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Erschienen in: European Journal of Applied Physiology 8/2015

01.08.2015 | Original Article

Training-induced dynamic changes in left atrial reservoir, conduit, and active volumes in professional soccer players

Erschienen in: European Journal of Applied Physiology | Ausgabe 8/2015

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Abstract

Purpose

Although left atrial (LA) enlargement is a recognized component of athlete’s heart, dynamic cavity changes occurring during the training period remain to be elucidated. We aimed to investigate the adaptive changes of LA reservoir, conduit, and active volumes in elite athletes vs. controls and their response to different training loads.

Methods

LA maximum, pre-P, and minimum volumes were assessed in 26 top-level athletes and 23 controls. In athletes, LA volumes were measured at pre-, mid-, end-training, and post-detraining time points using conventional 2D echocardiography.

Results

Athletes had larger maximum (27.5 ± 3.2 vs. 20.3 ± 5.8 mL/m2, p = 0.001), pre-P (11.5 ± 0.9 vs. 9.8 ± 2.2 mL/m2, p = 0.001), and minimum (6.6 ± 0.9 vs. 5.0 ± 1.2 mL/m2, p < 0.001) LA indexed volumes, compared with controls. Total and passive emptying volume indices were also larger in athletes compared with controls (18.7 ± 3.1 vs. 15.3 ± 4.9 mL/m2, p < 0.05 and 13.8 ± 2.9 vs. 10.5 ± 4.6 mL/m2, p < 0.05, respectively), while active emptying volume was similar (p = 0.74). During training, LA maximum (p < 0.0001), pre-P (p < 0.0001), minimum (p < 0.0001), total (p < 0.005), and passive (p < 0.05) emptying volume indices progressively increased, while active emptying volume (p = 0.10) and E/e′ ratio (p = 0.32) remained unchanged. After detraining, LA volume measurements were not different from pre-training ones. End-training left ventricular mass index was the only independent predictor of the respective maximum LA volume (β = 0.74, p < 0.005).

