Top

Published in:

Open Access 01-12-2019 | Research

Evaluation of left ventricular remodelling in young Afro-Caribbean athletes

Authors: Giorgio Galanti, Loira Toncelli, Benedetta Tosi, Melissa Orlandi, Chiara Giannelli, Laura Stefani, Gabriele Mascherini, Pietro A. Modesti

Published in: Cardiovascular Ultrasound | Issue 1/2019

Abstract

Background

Cardiac adaptation to intense physical training is determined by many factors including age, gender, body size, load training and ethnicity. Despite the wide availability of ECG analysis, with a higher presence of abnormalities in different races, echocardiographic studies on young Afro-Caribean (AA) and Caucasian athletes (CA) are lacking in literature. We aimed to assess the effect in the secondary LV remodelling of load training in young AA players compared to matched CA players.

Method

Seventy-seven AA and 53 CA matched soccer players (mean age 17.35 ± 0.50 and 18.25 ± 0.77 y) were enrolled. They were evaluated with echocardiography. A subgroup of 30 AA and 27 CA were followed up for a period of 4 years. The myocardial contractile function was evaluated by speckle-tracking echocardiographic global longitudinal strain (GLS).

Results

No significant differences were found in weight and height and in blood pressure response to maximal ergometer test in either group. In AA a higher level of LV remodelling, consisting in higher LV wall thickness, higher interventricular septum (IVS) and posterior wall (PW) thickness were found (IVS: 10.04 ± 0.14 and 9.35 ± 0.10 in AA and CA respectively, p < 0.001. PW: 9.70 ± 0.20 and 9.19 ± 0.10 mm in AA and CA respectively, p < 0.05). Strain data showed no significant differences between the two groups (22.35 ± 0.48 and 23.38 ± 0.69 in AA (n = 27) and CA (n = 25), respectively). At the beginning of the follow-up study AA showed a significantly higher left ventricular remodelling (IVS = 9.29 ± 0.3 and 8.53 ± 0.12 mm in AA and CA respectively, p < 0.002. PW = 9.01 ± 0.2 and 8.40 ± 0.20 in AA and CA respectively, p = 0.1). During the next four years of follow-up we observed a regular parallel increase in LV wall thickness and chamber diameters in both groups, proportionally to the increase in body size and LV mass. (IVS = 10.52 ± 0.17 and 9.03 ± 0.22 mm in AA and CA respectively, p < 0.001. PW: 10.06 ± 0.17 and 8.26 ± 0.19 mm in AA and CA respectively, p < 0.001).

Conclusion

The study shows that the ventricular remodelling observed in AA appears to be a specific phenotype already present in pre-adolescence. These data also suggest that genetic/ethnic factors play a central role in left ventricular remodelling during the first years of life in elite athletes.

Rawlins J, Bhan A, Sharma S. Left ventricular hypertrophy in athletes. Eur J Echocardiogr. 2009;10:350–6. https://doi.org/10.1093/ejechocard/jep017.CrossRef

Morganroth J, Maron BJ, Henry W, Epstein SE. Comparative left ventricular dimension in trained athletes. Ann Intern Med. 1975;82:521–4. https://doi.org/10.7326/0003-4819-82-4-521.CrossRef

Spence A L, Naylor L H, Carter H, Buck CL, Dembo L, Murray CP, Watson P, Oxborough D, George KP and Green DJ A prospective randomized longitudinal MRI study of left ventricular adaptation to endurance and resistance exercise training in humans. J Physiol 2011;589(Pt 22):5443–52. https://doi.org/10.1113/jphysiol.2011.217125.CrossRef

Sheikh N, Sharma S. Impact of ethnicity on cardiac adaptation to exercise. Nat Rev Cardiol. 2014;11(4):198–217. https://doi.org/10.1038/nrcardio.2014.15.CrossRefPubMed

Corrado D, Biffi A, Basso C, Pelliccia A, Thiene G. 12-lead ECG in the athlete: physiological versus pathological abnormalities. Br J Sports Med. 2009;43(9):669–76. https://doi.org/10.1136/bjsm.2008.054759.CrossRefPubMed

Brosnan M, La Gerche A, Kalman J, Lo W, Fallon K, MacISBPc A, Prior D. The Seattle criteria increase the specificity of preparticipation ECG screening among elite athletes. Br J Sports Med. 2014;48(15):1144–50. https://doi.org/10.1136/bjsports-2013-092420.CrossRefPubMed

Drezner JA, Sharma S, Baggish A, et al. Br J Sport Med. 2017;51:704–31.CrossRef

Bohm P, Ditzel R, Ditzel H, Urhausen A, Meyer T. Resting ECG findings in elite football players. J Sports Sci. 2013;31(13):1475–80. https://doi.org/10.1080/02640414.2013.796067.CrossRefPubMed

Chelliah RK, Senior R. Pathological and physiological left ventricular hypertrophy: echocardiography for differentiation. Futur Cardiol. 2009;5(5):495–502. https://doi.org/10.2217/fca.09.34.CrossRef

10.

