Skip to main content
Erschienen in: European Journal of Applied Physiology 6/2014

01.06.2014 | Original Article

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

verfasst von: Luigi Gabrielli, Bart H. Bijnens, Constantine Butakoff, Nicolas Duchateau, Silvia Montserrat, Beatriz Merino, Josep Gutierrez, Carles Paré, Lluis Mont, Josep Brugada, Marta Sitges

Erschienen in: European Journal of Applied Physiology | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
Zurück zum Zitat Abdulla J, Rokkedal J (2009) Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace 11:1156–1159PubMedCrossRef Abdulla J, Rokkedal J (2009) Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace 11:1156–1159PubMedCrossRef
Zurück zum Zitat Benito B, Gay-Jordi G, Serrano-Mollar A et al (2011) Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 123:13–22PubMedCrossRef Benito B, Gay-Jordi G, Serrano-Mollar A et al (2011) Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 123:13–22PubMedCrossRef
Zurück zum Zitat Bijnens BH, Cikes M, Butakoff C, Sitges M, Crispi F (2012) Myocardial motion and deformation: what does it tell as and how does it relate to function? Fetal Diag Ther 32:5–16CrossRef Bijnens BH, Cikes M, Butakoff C, Sitges M, Crispi F (2012) Myocardial motion and deformation: what does it tell as and how does it relate to function? Fetal Diag Ther 32:5–16CrossRef
Zurück zum Zitat D′Andrea Riegler L, Rucco MA et al (2013) Left atrial volume index in healthy subjects: clinical and echocardiographic correlates. Echocardiography 30:1001–1007 D′Andrea Riegler L, Rucco MA et al (2013) Left atrial volume index in healthy subjects: clinical and echocardiographic correlates. Echocardiography 30:1001–1007
Zurück zum Zitat D′Andrea A, Riegler L, Cocchia R et al (2010) Left atrial volume index in highly trained athletes. Am Heart J 159:1155–1161PubMedCrossRef D′Andrea A, Riegler L, Cocchia R et al (2010) Left atrial volume index in highly trained athletes. Am Heart J 159:1155–1161PubMedCrossRef
Zurück zum Zitat Di Martino E, Bellini C, Schwartzman D (2011) In vivo porcine left atrial wall stress: effect of ventricular tachypacing on spatial and temporal stress distribution. J Biomech 44:2755–2760PubMedCrossRef Di Martino E, Bellini C, Schwartzman D (2011) In vivo porcine left atrial wall stress: effect of ventricular tachypacing on spatial and temporal stress distribution. J Biomech 44:2755–2760PubMedCrossRef
Zurück zum Zitat Elosua R, Arquer A, Mont L, García-Moran E, Brugada J, Marrugat J (2006) Sport practice and the risk of lone atrial fibrillation: a case control study. Int J Cardiol 108:332–337PubMedCrossRef Elosua R, Arquer A, Mont L, García-Moran E, Brugada J, Marrugat J (2006) Sport practice and the risk of lone atrial fibrillation: a case control study. Int J Cardiol 108:332–337PubMedCrossRef
Zurück zum Zitat Erol MK, Karakelleoglu S (2002) Assessment of right heart function in the athletes heart. Heart Vessels 16:175–180PubMedCrossRef Erol MK, Karakelleoglu S (2002) Assessment of right heart function in the athletes heart. Heart Vessels 16:175–180PubMedCrossRef
Zurück zum Zitat Falsetti HL, Mates RE, Grant C, Greene DG, Bunnell IL (1970) Left ventricular wall stress calculated from one-plane cineangiography. Circ Res 26:71–83PubMedCrossRef Falsetti HL, Mates RE, Grant C, Greene DG, Bunnell IL (1970) Left ventricular wall stress calculated from one-plane cineangiography. Circ Res 26:71–83PubMedCrossRef
Zurück zum Zitat Gabrielli L, Corbalan R, Córdova S et al (2011) Left atrial dysfunction is a predictor of postcoronary artery bypass atrial fibrillation: association of left atrial strain and strain rate assessed by speckle tracking. Echocardiography 28:1104–1108PubMedCrossRef Gabrielli L, Corbalan R, Córdova S et al (2011) Left atrial dysfunction is a predictor of postcoronary artery bypass atrial fibrillation: association of left atrial strain and strain rate assessed by speckle tracking. Echocardiography 28:1104–1108PubMedCrossRef
