Second University of Naples, Naples, Italy.
Am Heart J. 2010 Jun;159(6):1155-61. doi: 10.1016/j.ahj.2010.03.036.
Increase of left atrial (LA) diameter in trained athletes has been regarded as another component of the "athlete's heart".
To evaluate the possible impact of competitive training on LA volume and to define reference values of LA volume index in athletes.
Six hundred fifteen consecutive elite athletes (370 endurance- [ATE] vs 245 strength-trained athletes [ATS]; 385 men; 28.4 +/- 10.2 years, range 18-40 years) underwent a comprehensive transthoracic echocardiography exam. LA maximal volume was measured at the point of mitral valve opening using the biplane area-length method, and corrected for body surface area. LA mild dilatation was defined as a LA volume index between 29 and 33 mL/m(2), while a moderate dilatation was identified by a LA volume index > or =34 mL/m(2). Left ventricular (LV) mass index and ejection fraction did not significantly differ between the 2 groups. Conversely, ATS showed increased body surface area, sum of wall thickness (septum + LV posterior wall), LV circumferential end-systolic stress (ESSc) and relative wall thickness, whereas LA volume index, LV stroke volume and LV end-diastolic volume were greater in ATE. The range of LA volume index was 26 to 36 mL/m(2) (mean 28.2 +/- 9.2) in men and 22 to 33 mL/m(2) (mean 26.5 +/- 7.2) in women (P < .01). LA volume index was mildly enlarged in 150 athletes (24.3%) and moderately enlarged only in 20, all males (3.2%). Mild mitral regurgitation was observed in 64 athletes (10.3%). LA volume index was significantly greater in ATE (P < .01). By multivariate analysis, the overall population type (P < .01) and duration (P < .01) of training and LV end-diastolic volume (P < .001) were the only independent predictors of LA volume index.
In a large population of highly trained athletes, a mild enlargement of LA volume index was relatively common and may be regarded as a physiologic adaptation to exercise conditioning.
左心房（LA）直径的增加在训练有素的运动员中被认为是“运动员心脏”的另一个组成部分。
评估竞技训练对 LA 容积的可能影响，并确定运动员 LA 容积指数的参考值。
连续 615 名精英运动员（370 名耐力运动员 [ATE]与 245 名力量训练运动员 [ATS]；385 名男性；28.4 +/- 10.2 岁，范围 18-40 岁）接受了全面的经胸超声心动图检查。使用双平面面积-长度法在二尖瓣开口处测量 LA 最大容积，并根据体表面积进行校正。LA 轻度扩张定义为 LA 容积指数在 29 至 33 mL/m(2)之间，而 LA 容积指数>或=34 mL/m(2)则定义为中度扩张。两组之间左心室（LV）质量指数和射血分数无显著差异。相反，ATS 显示体表面积、壁厚度总和（间隔+LV 后壁）、LV 环向收缩末期压力（ESSc）和相对壁厚度增加，而 ATE 的 LA 容积指数、LV 每搏量和 LV 舒张末期容积增加。男性 LA 容积指数范围为 26 至 36 mL/m(2)（平均 28.2 +/- 9.2），女性为 22 至 33 mL/m(2)（平均 26.5 +/- 7.2）（P <.01）。150 名运动员（24.3%）的 LA 容积指数轻度增大，仅 20 名男性（3.2%）的 LA 容积指数中度增大。64 名运动员（10.3%）出现轻度二尖瓣反流。ATE 的 LA 容积指数明显更大（P <.01）。多元分析显示，人群类型（P <.01）和训练时间（P <.01）以及 LV 舒张末期容积（P <.001）是 LA 容积指数的唯一独立预测因子。
在大量高度训练的运动员中，LA 容积指数的轻度增大相对常见，可能被视为运动适应的生理适应。
