title: Differential atrial performance at rest and exercise in athletes: Potential trigger for developing atrial dysfunction?
abstract: Highly trained athletes show an increased risk of atrial arrhythmias. Little is known about atrial volumes and function during exercise in this population. Our aim was to analyze atrial size and contractile function during exercise. Fifty endurance athletes with 11 ± 8 h of training per week and 30 sedentary control subjects were included. Echocardiography was performed at baseline and during exercise. Left (LA) and right atrial (RA) size and function were assessed by two-dimensional echocardiography. Peak negative strain (Sa) during atrial contraction and active atrial emptying volume (AEV) were measured. Athletes and control subjects showed a significant increment of deformation and AEV of both atria with exercise (P < 0.01 vs baseline for LA and RA). Among athletes, a subgroup with significant LA (n = 8)/RA (n = 15) dilatation (≥40 mL/m2) showed a significantly lower increment in AEV with exercise (LA∆AEV: 1.4 ± 1.1 mL/m2vs 2.1 ± 0.9 mL/m2, P = 0.04; RA∆AEV: 0.9 ± 0.8 mL/m2vs 2.3 ± 1.1 mL/m2, P < 0.01) and lower increment in deformation vs other athletes (LA∆Sa: -3.2 ± 2.9% vs -9.5 ± 4.4%, P < 0.01; RA∆Sa: -2.5 ± 3.3% vs. -9.8 ± 3.3%, P < 0.01). During exercise, active atrial strain increases, but less in athletes compared to controls, but due to larger atrial volumes, they reached similar increases in atrial emptying volume. However, this overall lesser deformation increases from a subgroup with significant atrial dilatation showing impairment in atrial contractile reserve.
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.|Advanced Center for Chronic Diseases, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: L
authors.initials: L
authors.lastname: Gabrielli
authors.affiliation: Universitat Pompeu Fabra, Barcelona, Spain.|ICREA, Barcelona, Spain.
authors.forename: B H
authors.initials: BH
authors.lastname: Bijnens
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Brambila
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.|Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Duchateau
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Marin
authors.affiliation: Consell Catala de l'Esport, Barcelona, Spain.|Imesport, Teknon Clinic, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Sitges-Serra
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Mont
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Brugada
authors.affiliation: IDIBAPS (IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer), Thorax Clinic Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sitges
mesh_terms: D000328:Adult; D056352:Athletes; D016275:Atrial Function; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D015444:Exercise; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009929:Organ Size; D010807:Physical Endurance; D012146:Rest; D057185:Sedentary Behavior
keywords: Atrial function; athletes; atrial arrhythmia; imaging stress test