The beneficial effect of low-intensity exercise on cardiac performance assessed by two-dimensional speckle tracking echocardiography.
athlete's heart
echocardiography
strain
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
10
05
2020
revised:
24
09
2020
accepted:
25
09
2020
pubmed:
19
10
2020
medline:
24
6
2021
entrez:
18
10
2020
Statut:
ppublish
Résumé
Regular physical activity is associated with cardiovascular health; however, intensive exercise can have harmful effects on the heart. Two-dimensional (2D) speckle tracking echocardiography (STE) is a well-established diagnostic tool to evaluate subclinical myocardial dysfunction and has been widely used in athletes in recent years. This study is designed to evaluate whether low-intensity exercise has beneficial effects on myocardial performance. We aimed to evaluate systolic and diastolic functions of myocardium derived from STE in sports practitioners in a low-intensity exercise training program. Eighty-four sports practitioners and eighty-two sedentary healthy controls were prospectively included in our study. In addition to standard 2D echocardiographic measurements, left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, RV-free wall strain (FWS), left atrium (LA) strain, and strain rate were analyzed. Mean LV GLS was significantly higher in sports practitioners compared with sedentary population (-19.21 ± 2.61% vs -18.37 ± 2.75%, P = .044). RV GLS was significantly higher in sports practitioners than sedentary population (-21.82 ± 4.86% vs -20.04 ± 4.62%, P = .016). Longitudinal strain and strain rate of LA conduit phase were significantly higher in sports practitioners than sedentary participants (-23.60 ± 6.83% vs -20.20 ± 6.64%, P = .001; -2.45 ± 0.81 L/s vs -2.10 ± 0.89 L/s, P = .010; respectively). Also, LA conduit phase strain/contraction phase strain and conduit phase strain rate/contraction phase strain rate ratios were higher in sports practitioners (1.88 ± 0.93 vs 1.48 ± 0.63, P = .001; 1.42 ± 0.65 vs 1.16 ± 0.53, P = .005; respectively). The findings in the current study suggest that regular low-intensity exercise may have a beneficial effect on both systolic and diastolic functions of the myocardium.
Sections du résumé
BACKGROUND
Regular physical activity is associated with cardiovascular health; however, intensive exercise can have harmful effects on the heart. Two-dimensional (2D) speckle tracking echocardiography (STE) is a well-established diagnostic tool to evaluate subclinical myocardial dysfunction and has been widely used in athletes in recent years. This study is designed to evaluate whether low-intensity exercise has beneficial effects on myocardial performance. We aimed to evaluate systolic and diastolic functions of myocardium derived from STE in sports practitioners in a low-intensity exercise training program.
METHOD
Eighty-four sports practitioners and eighty-two sedentary healthy controls were prospectively included in our study. In addition to standard 2D echocardiographic measurements, left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, RV-free wall strain (FWS), left atrium (LA) strain, and strain rate were analyzed.
RESULTS
Mean LV GLS was significantly higher in sports practitioners compared with sedentary population (-19.21 ± 2.61% vs -18.37 ± 2.75%, P = .044). RV GLS was significantly higher in sports practitioners than sedentary population (-21.82 ± 4.86% vs -20.04 ± 4.62%, P = .016). Longitudinal strain and strain rate of LA conduit phase were significantly higher in sports practitioners than sedentary participants (-23.60 ± 6.83% vs -20.20 ± 6.64%, P = .001; -2.45 ± 0.81 L/s vs -2.10 ± 0.89 L/s, P = .010; respectively). Also, LA conduit phase strain/contraction phase strain and conduit phase strain rate/contraction phase strain rate ratios were higher in sports practitioners (1.88 ± 0.93 vs 1.48 ± 0.63, P = .001; 1.42 ± 0.65 vs 1.16 ± 0.53, P = .005; respectively).
CONCLUSION
The findings in the current study suggest that regular low-intensity exercise may have a beneficial effect on both systolic and diastolic functions of the myocardium.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1989-1999Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Galderisi M, Cardim N, D'Andrea A, et al. The multimodality cardiac imaging approach to the athlete’s heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:353.