Conclusions

Top-level athletes exhibit a dynamic morphological and functional LA remodeling, induced by training, with an increase in reservoir and conduit volumes, but stable active volume. LA remodeling is closely associated with left ventricular adaptation to exercise and both completely regress after detraining.
Literatur
Zurück zum Zitat Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS (2006) Left atrial size: physiological determinants and clinical implications. J Am Coll Cardiol 47:2357–2363PubMedCrossRef Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS (2006) Left atrial size: physiological determinants and clinical implications. J Am Coll Cardiol 47:2357–2363PubMedCrossRef
Zurück zum Zitat Boyd AC, Ng AC, da Tran T, Chia EM, French JK, Leung DY, Thomas L (2010) Left atrial enlargement and phasic function in patients following non-ST elevation myocardial infarction. J Am Soc Echocardiogr 23:1251–1258PubMedCrossRef Boyd AC, Ng AC, da Tran T, Chia EM, French JK, Leung DY, Thomas L (2010) Left atrial enlargement and phasic function in patients following non-ST elevation myocardial infarction. J Am Soc Echocardiogr 23:1251–1258PubMedCrossRef
Zurück zum Zitat Braunwald E, Frahm C (1961) Studies on Starling’s law of the heart, IV: observations on the hemodynamic functions of the left atrium in man. Circulation 24:633–642CrossRef Braunwald E, Frahm C (1961) Studies on Starling’s law of the heart, IV: observations on the hemodynamic functions of the left atrium in man. Circulation 24:633–642CrossRef
Zurück zum Zitat Calvo N, Brugada J, Sitges M, Mont L (2012) Atrial fibrillation and atrial flutter in athletes. Br J Sports Med 46(Suppl 1):i37–i43PubMedCrossRef Calvo N, Brugada J, Sitges M, Mont L (2012) Atrial fibrillation and atrial flutter in athletes. Br J Sports Med 46(Suppl 1):i37–i43PubMedCrossRef
Zurück zum Zitat D’Andrea A, Riegler L, Cocchia R, Scarafile R, Salerno G, Gravino R, Golia E, Vriz O, Citro R, Limongelli G, Calabrò P, Di Salvo G, Caso P, Russo MG, Bossone E, Calabrò R (2010) Left atrial volume index in highly trained athletes. Am Heart J 159:1155–1161PubMedCrossRef D’Andrea A, Riegler L, Cocchia R, Scarafile R, Salerno G, Gravino R, Golia E, Vriz O, Citro R, Limongelli G, Calabrò P, Di Salvo G, Caso P, Russo MG, Bossone E, Calabrò R (2010) Left atrial volume index in highly trained athletes. Am Heart J 159:1155–1161PubMedCrossRef
Zurück zum Zitat D’Ascenzi F, Cameli M, Zacà V, Lisi M, Santoro A, Causarano A, Mondillo S (2011) Supernormal diastolic function and role of left atrial myocardial deformation analysis by 2D speckle tracking echocardiography in elite soccer players. Echocardiography 28:320–326PubMedCrossRef D’Ascenzi F, Cameli M, Zacà V, Lisi M, Santoro A, Causarano A, Mondillo S (2011) Supernormal diastolic function and role of left atrial myocardial deformation analysis by 2D speckle tracking echocardiography in elite soccer players. Echocardiography 28:320–326PubMedCrossRef
Zurück zum Zitat D’Ascenzi F, Cameli M, Lisi M, Zacà V, Natali B, Malandrino A, Benincasa S, Catanese S, Causarano A, Mondillo S (2012) Left atrial remodelling in competitive adolescent soccer players. Int J Sports Med 33:795–801PubMedCrossRef D’Ascenzi F, Cameli M, Lisi M, Zacà V, Natali B, Malandrino A, Benincasa S, Catanese S, Causarano A, Mondillo S (2012) Left atrial remodelling in competitive adolescent soccer players. Int J Sports Med 33:795–801PubMedCrossRef
Zurück zum Zitat D’Ascenzi F, Pelliccia A, Natali BM, Cameli M, Andrei V, Incampo E, Alvino F, Lisi M, Padeletti M, Focardi M, Bonifazi M, Mondillo S (2015) Increased left atrial size is associated with reduced atrial stiffness and preserved reservoir function in athlete’s heart. Int J Cardiovasc Imaging (Epub ahead of print) D’Ascenzi F, Pelliccia A, Natali BM, Cameli M, Andrei V, Incampo E, Alvino F, Lisi M, Padeletti M, Focardi M, Bonifazi M, Mondillo S (2015) Increased left atrial size is associated with reduced atrial stiffness and preserved reservoir function in athlete’s heart. Int J Cardiovasc Imaging (Epub ahead of print)
Zurück zum Zitat D’Ascenzi F, Cameli M, Padeletti M, Lisi M, Zacà V, Natali B, Malandrino A, Alvino F, Morelli M, Vassallo GM, Meniconi C, Bonifazi M, Causarano A, Mondillo S (2013) Characterization of right atrial function and dimension in top-level athletes: a speckle tracking study. Int J Cardiovasc Imaging 29:87–94PubMedCrossRef D’Ascenzi F, Cameli M, Padeletti M, Lisi M, Zacà V, Natali B, Malandrino A, Alvino F, Morelli M, Vassallo GM, Meniconi C, Bonifazi M, Causarano A, Mondillo S (2013) Characterization of right atrial function and dimension in top-level athletes: a speckle tracking study. Int J Cardiovasc Imaging 29:87–94PubMedCrossRef
