title: Relationship between cardiac deformation parameters measured by cardiovascular magnetic resonance and aerobic fitness in endurance athletes.
abstract: Athletic training leads to remodelling of both left and right ventricles with increased myocardial mass and cavity dilatation. Whether changes in cardiac strain parameters occur in response to training is less well established. In this study we investigated the relationship in trained athletes between cardiovascular magnetic resonance (CMR) derived strain parameters of cardiac function and fitness.
  
  
  
  Thirty five endurance athletes and 35 age and sex matched controls underwent CMR at 3.0 T including cine imaging in multiple planes and tissue tagging by spatial modulation of magnetization (SPAMM). CMR data were analysed quantitatively reporting circumferential strain and torsion from tagged images and left and right ventricular longitudinal strain from feature tracking of cine images. Athletes performed a maximal ramp-incremental exercise test to determine the lactate threshold (LT) and maximal oxygen uptake (V̇O2max).
  
  
  
  LV circumferential strain at all levels, LV twist and torsion, LV late diastolic longitudinal strain rate, RV peak longitudinal strain and RV early and late diastolic longitudinal strain rate were all lower in athletes than controls. On multivariable linear regression only LV torsion (beta = -0.37, P = 0.03) had a significant association with LT. Only RV longitudinal late diastolic strain rate (beta = -0.35, P = 0.03) had a significant association with V̇O2max.
  
  
  
  This cohort of endurance athletes had lower LV circumferential strain, LV torsion and biventricular diastolic strain rates than controls. Increased LT, which is a major determinant of performance in endurance athletes, was associated with decreased LV torsion. Further work is needed to understand the mechanisms by which this occurs.
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK. p.swoboda@leeds.ac.uk.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Swoboda
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Bara
authors.initials: B
authors.lastname: Erhayiem
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Adam K
authors.initials: AK
authors.lastname: McDiarmid
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and School of Biomedical Sciences, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Rosalind E
authors.initials: RE
authors.lastname: Lancaster
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and School of Biomedical Sciences, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Gemma K
authors.initials: GK
authors.lastname: Lyall
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Dobson
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: David P
authors.initials: DP
authors.lastname: Ripley
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Tarique A
authors.initials: TA
authors.lastname: Musa
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and School of Biomedical Sciences, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Carrie
authors.initials: C
authors.lastname: Ferguson
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: John P
authors.initials: JP
authors.lastname: Greenwood
authors.affiliation: Multidisciplinary Cardiovascular Research Centre (MCRC) and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
mesh_terms: D000328:Adult; D056352:Athletes; D001696:Biomechanical Phenomena; D059267:Cardiomegaly, Exercise-Induced; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D010101:Oxygen Consumption; D010807:Physical Endurance; D010809:Physical Fitness; D011237:Predictive Value of Tests; D011446:Prospective Studies; D054159:Torsion, Mechanical; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling; D055815:Young Adult
keywords: Aerobic capacity; Athlete; Cardiovascular magnetic resonance; Feature tracking; Lactate threshold; Tissue tagging