Correlation between myocardial work indices and main echocardiographic and cardiopulmonary exercise stress test parameters in Olympic endurance athletes.

INTRODUCTION

Myocardial works indices (MWI) are new echocardiographic parameters that innovatively assess left ventricular function. Although recent studies show correlation between these indices and traditional morpho-functional echocardiographic (TTE) and cardiopulmonary test (CPET) parameters in general population and in different pathologic conditions, data on athletes remains scarce. Aim of our study is to investigate a relationship between MWI and main TTE and CPET parameters in a large cohort of endurance athletes.

METHODS

We enrolled 306 endurance Olympic athletes, mean age 26.3 ± 4.3 years old, 170 (55.5%) males who underwent clinical and anthropometric evaluation, TTE and CPET. Strain rate and MWI were measured and the following parameters collected: global longitudinal strain (GLS), global myocardial work index (GWI), global constructive myocardial work (GCW), Global Wasted Work (GWW) and global cardiac work efficiency (GWE).

RESULTS

MWI showed correlation with peak systolic blood pressure at CPET (GWI, p = 0.012 and GCW, p < 0.0001) and functional TTE parameters such as EF (p = 0.016 for GWI and p = 0.017 for GCW), RV GLS% (p < 0.0001 for GWI and GCW) and LA strain (p < 0.0001 for GWI and GCW). Moreover, MWI were also correlated to echocardiographic heart remodeling parameters, such as LVEDVi (p = 0.046 for GWI) and LVEDDi (p = 0.035 for GWW and p = 0.018 for GWE). MWI correlate also with O2pulse (p = 0.005 for GWI; p = 0.010 for GCW), but not with VO2max/kg.

CONCLUSION

In this study, MWI were associated with cardiac remodeling, but not with VO2 max. It should therefore not be considered as a surrogate marker of an athlete's training status.