MethodsPulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function
Section snippets
Study group
We enrolled 20 highly competitive, male water polo players, who had been trained intensively 15 to 20 hours/week for >5 years, and 20 untrained healthy men. The training protocol included 3 hours/day of aerobic isotonic dynamic exercise at incremental workloads of 70% to 100% of maximal HR, and only 1-hour/week of isometric static exercise at 30% of maximal workload. Subjects were excluded for coronary artery disease, valvular and congenital heart disease, heart failure, cardiomyopathy,
Clinical characteristics of study group
The 2 groups were comparable for age (22.5 ± 5.3 years in controls and 19.7 ± 3.7 years in athletes), body surface area (BSA) (1.82 ± 0.15 and 1.86 ± 0.07 m2, respectively) and BP (125.1 ± 9.8/73.8 ± 7.2 and 115.0 ± 14.7/70.5 ± 5.6 mm Hg). As expected, HR was lower in the athletes (65.6 ± 3.9 vs 75.1 ± 9.4 beats/min, p <0.001).
Standard Doppler echocardiographic analysis (Table I)
Athletes had greater endocardial fractional shortening (p <0.05) and stroke volume (p <0.01), higher peak velocity E/A ratio (p <0.02), and greater LV mass index (p
Discussion
This study underscores the usefulness of DTI to identify myocardial diastolic properties of the trained heart. Endurance athletes have (1) greater inferior Em peak velocity than controls, (2) greater septal and inferior Em/Am ratio, and (3) longer myocardial DTm in both walls. Finally, and most important, in the overall population, the difference in Em/Am ratio and myocardial diastolic times are explained by HR changes, but Em peak velocity is directly and independently associated with LVIDD.
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