT group (p < 0.01; p < 0.001). The left ventricular apical circumferential strain in ET group was lower than ST group and CT group (-21.6 ± 4.1% vs. -26.8 ± 7.7%, p < 0.05; vs. -27.8 ± 5.6%, p < 0.01). ET group had lower left ventricular twist (LVT) and untwisting (UTW) than ST group (6.2 ± 0.1° vs. 12.0 ± 0.1°, p < 0.01; -67.3 ± 22.9°/s vs. -122.5 ± 52.8°/s, p < 0.01) and CT group (10.0 ± 0.1°, p < 0.01; -103.3 ± 29.3°/s, p < 0.01). The univariate analysis showed significant correlation between E/A ratio and HR (r = -0.54; p < 0.001), LVT (r = -0.45; p < 0.01), UTW (r = 0.24; p < 0.05). At the multivariate analysis only HR was confirmed as independent predictor of diastolic function in all groups (Beta -0.52; p < 0.001).
  
  
  CONCLUSIONS
  In ET there was a better global systolic and diastolic functional reserve at rest observed with strain analysis and it maybe depended on autonomic modulation.
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Amato
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Alvino
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Antonelli
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Caputo
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Padeletti
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lisi
authors.affiliation: Division of Cardiology, University of Siena, Siena, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
keywords: Athlete's heart; Endurance training; Speckle tracking echocardiography; Strength training; Twisting