The Influence of Extreme Mixed Exertion Load on the Right Ventricular Dimensions and Function in Elite Athletes: A Tissue Doppler Study

Król, Wojciech; Braksator, Wojciech; Kasprzak, Jarosław D.; Kuch, Marek; Mamcarz, Artur; Chybowska, Barbara; Krysztofiak, Hubert; Dłużniewski, Mirosław

doi:10.1111/j.1540-8175.2011.01437.x

Cited by 17 publications

(17 citation statements)

References 30 publications

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“…The aforementioned meta-analyses confirm this unequivocally [8,9]. Athletes also have proportionally larger left atria (LA) and right ventricles (RV), and this reflects a balanced cardiac remodelling process [9][10][11][12]. This adaptation process is very dynamic.…”

Section: Left Ventricular Hypertrophysupporting

confidence: 49%

Differentiating physiology from pathology in elite athletes. Left ventricular hypertrophy versus hypertrophic cardiomyopathy

Krysztofiak

Dimitrow

2016

Kardiol Pol

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. The main fields of his scientific interests include hypertrophic cardiomyopathy (HCM), storage diseases, and pathophysiology of coronary circulation. He is also interested in the topics of left ventricular hypertrophy and athlete's heart. He conducts research on biochemical biomarkers in HCM, and aortic stenosis and non-invasive assessment of the endothelial vasomotor function of coronary arteries. He introduced stress echocardiography in an upright position in the diagnostic examination of HCM patients. He is an author of original publications concerning HCM, which are recognised by the

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Section: Left Ventricular Hypertrophysupporting

confidence: 49%

Differentiating physiology from pathology in elite athletes. Left ventricular hypertrophy versus hypertrophic cardiomyopathy

Krysztofiak

Dimitrow

2016

Kardiol Pol

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“…Left and right ventricle size is generally larger in male athletes, however, indexation with a body surface area can decrease observed differences (Konopka et al, 2015; Krol et al, 2011). A similar observation can be made with regard to LA enlargement in our examined group.…”

Section: Discussionmentioning

confidence: 99%

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

Król

Jedrzejewska

Konopka

et al. 2016

Journal of Human Kinetics

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Enlargement 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.

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“…18,36 Of the 10 studies that did not explicitly state whether they matched for body size, 4 studies provided mean values for body surface area (BSA) and/or height in controls that were either greater than or not significantly different from the values in the athletes. 18,20,33,38 In 4 studies, mean values for BSA and/ or height were significantly greater in athletes than in their controls, [21][22][23]29 and 2 studies did not statistically compare body size measurements. 36,39 Most studies did not specify whether athletes with BAV were included, although 2 and 4 studies, respectively, explicitly included 32,33 or excluded 7,23,24,28 subjects with BAV.…”

Section: Resultsmentioning

confidence: 99%

“…Aortic root was measured at the aortic valve annulus in 15 studies 7,[18][19][20][23][24][25]27,28,30,31,34,36,38,39 and at the sinuses of Valsalva in 12 studies. 7,[21][22][23][24]26,28,29,32,33,35,37 (Tables 1 and 2). In the 13 studies that directly compared athletes with controls, there were variations in the degree of matching; 11 studies matched for age, and 3 studies explicitly stated that they matched for body size.…”

Section: Resultsmentioning

confidence: 99%

“…A final total of 23 studies met our inclusion criteria, 7, with athletes directly compared with controls in 13 studies. 7,18,[20][21][22][23]27,29,33,35,36,38,39 The identified studies included 19 cross-sectional and 4 longitudinal studies conducted in Europe (n=14), the United States (n=6), Africa (n=2), and Iran (n=1). Across the studies, aortic root dimensions were reported in 5580 unique elite athletes comprised of 1506 endurance-trained athletes, 425 strength-trained athletes, 213 combined endurance-and strength-trained athletes, and a heterogeneous group of 3436 athletes with mixed training.…”

Section: Resultsmentioning

confidence: 99%

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A Meta-Analysis of Aortic Root Size in Elite Athletes

2013

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and atrium (Appendix I in the online-only Data Supplement). In addition, we manually reviewed the references of included studies Background-The aorta is exposed to hemodynamic stress during exercise, but whether or not the aorta is larger in athletes is not clear. We performed a systematic literature review and meta-analysis to examine whethere athletes demonstrate increased aortic root dimensions compared with nonathlete controls. Methods and Results-We searched MEDLINE and Scopus from inception through August 12, 2012, for Englishlanguage studies reporting the aortic root size in elite athletes. Two investigators independently extracted athlete and study characteristics. A multivariate linear mixed model was used to conduct meta-regression analyses. We identified 71 studies reporting aortic root dimensions in 8564 unique athletes, but only 23 of these studies met our criteria by reporting aortic root dimensions at the aortic valve annulus or sinus of Valsalva in elite athletes (n=5580). Athletes were compared directly with controls (n=727) in 13 studies. On meta-regression, the weighted mean aortic root diameter measured at the sinuses of Valsalva was 3.2 mm (P=0.02) larger in athletes than in the nonathletic controls, whereas aortic root size at the aortic valve annulus was 1.6 mm (P=0.04) greater in athletes than in controls. Conclusions-Elite athletes have a small but significantly larger aortic root diameter at the sinuses of Valsalva and aortic valve annulus, but this difference is minor and clinically insignificant. Clinicians evaluating athletes should know that marked aortic root dilatation likely represents a pathological process and not a physiological adaptation to exercise. .).The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

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The Influence of Extreme Mixed Exertion Load on the Right Ventricular Dimensions and Function in Elite Athletes: A Tissue Doppler Study

Abstract: RV enlargement in professional athletes is not connected with deterioration of diastolic or systolic RV function. Athletes with elevated pulmonary systolic pressure at rest, however, present with lower longitudinal systolic velocities of RV assessed using TDE.

Cited by 17 publications

References 30 publications

Differentiating physiology from pathology in elite athletes. Left ventricular hypertrophy versus hypertrophic cardiomyopathy

Differentiating physiology from pathology in elite athletes. Left ventricular hypertrophy versus hypertrophic cardiomyopathy

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

A Meta-Analysis of Aortic Root Size in Elite Athletes

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