Zurück zum Zitat Gabrielli L, Enríquez A, Córdova S, Yañez F, Godoy I, Corbalán R (2012) Assessment of left atrial function in hypertrophic cardiomyopathy and athlete′s heart: a left atrial myocardial deformation study. Echocardiography 29:943–949PubMedCrossRef Gabrielli L, Enríquez A, Córdova S, Yañez F, Godoy I, Corbalán R (2012) Assessment of left atrial function in hypertrophic cardiomyopathy and athlete′s heart: a left atrial myocardial deformation study. Echocardiography 29:943–949PubMedCrossRef
Zurück zum Zitat Hoogsteen J, Schep G, Van Hemel NM, Van Der Wall EE (2004) Paroxysmal atrial fibrillation in male endurance athletes. A 9 years follow up. Europace 6:222–228PubMedCrossRef Hoogsteen J, Schep G, Van Hemel NM, Van Der Wall EE (2004) Paroxysmal atrial fibrillation in male endurance athletes. A 9 years follow up. Europace 6:222–228PubMedCrossRef
Zurück zum Zitat Hunter RJ, Liu Y, Lu Y, Wang W, Schilling RJ (2012) Left atrial wall stress distribution and its relationship to electrophysiologic remodeling in persistent atrial fibrillation. Circ Arrhythm Electrophysiol 5:351–360PubMedCrossRef Hunter RJ, Liu Y, Lu Y, Wang W, Schilling RJ (2012) Left atrial wall stress distribution and its relationship to electrophysiologic remodeling in persistent atrial fibrillation. Circ Arrhythm Electrophysiol 5:351–360PubMedCrossRef
Zurück zum Zitat Lang RM, Bierig M, Devereux RB et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108PubMedCrossRef Lang RM, Bierig M, Devereux RB et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108PubMedCrossRef
Zurück zum Zitat Marciniak A, Claus P, Sutherland GR et al (2007) Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study. Eur Heart J 28:2627–2636PubMedCrossRef Marciniak A, Claus P, Sutherland GR et al (2007) Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study. Eur Heart J 28:2627–2636PubMedCrossRef
Zurück zum Zitat Margreet A, Maass A, Oberdorf-Maass S, Van Veldhuisen D, Van Gilst W, Van Gelder I (2010) Mechanisms of atrial structural changes caused by stretch occurring before and during early atrial fibrillation. Cardiovasc Res 89:754–765 Margreet A, Maass A, Oberdorf-Maass S, Van Veldhuisen D, Van Gilst W, Van Gelder I (2010) Mechanisms of atrial structural changes caused by stretch occurring before and during early atrial fibrillation. Cardiovasc Res 89:754–765
Zurück zum Zitat Mirsky I, Krayenbuehl HP (1981) The role of wall stress in the assessment of ventricular function. Herz 6:288–299PubMed Mirsky I, Krayenbuehl HP (1981) The role of wall stress in the assessment of ventricular function. Herz 6:288–299PubMed
Zurück zum Zitat Molina L, Mont L, Marrugat J et al (2008) Long term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow up study. Europace 10:618–623PubMedCrossRef Molina L, Mont L, Marrugat J et al (2008) Long term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow up study. Europace 10:618–623PubMedCrossRef
Zurück zum Zitat Padeletti M, Cameli M, Lisi M, Malandrino A, Zacá V, Montillo S (2012) Reference values of right atrial longitudinal strain imaging by two-dimensional speckle tracking. Echocardiography 29:147–152PubMedCrossRef Padeletti M, Cameli M, Lisi M, Malandrino A, Zacá V, Montillo S (2012) Reference values of right atrial longitudinal strain imaging by two-dimensional speckle tracking. Echocardiography 29:147–152PubMedCrossRef
Zurück zum Zitat Pelliccia A, Maron BJ, Di Paolo FM et al (2005) Prevalence and clinical significance of left atrial remodelling in competitive athletes. J Am Coll Cardiol 46:690–696PubMedCrossRef Pelliccia A, Maron BJ, Di Paolo FM et al (2005) Prevalence and clinical significance of left atrial remodelling in competitive athletes. J Am Coll Cardiol 46:690–696PubMedCrossRef
