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Effects of training on LV strain in competitive athletes
  1. Flavio D'Ascenzi1,
  2. Antonio Pelliccia2,
  3. Federico Alvino1,
  4. Marco Solari1,
  5. Antonella Loffreno1,
  6. Matteo Cameli1,
  7. Marta Focardi1,
  8. Marco Bonifazi3,
  9. Sergio Mondillo1
  1. 1Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
  2. 2Institute of Sports Medicine and Science, Rome, Italy
  3. 3Department of Medicine, Surgery, and NeuroScience, University of Siena, Siena, Italy
  1. Correspondence to Dr Flavio D'Ascenzi, Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy; flavio.dascenzi{at}


Objective LV longitudinal strain, a recognised marker of LV function, has been recently applied to the evaluation of the athlete's heart. At present, little is known about the influence of training on LV global longitudinal strain (GLS) in athletes. The aim of this study was to prospectively investigate the impact of training on LV longitudinal strain and twist mechanics in a cohort of competitive athletes.

Methods Ninety-one competitive athletes, practising team sports and competing at national or international level, were analysed. Echocardiographic evaluation was performed at the beginning of the season (low training) and after 18±2 weeks of a supervised, intensive training programme (peak training).

Results A significant increase in LV mass (p<0.0001), LV end-diastolic and end-systolic volume (p=0.0001 and <0.0001, respectively) was found at peak training. LV basal and apical torsion (p=0.59 and 0.43, respectively) and LV twisting (p=0.78) did not change, and only a mild increase in LV GLS was evident after training (p=0.044). Resting heart rate was identified as the only independent predictor of LV GLS after training (β=0.30, p=0.005).

Conclusions A 18-week, intensive training programme induced only a slight increase in LV GLS despite marked changes in cardiac morphology, suggesting a physiological adaptation of the LV to exercise conditioning.

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