Skip to main content
Top
Published in: Cardiovascular Ultrasound 1/2011

Open Access 01-10-2011 | Research

The effect of exercise training on left ventricular function in young elite athletes

Authors: Alessio De Luca, Laura Stefani, Gianni Pedrizzetti, Stefano Pedri, Giorgio Galanti

Published in: Cardiovascular Ultrasound | Issue 1/2011

Login to get access

Abstract

Background

Regular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters (strain, rotation and twist). Aim of study is to assess the role of rotation and twist parameters for better characterize the heart performance in trained elite young athletes from different kind of sports. Eventually, verify early on any possible impact due to the regular sport activity not revealed by the standard parameters.

Methods

50 young athletes (16 cyclists, 17 soccer players, 17 basket players) regularly trained at least three times a week for at least 9 months a year and 10 young controls (mean age 18.5 ± 0.5 years) were evaluated either by to 2D echocardiography or by a Speckle Tracking (ST) multi-layer approach to calculate Left Ventricle (LV) endocardial and epicardial rotation, twist, circumferential strain (CS) and longitudinal strain (LS). Data were compared by ANOVA test.

Results

All the found values were within the normal range. Left Ventricle Diastolic Diameter (LVDD 51.7 ± 2.6 mm), Cardiac Mass index (CMi 114.5 ± 18.5 g/m2), epi-CS, epi-LS, epicardial apex rotation and the Endo/Epi twist were significantly higher only in cyclists. In all the groups, a physiological difference of the Endo/Epi basal circumferential strain and twist values have been found. A weak but not significant relationship between the Endo and twist values and LVDD (r2 = 0.44, p = .005) and CMi was also reported in cyclists.

