Atrial Enlargement in the Athlete's Heart: Assessment of Atrial Function May Help Distinguish Adaptive from Pathologic Remodeling

2018 ◽  
Vol 31 (2) ◽  
pp. 148-157 ◽  
Author(s):  
Flavio D'Ascenzi ◽  
Francesca Anselmi ◽  
Marta Focardi ◽  
Sergio Mondillo
Keyword(s):  
Athlete’S Heart ◽  
Atrial Function ◽  
Atrial Enlargement ◽  
Athlete's Heart

scholarly journals Left Atrial Enlargement in Young High-Level Endurance Athletes – Another Sign of Athlete’s Heart?

2016 ◽  
Vol 53 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Wojciech Król ◽  
Ilona Jędrzejewska ◽  
Marcin Konopka ◽  
Krystyna Burkhard-Jagodzińska ◽  
Andrzej Klusiewicz ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Athlete’S Heart ◽  
Left Atrial Strain ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement ◽  
Atrial Strain ◽  
High Level ◽  
Athlete's Heart

AbstractEnlargement of the left atrium is perceived as a part of athlete’s heart syndrome, despite the lack of evidence. So far, left atrial size has not been assessed in the context of exercise capacity. The hypothesis of the present study was that LA enlargement in athletes was physiological and fitness-related condition. In addition, we tried to assess the feasibility and normal values of left atrial strain parameters and their relationship with other signs of athlete’s heart. The study group consisted of 114 international-level rowers (17.5 ± 1.5 years old; 46.5% women). All participants underwent a cardio-pulmonary exercise test and resting transthoracic echocardiography. Beside standard echocardiographic measurements, two dimensional speckle tracking echocardiography was used to assess average peak atrial longitudinal strain, peak atrial contraction strain and early left atrial diastolic longitudinal strain. Mild, moderate and severe left atrial enlargement was present in 27.2°%, 11.4% and 4.4% athletes, respectively. There were no significant differences between subgroups with different range of left atrial enlargement in any of echocardiographic parameters of the left ventricle diastolic function, filling pressure or hypertrophy. A significant correlation was found between the left atrial volume index and maximal aerobic capacity (R > 0.3; p < 0.001). Left atrial strain parameters were independent of atrial size, left ventricle hypertrophy and left ventricle filling pressure. Decreased peak atrial longitudinal strain was observed in 4 individuals (3.5%). We concluded that LA enlargement was common in healthy, young athletes participating in endurance sport disciplines with a high level of static exertion and was strictly correlated with exercise capacity, therefore, could be perceived as another sign of athlete’s heart.

Assessment of Left Atrial Function in Hypertrophic Cardiomyopathy and Athlete's Heart: A Left Atrial Myocardial Deformation Study

2012 ◽  
Vol 29 (8) ◽  
pp. 943-949 ◽  
Author(s):  
Luigi Gabrielli ◽  
Andrés Enríquez ◽  
Samuel Córdova ◽  
Fernando Yáñez ◽  
Iván Godoy ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Athlete’S Heart ◽  
Myocardial Deformation ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Athlete's Heart

scholarly journals Athlete’s Heart

Circulation ◽  
2001 ◽  
Vol 103 (6) ◽  
Author(s):  
Robert H. Fagard
Keyword(s):  
Athlete’S Heart ◽  
Athlete's Heart

Abstract 12760: Left Ventricular (LV) Remodeling in Aortic Regurgitation Differs From Athlete’s Heart With Similar LV Volumes and is Closely Related to Different Fiber Stress Distribution

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kaspar Broch ◽  
Stefano deMarchi ◽  
Richard Massey ◽  
Svend Aakhus ◽  
Lars Gullestad ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Aortic Regurgitation ◽  
Strain Curve ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Endurance Athletes ◽  
Fiber Stress ◽  
Lv Remodeling ◽  
Lv Volumes ◽  
Athlete's Heart

Introduction: Elite endurance athletes often develop left ventricular dilatation comparable to that observed in aortic regurgitation (AR). Hypothesis: We hypothesized that the LV remodeling observed in athlete’s heart differs from that seen in AR, and that the difference may be attributed to different fiber stress distribution. Methods: Thirty asymptomatic patients with moderate to severe AR, 15 age matched elite endurance athletes (Athl) and 17 age matched healthy controls (C) where analyzed with 3D speckle tracking echocardiography. We calculated the ratio between peak systolic circumferential (CS) - and peak systolic longitudinal strain (LS) and end-systolic (ES) circumferential (ESSc) and meridional (ESSm) fiber stress. Results: LV ejection fraction in C, Athl and AR patients was (61 ± 2, 61 ± 3 and 62 ± 3%, respectively, p=NS). LV end-diastolic volume was 78 ± 11, 112 ± 13 and 117 ± 20 ml/m 2 in C, Athl and AR, respectively, (C vs AR and Athl, p<0.01, AR vs Athl, p=NS). A non-uniform contraction pattern with a rightward shift of the LS strain curve was observed in AR (Figure 1). The CS/LS ratio was 0.91 ± 0.11, 0.91 ± 0.16 and 1.12 ± 0.24 in C, Athl and AR, respectively, (AR vs C and Athl, p<0.01, C vs Athl, p=NS). Consistently, the ESSc/ESSm ratio was similar in C and Athl (1.75 ± 0.08 and 1.74 ± 0.07, respectively, p=NS) and lower in AR patients (1.67 ± 0.07, AR vs C and Athl, p<0.01), indicating a relative increase in meridional fiber stress in the AR group (Figure 2). Conclusions: We have demonstrated that LV remodeling in AR patients differs from athlete’s heart with similar LV volumes, and may be attributed to a shift in the circumferential-meridional fiber stress ratio in AR patients.

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