title: Training-induced dynamic changes in left atrial reservoir, conduit, and active volumes in professional soccer players.
abstract: OBJECTIVE
  Although left atrial (LA) enlargement is a recognized component of athlete's heart, dynamic cavity changes occurring during the training period remain to be elucidated. We aimed to investigate the adaptive changes of LA reservoir, conduit, and active volumes in elite athletes vs. controls and their response to different training loads.
  
  
  METHODS
  LA maximum, pre-P, and minimum volumes were assessed in 26 top-level athletes and 23 controls. In athletes, LA volumes were measured at pre-, mid-, end-training, and post-detraining time points using conventional 2D echocardiography.
  
  
  RESULTS
  Athletes had larger maximum (27.5 ± 3.2 vs. 20.3 ± 5.8 mL/m(2), p = 0.001), pre-P (11.5 ± 0.9 vs. 9.8 ± 2.2 mL/m(2), p = 0.001), and minimum (6.6 ± 0.9 vs. 5.0 ± 1.2 mL/m(2), p < 0.001) LA indexed volumes, compared with controls. Total and passive emptying volume indices were also larger in athletes compared with controls (18.7 ± 3.1 vs. 15.3 ± 4.9 mL/m(2), p < 0.05 and 13.8 ± 2.9 vs. 10.5 ± 4.6 mL/m(2), p < 0.05, respectively), while active emptying volume was similar (p = 0.74). During training, LA maximum (p < 0.0001), pre-P (p < 0.0001), minimum (p < 0.0001), total (p < 0.005), and passive (p < 0.05) emptying volume indices progressively increased, while active emptying volume (p = 0.10) and E/e' ratio (p = 0.32) remained unchanged. After detraining, LA volume measurements were not different from pre-training ones. End-training left ventricular mass index was the only independent predictor of the respective maximum LA volume (β = 0.74, p < 0.005).
  
  
  CONCLUSIONS
  Top-level athletes exhibit a dynamic morphological and functional LA remodeling, induced by training, with an increase in reservoir and conduit volumes, but stable active volume. LA remodeling is closely associated with left ventricular adaptation to exercise and both completely regress after detraining.
authors: Department of Cardiovascular Diseases, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy, flavio.dascenzi@unisi.it.
authors: Flavio
authors: F
authors: D'Ascenzi
authors: Antonio
authors: A
authors: Pelliccia
authors: Benedetta Maria
authors: BM
authors: Natali
authors: Matteo
authors: M
authors: Cameli
authors: Matteo
authors: M
authors: Lisi
authors: Marta
authors: M
authors: Focardi
authors: Margherita
authors: M
authors: Padeletti
authors: Paola
authors: P
authors: Palmitesta
authors: Domenico
authors: D
authors: Corrado
authors: Marco
authors: M
authors: Bonifazi
authors: Sergio
authors: S
authors: Mondillo
authors: Michael
authors: M
authors: Henein
mesh_terms: D000328:Adult; D054874:Athletic Performance / Q000502:physiology; D016279:Atrial Function, Left / Q000502:physiology*; D004452:Echocardiography; D006801:Humans; D008297:Male; D009929:Organ Size / Q000502:physiology; D010806:Physical Education and Training; D012916:Soccer / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult