Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes

Pengge Li,Yingchun Chen,Yonggao Zhang,Zhen Li,Songyan Liu,Shaohua Hua,Lijin Li

doi:10.1186/s12947-020-00227-w

Pengge Li, Yingchun Chen + Show 5 more

Open Access

https://doi.org/10.1186/s12947-020-00227-w

Copy DOI

Abstract

BackgroundThe health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes.MethodsThirty-six professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed.ResultsThe athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P<0.05). Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P>0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. Conventional echocardiography parameters were well correlated with GWW and GWE (P<0.05). The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%.ConclusionsSubclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete’s LV contractile performance.

Highlights

The concept of “athlete’s heart”, including physiological adaptation and pathological changes both in cardiac morphology and function after prolonged and intensive exercise, was firstly raised by the end of nineteenth century [1,2,3]
Compared with the control group, the values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) increased, while those of global myocardial work efficiency (GWE) decreased in the athlete group, with striking differences (P
In correlation analysis (Table 3), systolic blood pressure (SBP) exhibited a significant positive correlation with myocardial work (MW) parameters, and global longitudinal strain (GLS) was related to Global myocardial work index (GWI), global constructive myocardial work (GCW) and GWE

Summary

Introduction

The concept of “athlete’s heart”, including physiological adaptation and pathological changes both in cardiac morphology and function after prolonged and intensive exercise, was firstly raised by the end of nineteenth century [1,2,3]. With the wide application of echocardiography and the continuous development of new ultrasonic technology, studies on the athletes’ hearts are getting more thorough, making it play a pivotal role in detecting and monitoring the subclinical changes of athletes’ cardiac morphology and function in time [6]. As a new parameter taking both deformation and afterload of left ventricular (LV) into account, myocardial work (MW) potentially could provide more reliable value to myocardial function assessment than that of strain only [7]. Russell et al [8] has demonstrated the effectiveness of the non-invasive method to evaluate LVMW, via combining LV strain data by twodimensional speckle tracking echocardiography A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes

Objectives

Methods

Results

Conclusion