title: Volumetric and functional assessment of the left atrium in young competitive athletes without left ventricular hypertrophy: the MAGYAR-Sport Study.
abstract: BACKGROUND
  Left atrial (LA) remodeling may be regarded as a physiologic adaptation to exercise conditioning. Three-dimensional speckle tracking echocardiography (3DSTE) is a new promising tool for volumetric and functional characterization of the LA. The present study was undertaken to assess adaptive changes in LA volumes and functional properties respecting cardiac cycle in young competitive athletes without left ventricular hypertrophy (LVH) by detailed 3DSTE assessment.
  
  
  METHODS
  The study group consisted of 20 young elite basketball and handball players (mean age: 28.1±10.1 years, 8 men) without LVH, their results were compared to 23 age- and gender-matched non-sportive healthy controls (mean age: 31.7±8.5 years, 11 men. All subjects had undergone standard transthoracic two-dimensional Doppler echocardiographic study with 3DSTE.
  
  
  RESULTS
  Increased systolic maximum (66.5±13.6 mL vs. 38.5±8.6 mL, P<0.0001) and diastolic minimum (36.7±8.1 mL vs. 17.5±5.8 mL, P<0.0001) and preatrial contraction (46.2±10.1 mL vs. 26.2±7.8 mL, P<0.0001) LA volumes could be demonstrated in athletes. Total (29.7±9.0 mL vs. 20.7±5.0 mL, P=0.0002) and passive LA stroke volumes (19.8±8.7 mL vs. 12.4±4.6 mL, P=0.0009) were increased, while total (44.2±9.1 mL vs. 54.2±9.4 mL, P=0.001) and active LA emptying fractions (20.6±11.8% vs. 31.9±8.7%, P=0.0008) proved to be decreased in athletes as compared to controls. Active LA stroke volume (9.9±5.8 mL vs. 8.3±3.3 mL, P=0.29) and passive LA emptying fraction (29.1±10.6 mL vs. 32.6±11.2 mL, P=0.31) did not differ between the groups. Only circumferential global (21.1±7.7% vs. 27.6±9.9%, P=0.02) and mean segmental (26.1±7.1% vs. 35.7±12.0%, P=0.003) peak LA strains proved to be significantly reduced in athletes as compared to controls.
  
  
  CONCLUSIONS
  3DSTE-derived increased cyclic LA volumes and specific alterations in LA functional properties could be demonstrated in young competing athletes which is most likely a physiologic consequence of a global cardiac adaptation to intensive and chronic training.
authors.affiliation: Second Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary - nemes.attila@med.u-szeged.hu.
authors.forename: Attila
authors.initials: A
authors.lastname: Nemes
authors.affiliation: Second Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Domsik
authors.affiliation: Second Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Kalapos
authors.affiliation: Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Orosz
authors.affiliation: Second Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Mónika
authors.initials: M
authors.lastname: Oszlánczi
authors.affiliation: Department of Traumatology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.|Department of Sports Medicine, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Török
authors.affiliation: Intitute of Physical Education and Sports Science, Gyula Juhász Faculty of Education, University of Szeged, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Balogh
authors.affiliation: Department of Sports Medicine, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Márton
authors.affiliation: Second Department of Medicine and Cardiology Centre, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Forster
authors.affiliation: First Department of Medicine, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Lengyel
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D016279:Atrial Function, Left / Q000502:physiology*; D064752:Atrial Remodeling / Q000502:physiology*; D001490:Basketball / Q000502:physiology; D002648:Child; D019560:Echocardiography, Three-Dimensional; D015444:Exercise / Q000502:physiology*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D013177:Sports / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D055815:Young Adult