Patterns of Left Ventricular Longitudinal Strain and Strain Rate in Olympic Athletes

Caselli, Stefano; Montesanti, Dalma; Autore, Camillo; Paolo, Fernando M. Di; Pisicchio, Cataldo; Squeo, Maria Rosaria; Musumeci, Beatrice; Spataro, Antonio; Pandian, Natesa G.; Pelliccia, Antonio

doi:10.1016/j.echo.2014.10.010

Cited by 93 publications

(75 citation statements)

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“…Specifically, the LVLSR values of the A4C view, the A3C view, the A2C view, and the LVGLSR were −1.18 ± 0.18, −1.20 ± 0.21, −1.25 ± 0.21, and −1.21 ± 0.21 −S , respectively. Our calculated mean LVGLSR is similar to those of previous studies with healthy subjects 25)26)…”

Section: Discussionsupporting

confidence: 89%

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Park

Lee

et al. 2016

J Cardiovasc Ultrasound

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BackgroundIt is important to understand the distribution of 2-dimensional strain values in normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population.MethodsThis was a substudy of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL) study. Echocardiographic specialists measured frequently used echocardiographic indices in healthy people according to a standardized method at 23 different university hospitals. The strain values were analyzed from digitally stored images.ResultsOf a total of 1003 healthy participants in NORMAL study, 2-dimensional strain values were measured in 501 subjects (265 females, mean age 47 ± 15 years old) with echocardiographic images only by GE echocardiographic machines. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV dimensions, and LV ejection fraction were 7.5 ± 1.0 mm, 7.4 ± 1.0 mm, 29.9 ± 2.8 mm, 48.9 ± 3.6 mm, and 62 ± 4%, respectively. LV longitudinal systolic strain (LS) values of apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were −20.1 ± 2.3, −19.9 ± 2.7, −21.2 ± 2.6, and −20.4 ± 2.2%, respectively. LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were −1.18 ± 0.18, −1.20 ± 0.21, −1.25 ± 0.21, and −1.21 ± 0.21−s, respectively. Females had lower LVGLS (−21.2 ± 2.2% vs. −19.5 ± 1.9%, p < 0.001) and LVGLSR (−1.25 ± 0.18−s vs. −1.17 ± 0.15−s, p < 0.001) values than males.ConclusionWe measured LV longitudinal strain and strain rate values in the normal Korean population. Since considerable gender differences were observed, normal echocardiographic cutoff values should be differentially applied based on sex.

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Section: Discussionsupporting

confidence: 89%

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Park

Lee

et al. 2016

J Cardiovasc Ultrasound

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“…This is probably the reason why we observed higher LV GLS values compared with previous data by D'Andrea et al 28 and Caselli et al , 29 who studied different athletic populations. Although all these potential determinants of LV strain should be taken into account and further studies investigating different sports disciplines are needed, a GLS <−14% or <−15% (depending on the brand of imaging equipment) is an uncommon feature of athlete's heart 7 8 29…”

Section: Discussionsupporting

confidence: 72%

Effects of training on LV strain in competitive athletes

D’Ascenzi

Pelliccia²,

Alvino

et al. 2015

Heart

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“…Only males were included because current knowledge indicates that cardiac strain may be sex dependent [26, 41, 42]. Likewise, twist mechanics are known to be affected by age [43–46].…”

Section: Methodsmentioning

confidence: 99%

“…These problems are not resolved when comparing functional adaptations using the traditional dichotomous classification of endurance and resistance athletes versus controls [23, 32, 35, 37]. One study broadly utilized the contemporary framework by subdividing Olympic athletes into four groups according to their predominant training characteristics (skill, power, mixed discipline, endurance) [26]. Despite this, each group still included sports with an assortment of static and dynamic components, which resulted in heterogeneous samples and does not truly represent the ‘four corners’ of Mitchell’s classification.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Speckle Tracking-Derived Cardiac Strain and Cardiac Twist Mechanics in Athletes: A Systematic Review and Meta-Analysis of Controlled Studies

et al. 2016

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BackgroundThe athlete’s heart is associated with physiological remodeling as a consequence of repetitive cardiac loading. The effect of exercise training on left ventricular (LV) cardiac strain and twist mechanics are equivocal, and no meta-analysis has been conducted to date.ObjectiveThe objective of this systematic review and meta-analysis was to review the literature pertaining to the effect of different forms of athletic training on cardiac strain and twist mechanics and determine the influence of traditional and contemporary sporting classifications on cardiac strain and twist mechanics.MethodsWe searched PubMed/MEDLINE, Web of Science, and ScienceDirect for controlled studies of aged-matched male participants aged 18–45 years that used two-dimensional (2D) speckle tracking with a defined athlete sporting discipline and a control group not engaged in training programs. Data were extracted independently by two reviewers. Random-effects meta-analyses, subgroup analyses, and meta-regressions were conducted.ResultsOur review included 13 studies with 945 participants (controls n = 355; athletes n = 590). Meta-analyses showed no athlete–control differences in LV strain or twist mechanics. However, moderator analyses showed greater LV twist in high-static low-dynamic athletes (d = –0.76, 95% confidence interval [CI] –1.32 to –0.20; p < 0.01) than in controls. Peak untwisting velocity (PUV) was greater in high-static low-dynamic athletes (d = –0.43, 95% CI –0.84 to –0.03; p < 0.05) but less than controls in high-static high-dynamic athletes (d = 0.79, 95% CI 0.002–1.58; p = 0.05). Elite endurance athletes had significantly less twist and apical rotation than controls (d = 0.68, 95% CI 0.19–1.16, p < 0.01; d = 0.64, 95% CI 0.27–1.00, p = 0.001, respectively) but no differences in basal rotation. Meta-regressions showed LV mass index was positively associated with global longitudinal (b = 0.01, 95% CI 0.002–0.02; p < 0.05), whereas systolic blood pressure was negatively associated with PUV (b = –0.06, 95% CI –0.13 to –0.001; p = 0.05).ConclusionEchocardiographic 2D speckle tracking can identify subtle physiological differences in adaptations to cardiac strain and twist mechanics between athletes and healthy controls. Differences in speckle tracking echocardiography-derived parameters can be identified using suitable sporting categorizations.

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Patterns of Left Ventricular Longitudinal Strain and Strain Rate in Olympic Athletes

Cited by 93 publications

References 47 publications

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Effects of training on LV strain in competitive athletes

Left Ventricular Speckle Tracking-Derived Cardiac Strain and Cardiac Twist Mechanics in Athletes: A Systematic Review and Meta-Analysis of Controlled Studies

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