Abergel E, Chatellier G, Hagege AA, et al. Serial left ventricular adaptations in world-class professional cyclists: implications for disease screening and follow-up. J Am Coll Cardiol. 2004;44:144-449.
Scharhag J, Schneider G, Urhausen A, Rochette V, Kramann B, Kindermann W. Athlete’s heart: right and left ventricular mass and function in male endurance athletes and untrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol. 2002;40:1856-1863.
Vitarelli A, Capotosto L, Placanica G, et al. Comprehensive assessment of biventricular function and aortic stiffness in athletes with different forms of training by three-dimensional echocardiography and strain imaging. Eur Heart J Cardiovasc Imaging. 2013;14(1010-20):11.
Cote AT, Bredin SS, Phillips AA, et al. Left ventricular mechanics and arterial-ventricular coupling following high-intensity interval exercise. J Appl Physiol. 2013;115:1705-1713.
Fagard RH. Impact of different sports and training on cardiac structure and function. Cardiol Clin. 1997;15:397-412.
Donal E, Rozoy T, Kervio G, Schnell F, Mabo P, Carré F. Comparison of the heart function adaptation in trained and sedentary men after 50 and before 35 years of age. Am J Cardiol. 2011;108:1029-1037.
Hubert A, Galand V, Donal E, et al. Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes. Eur Heart J Cardiovasc Imaging. 2018;19:145-153.
Cameli M, Partho S, Edvardsen T. Deformation Echocardiography. In: Lancellotti P, Zamorano JL, Habib G, et al., eds. The EACVI Textbook of Echocardiography. Oxford, UK: Oxford University Press; 2017;38.
Hurlburt HM, Aurigemma GP, Hill JC, et al. Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults. Echocardiography. 2007;24:723-731.
Beaumont A, Grace F, Richards J, Hough J, Oxborough D, Sculthorpe N. Left ventricular speckle tracking-derived cardiac strain and cardiac twist mechanics in athletes: a systematic review and meta-analysis of controlled studies. Sports Med. 2017;47:1145-1170.
Forsythe L, George K, Oxborough D. Speckle tracking echocardiography for the assessment of the athlete’s heart: Is it ready for daily practice? Curr Treat Options Cardiovasc Med. 2018;20:83.
Galderisi M, Lomoriello VS, Santoro A, et al. Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study. J Am Soc Echocardiogr. 2010;23:1190-1198.
Santoro A, Alvino F, Antonelli G, et al. Endurance and strength athlete’s heart: analysis of myocardial deformation by speckle tracking echocardiography. J Cardiovasc Ultrasound. 2014;22:196-204.
Saghir M, Areces M, Makan M. Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete’s heart). J Am Soc Echocardiogr. 2007;20:151-157.
Forsythe L, Somauroo J, George K, et al. The right heart of the elite senior rugby football league athlete. Echocardiography. 2019;36(5):888-896.
Żebrowska A, Mikołajczyk R, Waśkiewicz Z, et al. Left ventricular systolic function assessed by speckle tracking echocardiography in athletes with and without left ventricle hypertrophy. J Clin Med. 2019;8(5):687.
Mosteller RD. Simplified calculation of body-surface area. N Engl J Med. 1987;317:1098.
Lang RM, Badano LP, Mor-Avi V, et al. 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 Soc Echocardiogr. 2015;28:1-394.
Badano LP, Kolias TJ, Muraru D, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2018;19(6):591-600.
Fiuza-Luces C, Santos-Lozano A, Joyner M, et al. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol. 2018;15(12):731-743.
Wen CP, Wai JPM, Tsai MK, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet. 2011;378:1244-1253.
Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388:1302-1310.
Heidbuchel H, Hoogsteen J, Fagard R, et al. High prevalence of right ventricular involvement in endurance athletes. Role of an electrophysiologic study in risk stratification. Eur Heart J. 2003;24:1473-1480.
La Gerche A, Burns AT, Mooney DJ, et al. Exercise-induced right ventricular dysfunction and structural remodeling in endurance athletes. Eur Heart J. 2012;33:998-1006.
Scimia MC, Hurtado C, Ray S, et al. APJ acts as a dual receptor in cardiac hypertrophy. Nature. 2012;488(7411):394-398.
