Right and left ventricular diastolic function of male endurance athletes

Patterns of Left Ventricular Diastolic Function in Olympic Athletes

“…28 Another possible explanation for this phenomenon is the hypothesis that under resting condition, the untwisting of the left ventricle occurs at a lower velocity (as also demonstrated by an increased IVRT), with a consequently slower decay in LV pressure needed to generate the suction forces 40 ; however, the untwisting forces may become more relevant during exercise and at higher heart rates to generate more efficient filling of the left ventricle. 41 Our results are partially different from those of previous studies, which are largely heterogeneous: the E/A ratio was reported to be unchanged by some authors 42,43 but increased by others 16,37 ; certain studies reported increased E-wave velocity, 20,37 whereas most the others showed that it was unchanged 14,36,37 ; and e 0 velocity was increased in some studies 18,37,43 and unchanged in others. 14,16,36 These marked differences are likely due to the restricted and selected athlete populations included in previous studies, which do not allow a complete picture of diastolic function in athletes.…”

“…41 Our results are partially different from those of previous studies, which are largely heterogeneous: the E/A ratio was reported to be unchanged by some authors 42,43 but increased by others 16,37 ; certain studies reported increased E-wave velocity, 20,37 whereas most the others showed that it was unchanged 14,36,37 ; and e 0 velocity was increased in some studies 18,37,43 and unchanged in others. 14,16,36 These marked differences are likely due to the restricted and selected athlete populations included in previous studies, which do not allow a complete picture of diastolic function in athletes. The only meta-analysis available, encompassing 59 studies and including 1,451 athletes, demonstrated the absence of any difference in E/A ratio among athletes engaged in power, mixed, and endurance disciplines but did not mention other diastolic function parameter.…”

“…[14][15][16][17][18]36,37 However, within the broad spectrum of sport disciplines included in the present study, we observed a small but nonnegligible subset of athletes (3%) with E/A ratios > 3.0, sometimes up to 4.8. Therefore, a practical clinical consequence of this observation is that in elite athletes, LV filling should not raise suspicion of a restrictive filling pattern, despite the marked increase of E/A ratio (>3) and the presence of LA enlargement, 38,39 In this context, the normal DTI e 0 velocity and E/e 0 ratio, the normal PASP, and the overall clinical picture may help avoid the misdiagnosis of a pathologic cardiac condition.…”

“…So far, several studies have explored LV diastolic function in a variety of athletes, with, however, substantial limitations regarding the small number of subjects examined and/or the restricted representation of the sport disciplines. [12][13][14][15][16][17][18][19][20][35][36][37] Accurate understanding of the diastolic properties may help define the physiologic nature of LV remodeling in athletes and help distinguish it from pathologic cardiac conditions, such as hypertrophic cardiomyopathy, which may mimic the morphologic characteristics of the athlete's heart, but is usually associated with early impairment of diastolic performance. 11,[21][22][23][24][25]35 In the present study, we planned a comprehensive assessment of LV diastolic function, derived from a large cohort of elite athletes, of both genders and encompassing a broad variety of sport disciplines.…”

Left ventricular long-axis function in myasthenia gravis

“…MG patients had a significantly lower early diastolic AV-plane velocity before pyridostigmine than controls. Changes in early diastolic AV-plane velocity can identify changes in left ventricular diastolic function not detectable by measurement of left ventricular EF or transmitral early to late filling ratio (E:A-ratio) [1,15,20,21,23,34]. Even though early diastolic AV-plane velocity tended to decrease with increasing age, duration of MG symptoms was an independent determinant for the reduction of early diastolic AV-plane velocity, supporting the suggestion of an MG-related change in cardiac function [20].…”