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Atrial functional and geometrical remodeling in highly trained male athletes: for better or worse?

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Highly trained athletes have an increased risk of atrial arrhythmias. Atrial geometrical and functional remodeling may be the underlying substrate. We analyze and relate atrial size, deformation and performance in professional handball players compared with non-sportive subjects.

Methods

24 Professional handball players and 20 non-sportive males were compared. All subjects underwent an echocardiographic study with evaluation of left (LA), right atrial (RA) dimensions and deformation by strain (Sa) and strain rate (SRa). Atrial performance was assessed from the atrial stroke volume (SV). With computational geometrical models, we studied the relation between atrial volumes, strains and SV and compared atrial working conditions. We estimated the functional reserve and a resulting average wall stress.

Results

LA and RA volumes were larger in athletes than in controls (35.2 ± 8.8 vs. 24.8 ± 4.3 ml/m2, p < 0.01 and 29.0 ± 8.4 vs. 19.0 ± 5.1 ml/m2, p < 0.01 respectively). LASa and RASa during active atrial contraction were decreased in athletes (−12.2 ± 2.0 vs. −14.5 ± 2.1 %, p < 0.01 and −12.1 ± 1.8 vs. −14.2 ± 1.5 %, p < 0.01 respectively). LASV was similar between groups (6.6 ± 1.4 vs. 7.3 ± 1.1 ml, p = 0.19) and RASV was lower in athletes (6.2 ± 1.3 vs. 7.2 ± 1.1 ml, p < 0.01). Computational models showed that this different operational mode potentially increases performance reserve, but at the cost of higher atrial wall stress.

Conclusion

A proportion of athletes with enlarged LA and RA showed different atrial contractile performance, likely resulting in atria working at higher wall stress.

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Abbreviations

AF:

Atrial fibrillation

CMR:

Cardiac magnetic resonance

LA:

Left atrium

LASa:

Peak negative left atrial strain during active atrial contraction

LASRa:

Peak negative left atrial strain rate during active atrial contraction

LASRe:

LA early diastolic peak strain rate

LASRs:

LA peak strain rate during ventricular systole

LASs:

LA peak strain during ventricular systole

LV:

Left ventricle

RA:

Right atrium

RASa:

Peak negative right atrial strain during active atrial contraction

RASRa:

Peak negative right atrial strain rate during active atrial contraction

RASRe:

RA early diastolic peak strain rate

RASRs:

RA peak strain rate during ventricular systole

RASs:

RA peak strain during ventricular systole

RV:

Right ventricle

SV:

Stroke volume

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Acknowledgments

This study was partially supported by Grants from the “Generalitat de Catalunya (Consell Catala de l’Esport)”, from “Grupo Memora (SFB-Grupo Memora)”, Spanish Society of Cardiology (Spanish Heart Foundation), from the “Plan Nacional I + D + I”, Spanish Government (DEP2010-20565), and from the “Subprograma de Proyectos en Salud”, Instituto de Salud Carlos III, Spanish Government (FIS—PI11/01709).

Conflict of interest

Authors have nothing to disclose.

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Authors and Affiliations

  1. Thorax Clinic Institute, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain

    Luigi Gabrielli, Nicolas Duchateau, Silvia Montserrat, Beatriz Merino, Carles Paré, Lluis Mont, Josep Brugada & Marta Sitges

  2. Cardiovascular Disease Division, Pontificia Universidad Católica de Chile, Santiago, Chile

    Luigi Gabrielli

  3. Universitat Pompeu Fabra, Barcelona, Spain

    Bart H. Bijnens & Constantine Butakoff

  4. ICREA (Institució Catalana de Recerca i Estudis Avançats), Barcelona, Spain

    Bart H. Bijnens

  5. Consell Catala de l′Esport, Barcelona, Spain

    Josep Gutierrez

Authors
  1. Luigi Gabrielli
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  2. Bart H. Bijnens
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  3. Constantine Butakoff
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  4. Nicolas Duchateau
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  5. Silvia Montserrat
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  6. Beatriz Merino
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  7. Josep Gutierrez
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  8. Carles Paré
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  9. Lluis Mont
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  10. Josep Brugada
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  11. Marta Sitges
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Corresponding authors

Correspondence to Luigi Gabrielli or Marta Sitges.

Additional information

Communicated by Keith Phillip George.

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Gabrielli, L., Bijnens, B.H., Butakoff, C. et al. Atrial functional and geometrical remodeling in highly trained male athletes: for better or worse?. Eur J Appl Physiol 114, 1143–1152 (2014). https://doi.org/10.1007/s00421-014-2845-6

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  • DOI: https://doi.org/10.1007/s00421-014-2845-6

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