Barbier J, Ville N, Kervio G, Walther G, Carré F. Sports-specific features of athlete’s heart and their relation to echocardiographic parameters. Herz. 2006;31:531–43.CrossRef

11.

DuBois D, DuBois DF. A formula to estimate the approximate surface area if height and weight be known. Arch Int Med. 1916;17:863–71.CrossRef

12.

Pelliccia A, Maron BJ, Culasso F, Di Paolo FM, Spataro A, Biffi A, Caselli G, Piovano P. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation. 2000;102(3):278–84.CrossRef

13.

Bazett HC. An analysis of the time relations of electrocardiograms. Heart. 1920;7:353–67.

14.

Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949;37:161–86.CrossRef

15.

Bruce RA. Exercise testing of patients with coronary heart disease: principles and normal standards for evaluation. Ann Clin Res. 1971;3:323–32.PubMed

16.

Frenneaux MP, Counihan PJ, Caforio AL, Chikamori T, McKenna WJ. Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy. Circulation. 1990;82:1995–2002.CrossRef

17.

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W. Voight JU recommendations for cardiac chamber quantification by echocardiography in adults: an update from American Society of Echocardiography and European association of cardiovascular imaging. J Am SocEchocardiogr. 2015;28:1):1–39. e 14. https://doi.org/10.1016/j.echo.2014.10.003.CrossRef

18.

Galderisi M, Cosyns B, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J - Cardiovascular Imaging. 2017;18:1301–10. https://doi.org/10.1093/ehjci/jex244.CrossRef

19.

Recommendations for Cardiac Chamber. Quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am SocEchocardiogr. 2015;28:1–39.CrossRef

20.

Ternacle J, Bremont C, d'Humieres T, Faivre L, Doan HL, Gallet R, Oliver L, Dubois-Randé JL, Lim P. Left ventricular dyssynchrony and 2D and 3D global longitudinal strain for differentiating physiological and pathological left ventricular hypertrophy.Arch Cardiovasc Dis. 2017. https://doi.org/10.1016/j.acvd.2016.11.003.CrossRef

21.

Sheikh N, Papadakis M, Carre F, Kervio G, Panoulas VF, Ghani S, Zaidi A, Gati S, Rawlins J, Wilson MG, Sharma S. Cardiac adaptation to exercise in adolescent athletes of African ethnicity: an emergent elite athletic population. Br J Sports Med. 2013;47(9):585–92. https://doi.org/10.1136/bjsports-2012-091874.CrossRefPubMed

22.

Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, Basavarajaiah S, Carby L, Fonseca T, Sharma S. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/afro-Caribbean origin. EurHeart J. 2011;32(18):2304–13. https://doi.org/10.1093/eurheartj/ehr140.CrossRef

23.

Caselli S, Maron MS, Urbano-Moral JA, Pandian NG, Maron BJ, Pelliccia A. Differentiating left ventricular hypertrophy in athletes from that in patients with hypertrophic cardiomyopathy. Am J Cardiol. 2014;114(9):1383–9. https://doi.org/10.1016/j.amjcard.2014.07.070.CrossRefPubMed

24.

Rawlins J, Carre F, Kervio G, Papadakis M, Chandra N, Edwards C, Whyte GP, Sharma S. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation. 2010;121(9):1078–85. https://doi.org/10.1161/circulationaha.109.917211.CrossRefPubMed

25.

Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, Di Tullio MR. Race-ethnic differences in subclinical left ventricular systolic dysfunction by global longitudinal strain: a community-based cohort study. Am Heart J. 2015 May;169(5):721–6. https://doi.org/10.1016/j.ahj.2015.02.011.CrossRefPubMedPubMedCentral

Title: Evaluation of left ventricular remodelling in young Afro-Caribbean athletes
Authors: Giorgio Galanti
Loira Toncelli
Benedetta Tosi
Melissa Orlandi
Chiara Giannelli
Laura Stefani
Gabriele Mascherini
Pietro A. Modesti
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: Cardiovascular Ultrasound / Issue 1/2019
Electronic ISSN: 1476-7120
DOI: https://doi.org/10.1186/s12947-019-0169-8

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of left ventricular remodelling in young Afro-Caribbean athletes

Abstract

Background

Method

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

Normative reference ranges for echocardiographic chamber dimensions in a healthy Central European population: results from the Czech post-MONICA survey

Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study

Clinical implication of disturbed left atrial phasic functions in the heterogeneous population associated with hypertension or atrial fibrillation

The effect of cardiac shock wave therapy on myocardial function and perfusion in the randomized, triple-blind, sham-procedure controlled study

Accurate assessment of LV function using the first automated 2D-border detection algorithm for small animals - evaluation and application to models of LV dysfunction

Area of the pressure-strain loop during ejection as non-invasive index of left ventricular performance: a population study

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page