Conclusions

Progressive increase of apical LV twist may represent an important component of myocardial remodelling. This aspect is particularly evident in the young cyclists group where the CMi and the LVDD are higher. ST multilayer approach completes the LV performance evaluation in young trained athletes showing values similar to adults.
Appendix
Available only for authorised users
Literature
1.
go back to reference Shephard RJ: The athlete's heart: is big beautiful?. Br J Sport Med. 1996, 30: 5-10. 10.1136/bjsm.30.1.5.CrossRef Shephard RJ: The athlete's heart: is big beautiful?. Br J Sport Med. 1996, 30: 5-10. 10.1136/bjsm.30.1.5.CrossRef
2.
go back to reference Pluim BM, Zwinderman AH, Van der Laarse A, van der Wall E: The athlete's heart: a meta-analysis of cardiac structure and function. Circulation. 1999, 100: 336-344. Pluim BM, Zwinderman AH, Van der Laarse A, van der Wall E: The athlete's heart: a meta-analysis of cardiac structure and function. Circulation. 1999, 100: 336-344.
3.
go back to reference Rawlins J, Bhan A, Sharma S: Left ventricular hypertrophy in athletes. Eur J Echocardio. 2009, 10: 350-356. 10.1093/ejechocard/jep017.CrossRef Rawlins J, Bhan A, Sharma S: Left ventricular hypertrophy in athletes. Eur J Echocardio. 2009, 10: 350-356. 10.1093/ejechocard/jep017.CrossRef
4.
go back to reference Mitchell JH, Haskell W, Snell P, Van Camp SP: Task Force 8: Classification of sport. J Am Coll Cardiol. 2005, 45: 1364-1367. 10.1016/j.jacc.2005.02.015CrossRefPubMed Mitchell JH, Haskell W, Snell P, Van Camp SP: Task Force 8: Classification of sport. J Am Coll Cardiol. 2005, 45: 1364-1367. 10.1016/j.jacc.2005.02.015CrossRefPubMed
5.
go back to reference Baggish AL, Wang F, Weiner RB, Elinoff JM, Tournoux F, Boland A, Picard MH, Hutter AM, Wood MJ: Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment od competitive athletes. J Appl Physiol. 2008, 104: 1121-1128. 10.1152/japplphysiol.01170.2007CrossRefPubMed Baggish AL, Wang F, Weiner RB, Elinoff JM, Tournoux F, Boland A, Picard MH, Hutter AM, Wood MJ: Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment od competitive athletes. J Appl Physiol. 2008, 104: 1121-1128. 10.1152/japplphysiol.01170.2007CrossRefPubMed
6.
go back to reference Kim WJ, Lee BH, Kim YJ, Kang JH, Yung YJ, Song JM, Kang DH, Song JK: Apical rotation assessed by speckle tracking echocardiography as an index of global left ventricular contractility. Circ Cariovasc Imaging. 2009, 2: 123-131. 10.1161/CIRCIMAGING.108.794719.CrossRef Kim WJ, Lee BH, Kim YJ, Kang JH, Yung YJ, Song JM, Kang DH, Song JK: Apical rotation assessed by speckle tracking echocardiography as an index of global left ventricular contractility. Circ Cariovasc Imaging. 2009, 2: 123-131. 10.1161/CIRCIMAGING.108.794719.CrossRef
7.
go back to reference Simsek Z, Gundogdu F, Sertac A, Gerek Z, Ercis S, Sen I, Akgün M, Karakelleoglu S: Analysis of athlete's heart by tissue Doppler and strain/strain rate imaging. Int J Cardiovasc Imaging. 2011, 27: 105-111. 10.1007/s10554-010-9669-1CrossRefPubMed Simsek Z, Gundogdu F, Sertac A, Gerek Z, Ercis S, Sen I, Akgün M, Karakelleoglu S: Analysis of athlete's heart by tissue Doppler and strain/strain rate imaging. Int J Cardiovasc Imaging. 2011, 27: 105-111. 10.1007/s10554-010-9669-1CrossRefPubMed
8.
go back to reference MacGowan GA, Burkoff D, Rogers WJ, Salvador D, Azhari H, Hees PS, Zweier JL, Halperin HR, Siu CO, Lima JA, Weiss JL, Shapiro EP: Effects of afterload on regional left ventricular torsion Cardiovasc Reserch. 1996, 31: 917-925. MacGowan GA, Burkoff D, Rogers WJ, Salvador D, Azhari H, Hees PS, Zweier JL, Halperin HR, Siu CO, Lima JA, Weiss JL, Shapiro EP: Effects of afterload on regional left ventricular torsion Cardiovasc Reserch. 1996, 31: 917-925.
9.
go back to reference Stanton T, Leano R, Marwick T: Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging. 2009, 2: 356-364.CrossRefPubMed Stanton T, Leano R, Marwick T: Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging. 2009, 2: 356-364.CrossRefPubMed
10.
go back to reference Goffinet C, Chenot F, Robert A, Pouleur AC, le Polain de Waroux JB, Vancrayenest D, Gerard O, Pasquet A, Gerber BL, Vanoverschelde JL: Assessment of subendocardial vs. subepicardial left ventricular rotation and twist using two-dimensional speckle tracking echocardiography comparison with tagged cardiac magnetic resonance. Eur Heart J. 2009, 30: 608-617. 10.1093/eurheartj/ehn511CrossRefPubMed Goffinet C, Chenot F, Robert A, Pouleur AC, le Polain de Waroux JB, Vancrayenest D, Gerard O, Pasquet A, Gerber BL, Vanoverschelde JL: Assessment of subendocardial vs. subepicardial left ventricular rotation and twist using two-dimensional speckle tracking echocardiography comparison with tagged cardiac magnetic resonance. Eur Heart J. 2009, 30: 608-617. 10.1093/eurheartj/ehn511CrossRefPubMed
