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Left atrial strain after maximal exercise in competitive waterpolo players

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Abstract

Left atrial (LA) function is a determinant of left ventricular (LV) filling. It carries out three main functions: reservoir, conduit, contractile. Aim of this study was to evaluate the role of LA and its deformation properties on LV filling at rest (R) and immediately after a maximal exercise (ME) through the speckle tracking echocardiography. Population enrolled was composed by 23 water polo athletes who performed a ME of six repeats of 100 m freestyle swim sets. At ME peak atrial longitudinal strain was reduced but all strain rate (SR) parameters increased, respectively positive peak SR at reservoir phase, SR negative peak at rapid ventricular filling (SRep) and SR negative peak at late ventricular filling (SRlp), that corresponds to atrial contraction phase. We showed a parallel increase in E and A pulsed Doppler wave and SRep and SRlp; particularly at ME, A wave and SRlp increased more respectively than E wave and SRep. SRlp was related to ejection fraction (EF) (r = −0.47; p < 0.01). At multivariate analysis SRlp was an independent predictor of EF (β: −0.47; p = 0.016). The increased sympathetic tone results into increased late diastolic LV filling with augmented atrial contractility and a decrease in diastolic filling time. During exercise LV filling was probably optimized by an enhanced and rapid LA conduit phase and by a vigorous atrial contraction during late LV filling.

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References

  1. Mitchell JH, Haskell W, Snell P, Van Camp SP (2005) Task Force 8: classification of sports. J Am Coll Cardiol 45(8):1364–1367

    Article  PubMed  Google Scholar 

  2. Higginbotham MB, Morris KG, Williams RS, McHale PA, Coleman RE, Cobb FR (1986) Regulation of stroke volume during submaximal and maximal upright exercise in normal man. Circ Res 58:281–291

    Article  CAS  PubMed  Google Scholar 

  3. Cheng CP, Igarashi Y, Little WC (1992) Mechanism of augmented rate of LV filling during exercise. Circ Res 70(1):9–19

    Article  CAS  PubMed  Google Scholar 

  4. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the american society of echocardiography and the European association of cardiovascular imaging. J Am Soc Echocardiogr 28(1):1–39

    Article  PubMed  Google Scholar 

  5. Hoit BD (2005) Assessing atrial mechanical remodelling and its consequences. Circulation 112:304–306

    Article  PubMed  Google Scholar 

  6. Erol MK, Ugur M, Yilmaz M, Acikel M, Sevimli S, Alp N (2001) Left atrial mechanical functions in elite male athletes. Am J Cardiol 88(8):915–917

    Article  CAS  PubMed  Google Scholar 

  7. Gellish RL, Goslin BR, Olson RE, McDonald A, Russi GD, Moudgil VK (2007) Longitudinal modeling of the relationship between age and maximal heart rate. Med Sci Sports Exerc 39(5):822–829

    Article  PubMed  Google Scholar 

  8. Wohlfart B, Farazdaghi GR (2003) Reference values for the physical work capacity on a bicycle ergometer for men—a comparison with a previous study on women. Clin Physiol Funct Imaging 23(3):166–170

    Article  PubMed  Google Scholar 

  9. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193

    Article  PubMed  Google Scholar 

  10. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, Nesser HJ, Khandheria B, Narula J, Sengupta PP (2010) Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 23(4):351–369

    Article  PubMed  Google Scholar 

  11. Kim DG, Lee KJ, Leeetal S (2009) Feasibility o two-dimensional global longitudinal strain and strain rate imaging for the assessment of left atrial function: a study in subjects with a low probability of cardiovascular disease and normal exercise capacity. Echocardiography 26(10):1179–1187

    Article  PubMed  Google Scholar 

  12. Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TSM, Appleton CP (2009) Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr 22(3):299–305

    Article  PubMed  Google Scholar 

  13. Cameli M, Caputo M, Mondillo S, Ballo P, Palmerini E, Lisi M, Marino E, Galderisi M (2006) Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking. Cardiovasc Ultrasound 7:6

    Article  Google Scholar 

  14. Rosca M, Lancellotti P, Popescu BA, Piérard LA (2011) Left atrial function: pathophysiology, echocardiographic assessment, and clinical applications. Heart 97(23):1982–1989

    Article  PubMed  Google Scholar 

  15. Barbier P, Solomon SB, Schiller NB, Glantz SA (1999) Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation 100:427–436

    Article  CAS  PubMed  Google Scholar 

  16. Miyazaki S, Guth BD, Miura T, Indolfi C, Schulz R, Ross J Jr (1990) Changes of left ventricular diastolic function in exercising dogs without and with ischemia. Circulation 81:1058–1070

    Article  CAS  PubMed  Google Scholar 

  17. Neilan TG, Ton-Nu TT, Jassal DS, Popovic ZB, Douglas PS, Halpern EF, Marshall JE, Thomas JD, Picard MH, Yoerger DM, Wood MJ (2006) Myocardial adaptation to short-term high-intensity exercise in highly trained athletes. J Am Soc Echocardiogr 19(10):1280–1285

    Article  PubMed  Google Scholar 

  18. Oxborough D, Whyte G, Wilson M, O’Hanlon R, Birch K, Shave R, Smith G, Godfrey R, Prasad S, George K (2010) A depression in left ventricular diastolic filling following prolonged strenuous exercise is associated with changes in left atrial mechanics. J Am Soc Echocardiogr 23(9):968–976

    Article  PubMed  Google Scholar 

  19. Tsakiris AG, Padiyar R, Gordon DA, Lipton I (1977) Left atrial size and geometry in the intact dog. Am J Physiol Heart Circ Physiol 232:H167–H172

    CAS  Google Scholar 

  20. Santoro A, Alvino F, Antonelli G, Cameli M, Bertini M, Molle R, Mondillo S (2015) Left ventricular strain modifications after maximal exercise in athletes: a speckle tracking study. Echocardiography 32(6):920–927

    Article  PubMed  Google Scholar 

  21. Helmes M, Lim CC, Liao R, Bharti A, Cui L, Sawyer DB (2003) Titin determines the Frank–Starling relation in early diastole. J Gen Physiol 121(2):97–110

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank the staff athletes of Certaldo waterpolo team.

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Authors and Affiliations

  1. Division of Cardiology, Gaetano Palloni Clinical Institute, Via Pasteur 35-37, 52025, Montevarchi Arezzo, Tuscany, Italy

    Amato Santoro

  2. Department of Cardiology, University of Siena, Siena, Italy

    Federico Alvino & Sergio Mondillo

  3. Department of Pediatrics Cardiovascular Disease, Bambin Gesù Pediatric Hospital, Rome, Italy

    Giovanni Antonelli

  4. Department of Cardiology, S. Matteo degli Infermi Hospital, Spoleto, Italy

    Roberta Molle

Authors
  1. Amato Santoro
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  2. Federico Alvino
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  3. Giovanni Antonelli
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  4. Roberta Molle
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  5. Sergio Mondillo
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Corresponding author

Correspondence to Amato Santoro.

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This study has been performed in accordance with ethical standards of Declaration of Helsinki. The athletes gave their informed consent prior to inclusion in this study.

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Santoro, A., Alvino, F., Antonelli, G. et al. Left atrial strain after maximal exercise in competitive waterpolo players. Int J Cardiovasc Imaging 32, 399–405 (2016). https://doi.org/10.1007/s10554-015-0786-8

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  • DOI: https://doi.org/10.1007/s10554-015-0786-8

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