Peak Atrial Contraction Strain Research Articles

Left Atrial Remodelling in Competitive Adolescent Soccer Players

Left atrial (LA) enlargement and improved myocardial diastolic properties are a component of athlete's heart. We performed a longitudinal study involving adolescent athletes to investigate the impact of training on LA remodelling and diastolic function. 21 competitive adolescent soccer players were enrolled and engaged in an 8-month training program. Echocardiographic analysis was performed at baseline, after 4 and 8 months. We assessed diastolic function by Doppler tissue imaging and we analyzed LA adaptations by 2D speckle-tracking echocardiography. After 4 months, LA mean volume index significantly increased (Δ=5.47 ± 4.38 mL/m2, p ≤ 0.0001). After 8 months, a further increase occurred (Δ=8.95 ± 4.47 mL/m2, p ≤ 0.0001). A higher E velocity (p=0.001; p=0.001), a greater E/A ratio (p=0.002; p=0.0009), a higher e' peak (p= 0.005; p=0.001), and a greater e'/a' ratio (p=0.01; p=0.0006) were observed at 4 and at 8 months, respectively. E/e' ratio significantly decreased after 8 months (p ≤ 0.005). Global peak atrial longitudinal strain and global peak atrial contraction strain values significantly decreased after 8 months (p=0.0004, p=0.01, respectively). An 8-month training program is associated with LA dimensional and functional training-specific adaptations in competitive adolescent soccer players. Myocardial diastolic properties can improve after training also in subjects already presenting with features of athlete's heart.

Reference Values of Right Atrial Longitudinal Strain Imaging by Two‐Dimensional Speckle Tracking

The role of speckle tracking in the assessment of right atrial (RA) deformation dynamics has not been established yet. The reference ranges of RA longitudinal strain indices were measured by speckle tracking in a population of normal subjects. In 84 healthy individuals, peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and time to peak longitudinal strain (TPLS) were measured using a six-segment model for the RA. Strain rate (SR) was also measured starting from the QRS-wave onset, peak positive (x-wave), first peak negative (y-wave), and second negative peak (z-wave). The time from the QRS onset was measured to each wave peak. Adequate tracking quality was achieved in 64% of segments analyzed. Inter- and intraobserver variability coefficients of measurements ranged between 6% and 11%. Global PALS was 49 ± 13%, global TPLS was 363 ± 59 msec, x-wave was 2.12 ± 0.58 sec(-1) , y-wave was -1.91 ± 0.63 sec(-1) , and z-wave was -2.18 ± 0.78 sec(-1) . Speckle tracking is a feasible technique for the assessment of longitudinal myocardial RA deformation. Reference ranges of strain indices were reported.

Supernormal Diastolic Function and Role of Left Atrial Myocardial Deformation Analysis by 2D Speckle Tracking Echocardiography in Elite Soccer Players

Top-level training is associated with morphological and functional changes in the heart. Left atrial (LA) enlargement can be regarded as a physiologic adaptation to exercise conditioning. Athletes show an improvement in myocardial diastolic properties and supernormal left ventricular (LV) diastolic function. The aims of the study were to assess diastolic function by pulsed Doppler tissue imaging (DTI) and to analyze the role of LA in athletes by speckle tracking echocardiography (STE). Twenty-three male elite soccer players underwent a complete echocardiographic analysis. Twenty-six age-matched healthy sedentary men were used as controls. Measured variables included LA indexed volumes, DTI of the LV, peak atrial longitudinal strain, and peak atrial contraction strain (PACS). LA areas and indexed volumes were significantly higher in athletes (P < 0.001). Athletes had a higher peak E velocity (P < 0.001), a lower A peak (P < 0.01), and a higher peak E/A ratio (P < 0.0001); a higher Em peak (P < 0.001), a lower Am peak (P < 0.01), and a higher Em/Am ratio (P < 0.0001). Global PACS was lower in athletes compared with controls (P < 0.0001) and strongly correlated with mitral Am (r = 0.55; P < 0.0001), mitral Em (r =-0.41; P < 0.001), heart rate (r =-0.38; P < 0.01), and LA area (r = 0.18; P < 0.05). Athletes showed a shift in the pattern of ventricular filling period toward early diastole as seen through DTI analysis of the diastolic properties of LV and STE analysis of LA function. DTI is a useful tool to analyze the improved myocardial diastolic properties of athletes and STE may elucidate the role of LA in the context of athlete's heart remodeling.