11.
go back to reference Stefani L, Pedrizzetti G, De Luca A, Mercuri R, Innocenti G, Galanti G: Real-time evaluation of longitudinal peak systolic strain (speckle tracking measurement) in left and right ventricles of athletes. Cardiovascular Ultrasound. 2009, 7: 17- 10.1186/1476-7120-7-17CrossRefPubMedPubMedCentral Stefani L, Pedrizzetti G, De Luca A, Mercuri R, Innocenti G, Galanti G: Real-time evaluation of longitudinal peak systolic strain (speckle tracking measurement) in left and right ventricles of athletes. Cardiovascular Ultrasound. 2009, 7: 17- 10.1186/1476-7120-7-17CrossRefPubMedPubMedCentral
12.
go back to reference Stefani L, Toncelli L, Di Tante V, Vono MCR, Cappelli B, Pedrizzetti G, Galanti G: Supernormal functional reserve of apical segments in elite soccer players: an ultrasound speckle tracking handgrip stress study. Cardiovascular Ultrasound. 2008, 6: 14- 10.1186/1476-7120-6-14CrossRefPubMedPubMedCentral Stefani L, Toncelli L, Di Tante V, Vono MCR, Cappelli B, Pedrizzetti G, Galanti G: Supernormal functional reserve of apical segments in elite soccer players: an ultrasound speckle tracking handgrip stress study. Cardiovascular Ultrasound. 2008, 6: 14- 10.1186/1476-7120-6-14CrossRefPubMedPubMedCentral
13.
go back to reference Amaki M, Nakatani S, Kanzaki H, Tanaka J, Kamiya C, Tanaka T, Taneike R, Kitakaze M: Left ventricular apical endocardial rotation, but not epicardial rotation, is increased in patients with hypertension: insight into the mechanism of augmented twist in hypertensive heart. Circulation. 2007, 116 (II): 598- Amaki M, Nakatani S, Kanzaki H, Tanaka J, Kamiya C, Tanaka T, Taneike R, Kitakaze M: Left ventricular apical endocardial rotation, but not epicardial rotation, is increased in patients with hypertension: insight into the mechanism of augmented twist in hypertensive heart. Circulation. 2007, 116 (II): 598-
14.
go back to reference Bonow RO, Carabello BA, Chatterjee K, et al.: ACC/AHA 2006 Guidelines for the management of patient with valvular heart desease. A report of American College of Cardiology/American Heart Association task force on pratice guidelines. J Am Coll Cardiol. 2006, 48: 1-148. 10.1016/j.jacc.2006.02.056CrossRef Bonow RO, Carabello BA, Chatterjee K, et al.: ACC/AHA 2006 Guidelines for the management of patient with valvular heart desease. A report of American College of Cardiology/American Heart Association task force on pratice guidelines. J Am Coll Cardiol. 2006, 48: 1-148. 10.1016/j.jacc.2006.02.056CrossRef
15.
go back to reference Devereux RB, Reichek N: Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977, 55: 613-618.CrossRefPubMed Devereux RB, Reichek N: Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977, 55: 613-618.CrossRefPubMed
16.
go back to reference Nottin S, Doucende G, Schuster-Beck I, Dauzat M, Obert P: Alteration in left ventricular normal and shears strain evaluated by 2D-strain echocardiography in the athlete's heart. J Physiol. 2008, 19: 4721-4733.CrossRef Nottin S, Doucende G, Schuster-Beck I, Dauzat M, Obert P: Alteration in left ventricular normal and shears strain evaluated by 2D-strain echocardiography in the athlete's heart. J Physiol. 2008, 19: 4721-4733.CrossRef
17.
go back to reference Zhang Q, Fang F, Liang Y, Xie J, Wen YY, Yip GW, Lam YY, Chan JY, Fung JW, Yu CM: A novel multi-layer approach of measuring myocardial strain and torsion by 2D speckle tracking imaging in normal subjects and patients with heart diseases. Int J Cardiol. 2011, 147 (1): 32-37. 10.1016/j.ijcard.2009.07.041CrossRefPubMed Zhang Q, Fang F, Liang Y, Xie J, Wen YY, Yip GW, Lam YY, Chan JY, Fung JW, Yu CM: A novel multi-layer approach of measuring myocardial strain and torsion by 2D speckle tracking imaging in normal subjects and patients with heart diseases. Int J Cardiol. 2011, 147 (1): 32-37. 10.1016/j.ijcard.2009.07.041CrossRefPubMed
18.
go back to reference Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL: Current Evolving Echocardiographic techniques for the quantitative evaluation of cardiac Mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr. 2011, 24: 277-313. 10.1016/j.echo.2011.01.015CrossRefPubMed Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL: Current Evolving Echocardiographic techniques for the quantitative evaluation of cardiac Mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr. 2011, 24: 277-313. 10.1016/j.echo.2011.01.015CrossRefPubMed
19.
