Skip to main content
SpringerLink
Log in

Analysis of athletes’ heart by tissue Doppler and strain/strain rate imaging

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

After regular and prolonged training, some physical and structural changes occur in the heart. Strain (S) imaging and Strain Rate (SR) imaging are new and effective techniques derived from tissue Doppler imaging (TDI) which examine systolic and diastolic functions. The aim of the present study was to evaluate left ventricular TDI and S/SR imaging properties in athletes and sedentary controls. The study population consisted of 26 highly trained athletes (group I) and age, sex and body mass index (BMI) adjusted 23 control subjects (group II) who had no pathological conditions. Using standard transthoracic and Doppler echocardiographical measurements and reconstructed spectral pulsed wave tissue Doppler velocities, the S/SR imaging of six different myocardial regions were evaluated. There was a significant increase in left ventricular systolic (LVSD) and diastolic (LVDD) diameter, inter-ventricular septum (IVS), left ventricular mass (LVm), left atrial diameter (LA), and transmitral Doppler peak E velocity (flow velocity in early diastole) between group I and group II in the case of echocardiographic findings. In athletes, TDI analysis showed a significantly increased mitral annulus lateral TDI peak early diastolic (E) velocity (18.8 ± 4.1 cm/s vs. 15 ± 3.5 cm/s, P < 0.01), septal TDI peak E velocity (15.8 ± 2.8 cm/s vs. 12.8 ± 2.4 P < 0.001). There were no significant differences in myocardial velocity imaging parameters between group I and group II. Peak systolic strain/strain rates of septal and lateral walls in group I were significantly higher than group II. This study demonstrates that left ventricular S/SR imaging was higher in athletes than in healthy subjects. In addition to traditional echocardiographic parameters, SI/SRI could be utilised as a useful echocardiographic method for cardiac functions of athletes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Maron BJ (1986) Structural features of the athlete heart as defined by echocardiography. J Am Coll Cardiol 7:190–203

    Article  CAS  PubMed  Google Scholar 

  2. Fagard RH (1996) Athlete’s heart: a meta-analysis of the echocardiographic experience. Int J Sports Med 17(suppl 3):S140–S144

    Article  PubMed  Google Scholar 

  3. Fagard R (2003) Athlete’s heart. Heart 89:1455–1461

    Article  PubMed  Google Scholar 

  4. Lewis JF, Spirito P, Pelliccia A, Maron BJ (1992) Usefulness of Doppler echocardiographic assessment of diastolic filling in distinguishing “athlete’s heart” from hypertrophic cardiomyopathy. Br Heart J 68:296–300

    Article  CAS  PubMed  Google Scholar 

  5. Cardim N, Cordeiro R, Correia MJ, Gomes E, Longo S, Ferreira T et al (2002) Tissue Doppler imaging and long axis left ventricular function: hypertrophic cardiomyopathy versus athlete’s heart. Rev Port Cardiol 21:679–707

    PubMed  Google Scholar 

  6. Fisman EZ, Embon P, Pines A, Tenenbaum A, Drory Y, Shapira I et al (1997) Comparison of left ventricular function using isometric exercise Doppler echocardiography in competitive runners and weightlifters versus sedentary individuals. Am J Cardiol 79:355–359

    Article  CAS  PubMed  Google Scholar 

  7. Huonker M, König D, Keul J (1996) Assessment of left ventricular dimensions and functions in athletes and sedentary subjects at rest and during exercise using echocardiography, Doppler sonography and radionuclide ventriculography. Int J Sports Med 17(suppl 3):S173–S179

    Article  PubMed  Google Scholar 

  8. Voigt JU, Flachskampf FA (2004) Strain and strain rate. New and clinically relevant echo parameters of regional myocardial function. Z Kardiol 93:249–258

    Article  PubMed  Google Scholar 

  9. Perk G, Tunick PA, Kronzon I (2007) Non-Doppler two-dimensional strain imaging by echocardiography from technical considerations to clinical applications. J Am Soc Echo cardiogr 20:234–243

    Article  Google Scholar 

  10. Sahn DJ, DeMaria A, Kisslo J, Weyman A (1978) Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 58:1072–1083

    CAS  PubMed  Google Scholar 

  11. Lang RM, Bierig M, Devereux RB, Flachkampf FA, Foster E, Pellikka PA et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108

    Article  PubMed  Google Scholar 

  12. Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quiñones MA (1997) Doppler tissue imaging: a new noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressure. J Am Coll Cardiol 30:1527–1533

    Article  CAS  PubMed  Google Scholar 

  13. Pelliccia A (2000) Athlete’s heart and hypertrophic cardiomyopathy. Curr Cardiol Rep 2:166–171

    Article  CAS  PubMed  Google Scholar 

  14. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE (2000) The athlete’s heart. A meta-analysis of cardiac structure and function. Circulation 101:336–344

    CAS  PubMed  Google Scholar 

  15. Nishimura RA, Housmans PR, Hatle LK, Tajik AJ (1989) Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography, part 1: physiologic and pathophysiologic features. Mayo Clin Proc 64:71–81

    CAS  PubMed  Google Scholar 

  16. D’hooge J, Heimdal A, Jamal F, Kukulski T, Bijnens B, Rademakers F et al (2000) Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 1:154–170

    Article  PubMed  Google Scholar 

  17. Greenberg LN, Firstenberg MS, Castro PL, Main M, Travaglini A, Odabashian JA et al (2002) Doppler-derived myocardial systolic strain rate is a strong index of left ventricular contractility. Circulation 105:99–105

    Article  PubMed  Google Scholar 

  18. Hashimoto I, Li X, Hejmadi Bhat A, Jones M, Zetts AD, Sahn DJ (2003) Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue Doppler imaging. J Am Coll Cardiol 42:1574–1583

    Article  PubMed  Google Scholar 

  19. Sutherland GR, Salvo GD, Claus P, D’hooge J, Bijnens B (2004) Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 17:788–803

    Article  PubMed  Google Scholar 

  20. Kato TS, Noda A, Izawa H, Yamada A, Obata K, Nagata K et al (2004) Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation 110:3808–3814

    Article  PubMed  Google Scholar 

  21. Tümüklü MM, Etikan I, Cinar CS (2008) Left ventricular function in professional football players evaluated by tissue Doppler imaging and strain imaging. Int J Cardiovasc Imaging 24:25–35

    Article  PubMed  Google Scholar 

  22. Slordahl SA, Bjaerum S, Amundsen BH, Stoylen A, Heimdal A, Rabben SI et al (2001) High frame rate strain rate imaging of the interventricular septum in healthy subjects. Eur J Ultrasound 14:149–155

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey

    Ziya Simsek, Fuat Gundogdu, Sertac Alpaydin & Sule Karakelleoglu

  2. Department of Physical Education and Sport, Ataturk University, Erzurum, Turkey

    Zinnur Gerek, Sertac Ercis & Ilhan Sen

  3. Department of Chest Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey

    Metin Akgün

  4. Osman Gazi Mah., Gökdemir Sitesi A Blok, Kat: 2 Daire No: 13, 25100, Erzurum, Turkey

    Ziya Simsek

Authors
  1. Ziya Simsek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fuat Gundogdu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sertac Alpaydin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zinnur Gerek
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sertac Ercis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ilhan Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Metin Akgün
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sule Karakelleoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ziya Simsek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Simsek, Z., Gundogdu, F., Alpaydin, S. et al. Analysis of athletes’ heart by tissue Doppler and strain/strain rate imaging. Int J Cardiovasc Imaging 27, 105–111 (2011). https://doi.org/10.1007/s10554-010-9669-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-010-9669-1

Keywords

Search

Navigation