Di Gioia Giuseppe, Ferrera Armando, Mango Federica, Ortolina Davide, Maestrini Viviana, Monosilio Sara, Paoletti Giulia, Lemme Erika, Squeo Maria Rosaria, Pelliccia Antonio
Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197, Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis, 15, 00135, Rome, Italy.
Eur J Appl Physiol. 2025 May 10. doi: 10.1007/s00421-025-05801-6.
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.
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).
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.
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.
心肌做功指数（MWI）是创新性评估左心室功能的新型超声心动图参数。尽管最近的研究表明，在普通人群和不同病理状况下，这些指数与传统形态功能超声心动图（TTE）及心肺运动试验（CPET）参数之间存在相关性，但关于运动员的数据仍然稀少。我们研究的目的是在一大群耐力运动员中探究MWI与主要TTE和CPET参数之间的关系。
我们纳入了306名耐力项目的奥运运动员，平均年龄26.3±4.3岁，其中170名（55.5%）男性，他们接受了临床和人体测量评估、TTE及CPET检查。测量了应变率和MWI，并收集了以下参数：整体纵向应变（GLS）、整体心肌做功指数（GWI）、整体建设性心肌做功（GCW）、整体无用功（GWW）和整体心脏做功效率（GWE）。
MWI与CPET时的收缩压峰值相关（GWI，p = 0.012；GCW，p < 0.0001），还与功能性TTE参数相关，如射血分数（GWI，p = 0.016；GCW，p = 0.017）、右心室GLS%（GWI和GCW，p < 0.0001）以及左心房应变（GWI和GCW，p < 0.0001）。此外，MWI还与超声心动图心脏重构参数相关，如左心室舒张末期容积指数（GWI，p = 0.046）和左心室舒张末期内径（GWW，p = 0.035；GWE，p = 0.