go back to reference Van Dalen BM, Soliman OII, Vletter WB, ten Cate FJ, Geleijnse ML: Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography. Am J Physiol Heart Circ Physiol. 2008, 295: H1705-H1711. 10.1152/ajpheart.00513.2008CrossRefPubMed Van Dalen BM, Soliman OII, Vletter WB, ten Cate FJ, Geleijnse ML: Age-related changes in the biomechanics of left ventricular twist measured by speckle tracking echocardiography. Am J Physiol Heart Circ Physiol. 2008, 295: H1705-H1711. 10.1152/ajpheart.00513.2008CrossRefPubMed
20.
go back to reference Basavarajaiah S, Araceli B, Whyte G, Wilson M, Carby L, Shah A, Sharma S: Ethnic Differences in Left Ventricular Remodeling in Highly-Trained Athletes Relevance to Differentiating Physiologic Left Ventricular Hypertrophy From Hypertrophic Cardiomyopathy. J Am Coll Cardiol. 2008, 51 (23): 2256-2262. 10.1016/j.jacc.2007.12.061CrossRefPubMed Basavarajaiah S, Araceli B, Whyte G, Wilson M, Carby L, Shah A, Sharma S: Ethnic Differences in Left Ventricular Remodeling in Highly-Trained Athletes Relevance to Differentiating Physiologic Left Ventricular Hypertrophy From Hypertrophic Cardiomyopathy. J Am Coll Cardiol. 2008, 51 (23): 2256-2262. 10.1016/j.jacc.2007.12.061CrossRefPubMed
21.
go back to reference Naylor LH, George K, O'Driscoll G, Green DJ: The athlete's heart. A contemporary appraisal of the "Morganroth hypothesis". Sports Med. 2008, 38 (1): 69-90. 10.2165/00007256-200838010-00006CrossRefPubMed Naylor LH, George K, O'Driscoll G, Green DJ: The athlete's heart. A contemporary appraisal of the "Morganroth hypothesis". Sports Med. 2008, 38 (1): 69-90. 10.2165/00007256-200838010-00006CrossRefPubMed
22.
go back to reference Weiner RB, Hutter AM, Wang F, Kim J, Weyman AE, Wood MJ, Picard MH, Baggish AL: The impact of endurance exercise training on left ventricular torsion. Cardiovascular imaging. 2010, 3 (10): 1001-9. 10.1016/j.jcmg.2010.08.003CrossRefPubMed Weiner RB, Hutter AM, Wang F, Kim J, Weyman AE, Wood MJ, Picard MH, Baggish AL: The impact of endurance exercise training on left ventricular torsion. Cardiovascular imaging. 2010, 3 (10): 1001-9. 10.1016/j.jcmg.2010.08.003CrossRefPubMed
23.
go back to reference Rizzo M, Gensini F, Fatini C, Manetti P, Pucci N, Capalbo A, Vono MCR, Galanti G: ACE I/D polymorphism and cardiac adaptations in adolescent athletes. Med Sci Sports Exerc. 2003, 35 (12): 1986-1990. 10.1249/01.MSS.0000098993.51693.0BCrossRefPubMed Rizzo M, Gensini F, Fatini C, Manetti P, Pucci N, Capalbo A, Vono MCR, Galanti G: ACE I/D polymorphism and cardiac adaptations in adolescent athletes. Med Sci Sports Exerc. 2003, 35 (12): 1986-1990. 10.1249/01.MSS.0000098993.51693.0BCrossRefPubMed
24.
go back to reference Sengupta PP, Tajik AJ, Khandheria BK: Twist mechanics of the left ventricle: principles and application. J Am Coll Cardiol Img. 2008, 1 (3): 366-376.CrossRef Sengupta PP, Tajik AJ, Khandheria BK: Twist mechanics of the left ventricle: principles and application. J Am Coll Cardiol Img. 2008, 1 (3): 366-376.CrossRef
25.
go back to reference Chen X, Nakatani S: Transmural myocardial strain gradient: a new and robust quantitative index of left ventricular wall motion based on myocardial strain imaging. Echocardiography. 2011, 28: 181-187. 10.1111/j.1540-8175.2010.01287.xCrossRefPubMed Chen X, Nakatani S: Transmural myocardial strain gradient: a new and robust quantitative index of left ventricular wall motion based on myocardial strain imaging. Echocardiography. 2011, 28: 181-187. 10.1111/j.1540-8175.2010.01287.xCrossRefPubMed
26.
go back to reference Palka P, Lange A, Fleming AD, Donnelly JE, Dutka DP, Starkey IR, Shaw TR, Sutherland GR, Fox KA: Differences in myocardial velocity gradient measured throughout the athletes and patients with left ventricular hypertrophy due to hypertension. J Am Coll Cardiol. 1997, 30 (3): 760-768. 10.1016/S0735-1097(97)00231-3CrossRefPubMed Palka P, Lange A, Fleming AD, Donnelly JE, Dutka DP, Starkey IR, Shaw TR, Sutherland GR, Fox KA: Differences in myocardial velocity gradient measured throughout the athletes and patients with left ventricular hypertrophy due to hypertension. J Am Coll Cardiol. 1997, 30 (3): 760-768. 10.1016/S0735-1097(97)00231-3CrossRefPubMed
Metadata
Title
The effect of exercise training on left ventricular function in young elite athletes
Authors
Alessio De Luca
Laura Stefani
Gianni Pedrizzetti
Stefano Pedri
Giorgio Galanti
Publication date
01-10-2011
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2011
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/1476-7120-9-27

Other articles of this Issue 1/2011

Cardiovascular Ultrasound 1/2011 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.