title: Left ventricular biomechanics in professional football players.
abstract: Chronic exercise induces adaptive changes of left ventricular (LV) ejection and filling capacities which may be detected by novel speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. A total of 103 consecutive male elite Norwegian soccer players and 46 age-matched healthy controls underwent echocardiography at rest. STE was used to assess LV torsional mechanics and LV systolic longitudinal strain (LS). Diastolic function was evaluated by trans-mitral blood flow, mitral annular velocities by TDI, and LV inflow propagation velocity by color M-mode. Despite similar global LS, players displayed lower basal wall and higher apical wall LS values vs controls, resulting in an incremental base-to-apex gradient of LS. Color M-mode and TDI-derived data were similar in both groups. Peak systolic twist rate (TWR) was significantly lower in players (86.4±2.8 vs controls 101.9±5.2 deg/s, P<.01). Diastolic untwisting rate (UTWR) was higher in players (-124.5±4.2 vs -106.9±6.7 deg/s) and peaked earlier during the cardiac cycle (112.7±0.8 vs 117.4±2.4% of systole duration, both P<.05). Untwisting/twisting ratio (-1.48±0.05 vs -1.11±0.08; P<.001) and untwisting performance (=UTR/TW; -9.25±0.34 vs -7.38±0.40 s-1, P<.01) were increased in players. Augmented diastolic wall strain (DWS), a novel measure of LV compliance in players, was associated with improved myocardial mechanical efficiency. The described myocardial biomechanics may underlie augmented exertional cardiac function in athletes and may have a potential role to characterize athlete's heart by itself or to distinguish it from hypertensive or hypertrophic cardiomyopathy.
authors.affiliation: Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.|Center for Heart Failure Research, University of Oslo, Oslo, Norway.
authors.forename: T G
authors.identifier: http://orcid.org/0000-0002-6801-1190
authors.initials: TG
authors.lastname: von Lueder
authors.affiliation: Center for Heart Failure Research, University of Oslo, Oslo, Norway.|Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Hodt
authors.affiliation: Section of Vascular Investigations, Oslo University Hospital Aker, Oslo, Norway.
authors.forename: G F
authors.initials: GF
authors.lastname: Gjerdalen
authors.affiliation: Department of Cardiology, Akershus University Hospital, Lørenskog/Oslo, Norway.|Center for Heart Failure Research, University of Oslo, Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Steine
mesh_terms: D000328:Adult; D056352:Athletes; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012916:Soccer; D016277:Ventricular Function, Left
keywords: athlete; diastolic function; left ventricular function; speckle-tracking; strain; tissue Doppler; torsion