Right and Left Atrial Strain by Speckle Tracking Echocardiography: Sex Differences and Correlation with Cardiorespiratory Fitness in Olympic Athletes.

IF 6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography Pub Date : 2025-09-12 DOI:10.1016/j.echo.2025.09.002

Giuseppe Di Gioia, Armando Ferrera, Maria Rosaria Squeo, Francesco Raffaele Spera, Viviana Maestrini, Sara Monosilio, Federica Mango, Giulia Paoletti, Andrea Serdoz, Antonio Pelliccia

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引用次数: 0

Abstract

Introduction: Physiological cardiac remodeling in elite athletes has been extensively described for the ventricles, but less is known regarding atrial function and its relationship with cardiorespiratory fitness.

Objectives: This study aimed to evaluate right (RA) and left atrial (LA) strain in Olympic athletes, exploring sex and sport-specific differences and correlations with VO₂ max.

Methods: We enrolled 657 Olympic athletes (mean age 25.5±5.3 years; 51.7% male). All athletes underwent transthoracic echocardiography, including atrial strain analysis by 2D-STE and cardiopulmonary exercise test (CPET). Atrial reservoir (S_R), conduit (S_Cd) and contraction (S_Co) strain were measured. Athletes were grouped by sport discipline (skill, power, mixed, endurance).

Results: Endurance athletes exhibited the largest atrial dimensions and the highest VO₂ max (p<0.0001), and showed reduced RA S_R (34.9±9.1%, p<0.0001), S_Cd (-25.7±8.1%, p=0.0001) and S_Co (-9±4.4%, p=0.0006) and LA S_R (38±7.5%, p=0.048) compared to skill, power and mixed. No differences in LA S_Cd (p=0.07) and S_Co emerged (p=0.111). RA strain inversely correlated with VO₂ max (p<0.0001), while no such relationship was observed for LA. Sex differences were observed, with males displaying larger atria (LAVi 23.9±7.8 ml/m² vs. 22.3±6.3 ml/m², p=0.004) but lower S_R and S_Cd compared to females (p<0.05).

Conclusions: Functional atrial indexes (S_R, S_Cd and S_Co) appear more markedly altered in the atria of the less remodeled ventricles (more in skill than in endurance athletes) and even more in RA than in LA. Furthermore, male athletes demonstrated higher reservoir and conduit strain values, while females exhibited enhanced contractile function. Our results should be viewed in conjunction with the extent of ventricular remodeling, i.e., the more enlarged and performant (suction and contraction) the ventricular cavity is, the less relevant is the atrial contribution to filling.

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斑点跟踪超声心动图右心房和左心房应变：奥运会运动员的性别差异及其与心肺健康的相关性。

导读：关于优秀运动员心室的生理性心脏重构已经有了广泛的报道，但关于心房功能及其与心肺健康的关系却知之甚少。目的：本研究旨在评估奥运会运动员右心房（RA）和左心房（LA）劳损，探讨性别和运动特异性差异及其与VO2 max的相关性。方法：入选657名奥运会运动员，平均年龄25.5±5.3岁，男性51.7%。所有运动员都接受了经胸超声心动图检查，包括2D-STE心房应变分析和心肺运动试验（CPET）。测量心房贮液（S_R）、导管（S_Cd）和收缩（S_Co）应变。运动员按运动项目（技术、力量、混合、耐力）分组。结果：耐力运动员表现出最大的心房尺寸和最高的VO2 max (p2 max (p2 vs. 22.3±6.3 ml/m2, p=0.004)，但与女性相比，S_R和S_Cd更低(p结论：功能心房指数（S_R， S_Cd和S_Co）在心室重构较少的心房中表现出更明显的变化（技能运动员比耐力运动员更明显），RA比LA更明显。此外，男性运动员表现出更高的水库和管道应变值，而女性运动员表现出增强的收缩功能。我们的研究结果应该与心室重构的程度结合起来看，即，心室腔越大、表现越好（吸引和收缩），心房对充盈的贡献就越小。

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

Journal of the American Society of Echocardiography 医学-心血管系统

CiteScore

9.50

自引率

12.30%

发文量

257

审稿时长

66 days

期刊介绍： The Journal of the American Society of Echocardiography(JASE) brings physicians and sonographers peer-reviewed original investigations and state-of-the-art review articles that cover conventional clinical applications of cardiovascular ultrasound, as well as newer techniques with emerging clinical applications. These include three-dimensional echocardiography, strain and strain rate methods for evaluating cardiac mechanics and interventional applications.