Department of Cardiology, Normandie Univ, UNICAEN, CHU Caen Normandie, Caen, France.
EA4650 (SEILIRM), FHU REMOD-VHF, Caen, France.
PLoS One. 2022 Jul 15;17(7):e0271628. doi: 10.1371/journal.pone.0271628. eCollection 2022.
Age-associated changes in cardiac filling and function are well known in the general population. Yet, the effect of aging on left atrial (LA) function, and its interaction with left ventricular (LV) adaptation, remain less described when combined with high-intensity chronic training. We aimed to analyze the effects of aging on LA and LV functions in trained athletes.
Ninety-five healthy highly-trained athletes referred for resting echocardiography were included. Two groups of athletes were retrospectively defined based on age: young athletes aged <35 years (n = 54), and master athletes aged ≥35 years (n = 41). All subjects were questioned about their sports practice. Echocardiographic analysis of LV systolic and diastolic functions (2D-echo, 3D-echo, and Doppler), as well as LA 2D dimensions and phasic deformations assessed by speckle tracking, were analyzed. Master athletes (mean age = 46.3 ± 8.3 years, mean duration of sustained training = 13.7 ± 8.9 years) exhibited significantly stiffer LV and LA with reduced LV early diastolic functional parameters (ratio E/A, peak e', and ratio e'/a'), LA reservoir and conduit strain, whereas LA volume, LA contractile strain and LV peak a' were higher, compared to young athletes. Multivariate regression analysis confirmed that age was predictive of peak e', LA reservoir strain and LA conduit strain, independently of training variables. LA phasic strains were strongly associated with LV diastolic function.
Regardless of chronic sports practice, master athletes exhibited age-related changes in LA function closely coupled to LV diastolic properties, which led to LV filling shifts to late diastole.
在普通人群中，心脏充盈和功能的年龄相关性变化是众所周知的。然而，当与高强度慢性训练相结合时，衰老对左心房（LA）功能的影响及其与左心室（LV）适应性的相互作用仍描述较少。我们旨在分析衰老对训练有素的运动员的 LA 和 LV 功能的影响。
共纳入 95 名因静息超声心动图而就诊的健康高训练有素的运动员。根据年龄回顾性地将运动员分为两组：年龄<35 岁的年轻运动员（n=54）和年龄≥35 岁的大师运动员（n=41）。所有受试者均接受了运动实践的询问。分析了 LV 收缩和舒张功能（二维超声心动图、三维超声心动图和多普勒）以及 LA 的二维尺寸和通过斑点追踪评估的相变形，以及 LA 2D 尺寸和相变形。大师运动员（平均年龄=46.3±8.3 岁，持续训练的平均时间=13.7±8.9 年）的 LV 和 LA 明显更僵硬，LV 早期舒张功能参数（E/A 比值、峰值 e'和 e'/a'比值）降低，LA 储备和导管应变降低，而 LA 容量、LA 收缩应变和 LV 峰值 a'更高，与年轻运动员相比。多变量回归分析证实，年龄是预测峰值 e'、LA 储备应变和 LA 导管应变的独立因素，与训练变量无关。LA 相变形与 LV 舒张功能密切相关。
无论进行慢性运动训练，大师运动员的 LA 功能均会发生与年龄相关的变化，与 LV 舒张特性密切相关，从而导致 LV 充盈向晚期转变。
