Background : Myocardial contraction develops systolic increase in left ventricular radial, circumferential, and longitudinal strain, with enlarged chambers and wall thickness. However, those influences have not clarified cardiac rotation and torsion in elite athletes.
Methods : We used 2D echocardiography speckle tracking imaging (STI) to evaluate LV regional strain in elite soccer players compared to age-matched healthy controls.
29 elite soccer players and 22 healthy controls underwent conventional, tissue Doppler, and STI echocardiography at rest. We evaluated conventional Doppler measurements, and radial, circumferential strain at base and apex, longitudinal strain at four and two chamber views. The rotation data were measured at base and apex respectively by 2D STI, and the torsion was calculated.
Results : Although there is no difference in longitudinal strain (-17.6 ±1.8 vs -17.3 ± 2.9, p=ns), and basal strain (Table 1), there are significant differences in apical radial strain (33.1 ± 20.5 vs 22.5 ±19.4, p=0.02), and apical circumferential strain (-21.4 ± 4.8 vs -16.8 ±7.6, p=0.005)(Table 1). Meanwhile, there is no statistical significance in apical rotation, but larger basal rotation in athletes (-3.9 ± 1.9 vs -2.6 ±3.2, p=0.03)(Table 2). However, torsion calculation did not demonstrate the difference between athletes and controls (Table2).
Conclusion : These elite soccer players’ heart demonstrated unique ventricular adaptation including higher apical radial and circumferential strain without difference in apical rotation. However, the basal rotation is higher in athletes without basal strain differences. These alterations could benefit the cardiovascular adjustment to exercise without much change of torsion. This would be helpful for myocardial energy preservation in athletes' heart.
|
Table1. Radial and Circumferential Strain Comparison between Athletes and Conrols
|
Elite Soccer Player |
Healthy Control |
P value |
Base Rad* Strain |
40.8 ± 10.7 |
40.8 ± 23.7 |
ns |
Base Circ# Strain |
-17.5 ± 2.6 |
-15.5 ± 8.9 |
ns |
Apex Rad* Strain |
33.1 ± 20.5 |
22.5 ± 19.4 |
0.02 |
Apex Circ# Strain |
-21.4 ± 4.78 |
-16.8± 7.56 |
0.005 |
Rad* : radial, Circ# : circumferential
Table 2. Rotation and Torsion Measurements by 2D Speckle Tracking Imaging
|
Elite Soccer Player |
Healthy Control |
P value |
Base Rotation |
-3.91 ± 1.89 |
-3.91 ± 1.89 |
0.03 |
Apex Rotation |
6.88 ± 2.62 |
6.31 ± 3.81 |
ns |
Torsion |
10.78 ± 3.7 |
10.65 ± 5.3 |
ns |
|