Advanced myocardial deformation echocardiography for evaluation of the athlete's heart: Functional and mechanistic analysis

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2024-08-01 DOI:10.1016/j.acvd.2024.05.121

Eva Colne , Nathalie Pace , Antoine Fraix , Félix Gauthier , Christine Selton-Suty , Bruno Chenuel , Nicolas Sadoul , Nicolas Girerd , Zohra Lamiral , Jérôme Felloni , Karim Djaballah , Laura Filippetti , Olivier Huttin

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引用次数: 0

Abstract

Background

Assessment of the athlete's heart is challenging because of a phenotypic overlap between reactive physiological adaptation and pathological remodelling. The potential value of myocardial deformation remains controversial in identifying early cardiomyopathy.

Aim

To identify the echocardiographic phenotype of athletes using advanced two-dimensional speckle tracking imaging, and to define predictive factors of subtle left ventricular systolic dysfunction.

Methods

In total, 191 healthy male athletes who underwent a preparticipation medical evaluation at Nancy University Hospital between 2013 and 2020 were included. Clinical and echocardiographic data were compared with 161 healthy male subjects from the STANISLAS cohort. Borderline global longitudinal strain value was defined as < 17.5%.

Results

Athletes demonstrated lower left ventricular ejection fraction (57.9 ± 5.3% vs. 62.6 ± 6.4%; P < 0.01) and lower global longitudinal strain (17.5 ± 2.2% vs. 21.1 ± 2.1%; P < 0.01). No significant differences were found between athletes with and without a borderline global longitudinal strain value regarding clinical characteristics, structural echocardiographic features and exercise capacity. A borderline global longitudinal strain value was associated with a lower endocardial global longitudinal strain (18.8 ± 1.2% vs. 22.7 ± 1.9%; P = 0.02), a lower epicardial global longitudinal strain (14.0 ± 1.1% vs. 16.6 ± 1.2%; P < 0.01) and a higher endocardial/epicardial global longitudinal strain ratio (1.36 ± 0.07 vs. 1.32 ± 0.06; P < 0.01). No significant difference was found regarding mechanical dispersion (P = 0.46).

Conclusions

Borderline global longitudinal strain value in athletes does not appear to be related to structural remodelling, mechanical dispersion or exercise capacity. The athlete's heart is characterized by a specific myocardial deformation pattern with a more pronounced epicardial layer strain impairment.

Abstract Image

查看原文本刊更多论文

用于评估运动员心脏的先进心肌变形超声心动图：功能和机理分析。

背景：由于反应性生理适应和病理性重塑之间存在表型重叠，因此对运动员心脏的评估具有挑战性。目的：利用先进的二维斑点追踪成像技术鉴定运动员的超声心动图表型，并确定细微左心室收缩功能障碍的预测因素：共纳入191名2013年至2020年间在南锡大学医院接受赛前体检的健康男性运动员。临床和超声心动图数据与 STANISLAS 队列中的 161 名健康男性受试者进行了比较。结果显示，运动员的左心室纵向应变值较低：运动员的左心室射血分数较低（57.9±5.3% vs. 62.6±6.4%；PC）：运动员整体纵向应变值的边界似乎与结构重塑、机械分散或运动能力无关。运动员的心脏具有特殊的心肌变形模式，心外膜层应变损伤更为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.