Is elite sport activity associated with specific supranormal left ventricular contractility? (Insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Sport Study)

Attila Nemes, Anita Kalapos, Péter Domsik, Mónika Oszlánczi, Csaba Lengyel, Andrea Orosz, László Török, László Balogh, Tamás Forster
2016 International Journal of Cardiology  
Left ventricular (LV) strains are quantitative features of LV contractility which could be easily assessed by three-dimensional (3D) speckle-tracking echocardiography (3DSTE) [1] . Evaluating elite sport activity on LV contractility is an emerging topic in recent cardiovascular research. However, results regarding to its effects on LV myocardial function are contraversial and need further investigations. The present study aimed to assess 3DSTE-derived uni-and multidirectional strains in elite
more » ... ghly trained athletes and to compare their results to ageand gender-matched non-trained healthy controls. The present study comprised 20 young elite basketball and waterpolo players and runner athletes (mean age: 25.7 ± 8.6 years, 3 men). The mean previous years of training proved to be 13 ± 8 years. Their results were compared to 24 healthy controls (mean age: 22.9 ± 2.9 years, 9 men). None of sportmen and healthy controls has known diseases or other factors which could affect results. All sportmen and healthy controls have undergone complete two-dimensional (2D) Doppler echocardiographic examination extended with 3DSTE. Elite athletes were selected into the Motion Analysis of the heart and Great vessels bY three-dimensionAl speckle-tRacking echocardiography in Sportmen (MAGYAR-Sport) Study among others with the aim of evaluating (patho)physiologic consequences of sport activity on LV deformations ('magyar' means 'Hungarian' in Hungarian language) [2]. Local institutional ethics committee of the University of Szeged reviewed and approved the study which conformed to the principles outlined in the Declaration of Helsinki. Standard 2D-Doppler echocardiographic study with 3DSTE has been performed in all sportmen and matched-healthy controls with a commercially available echocardiography system (Toshiba Artida™, Toshiba Medical Systems, Tokyo, Japan) using a 1-5 MHz PST-30SBP phasedarray transducer [3]. 3DSTE imaging was performed from an apical position when six wedge-shaped subvolumes were acquired within a single breath-hold in all cases using a 1-4 MHz matrix-array PST-25SX transducer with 3DSTE capability. Chamber quantifications were performed using 3D Wall Motion Tracking software version 2.7 (Toshiba Medical Systems, Tokyo, Japan). 3D echocardiographic datasets were displayed in different views including apical two-(AP2CH) and fourchamber (AP4CH) views and different LV short-axis (basal, midventricular and apical) views (Fig. 1) . These views were automatically selected at end-diastole by the software. During assessments LV endocardial border was traced by setting several reference points at the edges of the mitral valve and at the apex on AP2CH and AP4CH views. Later, LV endocardial surface was tracked and automatically reconstructed through the heart cycle. Over unidirectional strains including radial (RS), longitudinal (LS), circumferential (CS) strains, multidirectional strains [area tracking/strain (AS) and 3D (3DS)] were calculated using time-strain curves generated automatically by the software. Clinical characteristics, 2D echocardiographic and 3DSTE data of sportmen and healthy subjects were compared (Tables 1 and 2) . No significant differences could be demonstrated in standard 2D echocardiographic data, while 3DSTE-derived LV-CS and LV-AS were found to be significantly increased in sportmen as compared to matched healthy controls. To the best of authors' knowledge this is the first time to demonstrate supranormal 3DSTE-derived deformational variables in elite
doi:10.1016/j.ijcard.2016.06.124 pmid:27372048 fatcat:43dne6lgbzhexhip3bpgd4h5da