Department of Cardiology, Nancy University Hospital, 54000 Nancy, France.
Department of Cardiology, Nancy University Hospital, 54000 Nancy, France.
Arch Cardiovasc Dis. 2024 Aug-Sep;117(8-9):490-496. doi: 10.1016/j.acvd.2024.05.121. Epub 2024 Aug 8.
Assessment of the athlete's heart is challenging because of a phenotypic overlap between reactive physiological adaptation and pathological remodelling. The potential value of myocardial deformation remains controversial in identifying early cardiomyopathy.
To identify the echocardiographic phenotype of athletes using advanced two-dimensional speckle tracking imaging, and to define predictive factors of subtle left ventricular systolic dysfunction.
In total, 191 healthy male athletes who underwent a preparticipation medical evaluation at Nancy University Hospital between 2013 and 2020 were included. Clinical and echocardiographic data were compared with 161 healthy male subjects from the STANISLAS cohort. Borderline global longitudinal strain value was defined as<17.5%.
Athletes demonstrated lower left ventricular ejection fraction (57.9±5.3% vs. 62.6±6.4%; P<0.01) and lower global longitudinal strain (17.5±2.2% vs. 21.1±2.1%; P<0.01). No significant differences were found between athletes with and without a borderline global longitudinal strain value regarding clinical characteristics, structural echocardiographic features and exercise capacity. A borderline global longitudinal strain value was associated with a lower endocardial global longitudinal strain (18.8±1.2% vs. 22.7±1.9%; P=0.02), a lower epicardial global longitudinal strain (14.0±1.1% vs. 16.6±1.2%; P<0.01) and a higher endocardial/epicardial global longitudinal strain ratio (1.36±0.07 vs. 1.32±0.06; P<0.01). No significant difference was found regarding mechanical dispersion (P=0.46).
Borderline global longitudinal strain value in athletes does not appear to be related to structural remodelling, mechanical dispersion or exercise capacity. The athlete's heart is characterized by a specific myocardial deformation pattern with a more pronounced epicardial layer strain impairment.
由于反应性生理适应与病理性重塑之间存在表型重叠，因此评估运动员的心脏具有挑战性。心肌变形的潜在价值在识别早期心肌病方面仍存在争议。
使用先进的二维斑点追踪成像技术确定运动员的超声心动图表型，并确定左心室收缩功能障碍的潜在预测因素。
共纳入 2013 年至 2020 年在南锡大学医院进行参赛前体检的 191 名健康男性运动员。将临床和超声心动图数据与 STANISLAS 队列中的 161 名健康男性进行比较。边界整体纵向应变值定义为<17.5%。
运动员的左心室射血分数（57.9±5.3% vs. 62.6±6.4%；P<0.01）和整体纵向应变（17.5±2.2% vs. 21.1±2.1%；P<0.01）较低。在具有和不具有边界整体纵向应变值的运动员之间，临床特征、结构超声心动图特征和运动能力方面没有差异。边界整体纵向应变值与较低的心内膜整体纵向应变（18.8±1.2% vs. 22.7±1.9%；P=0.02）、较低的心外膜整体纵向应变（14.0±1.1% vs. 16.6±1.2%；P<0.01）和较高的心内膜/心外膜整体纵向应变比值（1.36±0.07 vs. 1.32±0.06；P<0.01）相关。机械弥散方面无显著差异（P=0.46）。
运动员的边界整体纵向应变值似乎与结构重塑、机械弥散或运动能力无关。运动员的心脏具有特定的心肌变形模式，表现为更明显的心外膜层应变受损。
