title: Left atrial strain after maximal exercise in competitive waterpolo players.
abstract: Left atrial (LA) function is a determinant of left ventricular (LV) filling. It carries out three main functions: reservoir, conduit, contractile. Aim of this study was to evaluate the role of LA and its deformation properties on LV filling at rest (R) and immediately after a maximal exercise (ME) through the speckle tracking echocardiography. Population enrolled was composed by 23 water polo athletes who performed a ME of six repeats of 100 m freestyle swim sets. At ME peak atrial longitudinal strain was reduced but all strain rate (SR) parameters increased, respectively positive peak SR at reservoir phase, SR negative peak at rapid ventricular filling (SRep) and SR negative peak at late ventricular filling (SRlp), that corresponds to atrial contraction phase. We showed a parallel increase in E and A pulsed Doppler wave and SRep and SRlp; particularly at ME, A wave and SRlp increased more respectively than E wave and SRep. SRlp was related to ejection fraction (EF) (r = -0.47; p < 0.01). At multivariate analysis SRlp was an independent predictor of EF (β: -0.47; p = 0.016). The increased sympathetic tone results into increased late diastolic LV filling with augmented atrial contractility and a decrease in diastolic filling time. During exercise LV filling was probably optimized by an enhanced and rapid LA conduit phase and by a vigorous atrial contraction during late LV filling.
authors.affiliation: Division of Cardiology, Gaetano Palloni Clinical Institute, Via Pasteur 35-37, 52025, Montevarchi Arezzo, Tuscany, Italy. amato.santoro@alice.it.
authors.forename: Amato
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Department of Cardiology, University of Siena, Siena, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Alvino
authors.affiliation: Department of Pediatrics Cardiovascular Disease, Bambin Gesù Pediatric Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Antonelli
authors.affiliation: Department of Cardiology, S. Matteo degli Infermi Hospital, Spoleto, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Molle
authors.affiliation: Department of Cardiology, University of Siena, Siena, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D016279:Atrial Function, Left; D001696:Biomechanical Phenomena; D003163:Competitive Behavior; D018619:Echocardiography, Doppler, Pulsed; D006801:Humans; D009200:Myocardial Contraction; D010807:Physical Endurance; D013314:Stress, Mechanical; D013318:Stroke Volume; D013550:Swimming; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Atrial function; Left atrial strain and strain rate; Maximal exercise; Speckle tracking echocardiography