Caselli S, Montesanti D, Autore C, et al. Patterns of left ventricular longitudinal strain and strain rate in Olympic athletes. J Am Soc Echocardiogr. 2015;28:245-253.
Simsek Z, Hakan Tas M, Degirmenci H, et al. Speckle tracking echocardiographic analysis of left ventricular systolic and diastolic functions of young elite athletes with eccentric and concentric type of cardiac remodeling. Echocardiography. 2013;30:1202-1208.
Fagard R. Athlete’s heart. Heart. 2003;89(12):1455-1461.
Dores H, Mendes L, Dinis P, Cardim N, Monge JC, Santos JF. Myocardial deformation and volume of exercise: a new overlap between pathology and athlete's heart? Int J Cardiovasc Imaging. 2018;34(12):1869-1875.
Weiner RB, Hutter AM, Wang F, et al. The impact of endurance exercise training on left ventricular torsion. JACC Cardiovasc Imaging. 2010;3(10):1001-1009.
La Gerche A, Jurcut R, Voigt JU. Right ventricular function by strain echocardiography. Curr Opin Cardiol. 2010;25:430-436.
Teske AJ, Prakken NH, De Boeck BW, et al. Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes. Eur Heart J. 2009;30:969-977.
Esposito R, Galderisi M, Schiano-Lomoriello V, et al. Nonsymmetric myocardial contribution to supranormal right ventricular function in the athlete's heart: combined assessment by speckle tracking and real-time three-dimensional echocardiography. Echocardiography. 2014;31:996-1004.
Schnell F, Matelot D, Daudin M, et al. Mechanical dispersion by strain echocardiography: a novel tool to diagnose hypertrophic cardiomyopathy in athletes. J Am Soc Echocardiogr. 2017;30(3):251-261.
Levy WC, Cerqueira MD, Abrass IB, Schwartz RS, Stratton JR. Endurance exercise training augments diastolic filling at rest and during exercise in healthy young and older men. Circulation. 1993;88(1):116-126.
Schulman SP, Lakatta EG, Fleg JL, Lakatta L, Becker LC, Gerstenblith G. Age-related decline in left ventricular filling at rest and exercise. Am J Physiol. 1992;263(6 Pt 2):H1932-H1938.
Smiseth AO, Galderisi M, Oh KJ. Left Ventricle: Diastolic function. In: Lancellotti P, Zamorano JL, Habib G, et al., eds. The EACVI Textbook of Echocardiography. Oxford, UK: Oxford University Press; 2017;147.
Niemelä K, Palatsi I, Ikäheimo M, Airaksinen J, Takkunen J. Impaired left ventricular diastolic function in athletes after utterly strenuous prolonged exercise. Int J Sports Med. 1987;8(2):61-65.
Cuspidi C, Tadic M, Sala C, Gherbesi E, Grassi G, Mancia G. Left atrial function in elite athletes: A meta-analysis of two-dimensional speckle tracking echocardiographic studies. Clin Cardiol. 2019;42(5):579-587.
D'Ascenzi F, Solari M, Anselmi F, et al. Atrial chamber remodelling in healthy pre-adolescent athletes engaged in endurance sports: a study with a longitudinal design. The CHILD study. Int J Cardiol. 2016;223:325-330.
Argento LV, Travetto CM, de Las M, Colicigno M, et al. Tissue Doppler imaging of the atrial lateral wall: Correlation with atrial strain rate and parameters of diastolic function. Echocardiography. 2019;36:1282-1289.
Russo C, Hahn TR, Jin Z, et al. Comparison of echocardiographic single-plane versus biplane method in the assessment of left atrial volume and validation by real time three-dimensional echocardiography. J Am Soc Echocardiogr. 2010;23(9):954-960.
Pellikka PA, She L, Holly TA, et al. Variability in ejection fraction measured by echocardiography, gated single-photon emission computed tomography, and cardiac magnetic resonance in patients with coronary artery disease and left ventricular dysfunction. JAMA Netw Open. 2018;1(4):e181456.
Oh JK, Pellikka PA, Panza JA, et al. Core lab analysis of baseline echocardiographic studies in the STICH trial and recommendation for use of echocardiography in future clinical trials. J Am Soc Echocardiogr. 2012;25(3):327-336.