Zurück zum Zitat Prinz C, Van Buuren F, Bogunovic N, Bitter T, Faber L, Horstkotte D (2012) In patients with hypertrophic cardiomyopathy myocardial fibrosis is associated with both left ventricular and left atrial dysfunction. Acta Cardiol 67:187–193PubMed Prinz C, Van Buuren F, Bogunovic N, Bitter T, Faber L, Horstkotte D (2012) In patients with hypertrophic cardiomyopathy myocardial fibrosis is associated with both left ventricular and left atrial dysfunction. Acta Cardiol 67:187–193PubMed
Zurück zum Zitat Saraiva RM, Demirkol S, Buakhamsri A et al (2010) Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. J Am Soc Echocardiogr 2:172–180CrossRef Saraiva RM, Demirkol S, Buakhamsri A et al (2010) Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. J Am Soc Echocardiogr 2:172–180CrossRef
Zurück zum Zitat Schneider C, Malisius R, Krause K, Bahlmann E, Boczor S (2008) Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Heart J 20:1397–1409CrossRef Schneider C, Malisius R, Krause K, Bahlmann E, Boczor S (2008) Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Heart J 20:1397–1409CrossRef
Zurück zum Zitat Sitges M, Teijeira VA, Scalise A et al (2007) Is there an anatomical substrate for idiopathic paroxismal atrial fibrillation? A case control echocardiographic study. Europace 9:294–298PubMedCrossRef Sitges M, Teijeira VA, Scalise A et al (2007) Is there an anatomical substrate for idiopathic paroxismal atrial fibrillation? A case control echocardiographic study. Europace 9:294–298PubMedCrossRef
Zurück zum Zitat Sorokin AV, Araujo CG, Zweibel S, Thompson PD (2011) Atrial fibrillation in endurance-trained athletes. Br J Sports Med 45:185–188PubMedCrossRef Sorokin AV, Araujo CG, Zweibel S, Thompson PD (2011) Atrial fibrillation in endurance-trained athletes. Br J Sports Med 45:185–188PubMedCrossRef
Zurück zum Zitat Tsai CT, Tseng CD, Hwang JJ et al (2011) Tachycardia of atrial myocites induces collagen expression in atrial fibroblasts through transforming growth factor B1. Cardiovasc Res 89:805–815PubMedCrossRef Tsai CT, Tseng CD, Hwang JJ et al (2011) Tachycardia of atrial myocites induces collagen expression in atrial fibroblasts through transforming growth factor B1. Cardiovasc Res 89:805–815PubMedCrossRef
Zurück zum Zitat Tsang MY, Barnes ME, Tsang TS (2012) Left atrial volume: clinical value revisited. Curr Cardiol Rep 14:374–380PubMedCrossRef Tsang MY, Barnes ME, Tsang TS (2012) Left atrial volume: clinical value revisited. Curr Cardiol Rep 14:374–380PubMedCrossRef
Zurück zum Zitat Turagam M, Velagapudi P, Kocheril A (2012) Atrial fibrillation in athletes. Am J Cardiol 109:296–302PubMedCrossRef Turagam M, Velagapudi P, Kocheril A (2012) Atrial fibrillation in athletes. Am J Cardiol 109:296–302PubMedCrossRef
Zurück zum Zitat Van Buuren F, Mellwig KP, Faber L et al (2012) The occurrence of atrial fibrillation in former top-level handball players above the age of 50. Acta Cardiol 67:213–220PubMed Van Buuren F, Mellwig KP, Faber L et al (2012) The occurrence of atrial fibrillation in former top-level handball players above the age of 50. Acta Cardiol 67:213–220PubMed
Zurück zum Zitat Wilhelm M, Roten L, Tanner H, Wilhelm I, Schmid JP, Saner H (2011) Atrial remodeling, autonomic tone and lifetime training hours in nonelite athletes. Am J Cardiol 108:580–585PubMedCrossRef Wilhelm M, Roten L, Tanner H, Wilhelm I, Schmid JP, Saner H (2011) Atrial remodeling, autonomic tone and lifetime training hours in nonelite athletes. Am J Cardiol 108:580–585PubMedCrossRef
Metadaten
Titel
Atrial functional and geometrical remodeling in highly trained male athletes: for better or worse?
verfasst von
Luigi Gabrielli
Bart H. Bijnens
Constantine Butakoff
Nicolas Duchateau
Silvia Montserrat
Beatriz Merino
Josep Gutierrez
Carles Paré
Lluis Mont
Josep Brugada
Marta Sitges
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Applied Physiology / Ausgabe 6/2014
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-014-2845-6

Weitere Artikel der Ausgabe 6/2014

European Journal of Applied Physiology 6/2014 Zur Ausgabe