Zurück zum Zitat Du Bois D, Du Bois EF (1916) A formula to estimate the approximate body surface area if height and weight be known. Arch Intern Med 17:863–871CrossRef Du Bois D, Du Bois EF (1916) A formula to estimate the approximate body surface area if height and weight be known. Arch Intern Med 17:863–871CrossRef
Zurück zum Zitat Erol MK, Yilmaz M, Acikel M, Karakelleoglu S (2002) Left atrial mechanical function in patients with essential hypertension. Acta Cardiol 57:323–327PubMedCrossRef Erol MK, Yilmaz M, Acikel M, Karakelleoglu S (2002) Left atrial mechanical function in patients with essential hypertension. Acta Cardiol 57:323–327PubMedCrossRef
Zurück zum Zitat Eshoo S, Ross DL, Thomas L (2009) Impact of mild hypertension on left atrial size and function. Circ Cardiovasc Imaging 2:93–99PubMedCrossRef Eshoo S, Ross DL, Thomas L (2009) Impact of mild hypertension on left atrial size and function. Circ Cardiovasc Imaging 2:93–99PubMedCrossRef
Zurück zum Zitat Eshoo S, Semsarian C, Ross DL, Thomas L (2010) Left atrial phasic volumes are modulated by the type rather than the extent of left ventricular hypertrophy. J Am Soc Echocardiogr 23:538–544PubMedCrossRef Eshoo S, Semsarian C, Ross DL, Thomas L (2010) Left atrial phasic volumes are modulated by the type rather than the extent of left ventricular hypertrophy. J Am Soc Echocardiogr 23:538–544PubMedCrossRef
Zurück zum Zitat Inama G, Pedrinazzi C, Durin O, Inama L, Furlanello F (2010) Atrial fibrillation and flutter in athletes. G Ital Cardiol (Rome) 11:102S–106S Inama G, Pedrinazzi C, Durin O, Inama L, Furlanello F (2010) Atrial fibrillation and flutter in athletes. G Ital Cardiol (Rome) 11:102S–106S
Zurück zum Zitat Jarvinen V, Kupari M, Hekali P, Poutanen VP (1994) Assessment of left atrial volumes and phasic function using cine magnetic resonance imaging in normal subjects. Am J Cardiol 73:1135–1138PubMedCrossRef Jarvinen V, Kupari M, Hekali P, Poutanen VP (1994) Assessment of left atrial volumes and phasic function using cine magnetic resonance imaging in normal subjects. Am J Cardiol 73:1135–1138PubMedCrossRef
Zurück zum Zitat Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, Hoffmann W, Poller W, Schultheiss HP, Pauschinger M, Tschöpe C (2007) Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 116:637–647PubMedCrossRef Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, Hoffmann W, Poller W, Schultheiss HP, Pauschinger M, Tschöpe C (2007) Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 116:637–647PubMedCrossRef
Zurück zum Zitat Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108PubMedCrossRef Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108PubMedCrossRef
Zurück zum Zitat Leung DY, Boyd A, Ng AA, Chi C, Thomas L (2008) Echocaridographic evaluation of left atrial size and function: current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J 158:836–844 Leung DY, Boyd A, Ng AA, Chi C, Thomas L (2008) Echocaridographic evaluation of left atrial size and function: current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J 158:836–844
Zurück zum Zitat Mascia G, Perrotta L, Galanti G, Padeletti L (2013) Atrial fibrillation in athletes. Int J Sports Med 34:379–384PubMed Mascia G, Perrotta L, Galanti G, Padeletti L (2013) Atrial fibrillation in athletes. Int J Sports Med 34:379–384PubMed
Zurück zum Zitat Mujika I, Padilla S (2000) Detraining: loss of training-induced physiological and performance adaptations. Part I: short term insufficient training stimulus. Sports Med 30:79–87PubMedCrossRef Mujika I, Padilla S (2000) Detraining: loss of training-induced physiological and performance adaptations. Part I: short term insufficient training stimulus. Sports Med 30:79–87PubMedCrossRef
Zurück zum Zitat Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations of evalutation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193PubMedCrossRef Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations of evalutation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193PubMedCrossRef
Zurück zum Zitat Nikitin NP, Witte KKA, Thackray SDR, Goodge LJ, Clark AL, Cleland JGF (2003) Effect of age and sex on left atrial morphology and function. Eur J Echocardiogr 4:36–42PubMedCrossRef Nikitin NP, Witte KKA, Thackray SDR, Goodge LJ, Clark AL, Cleland JGF (2003) Effect of age and sex on left atrial morphology and function. Eur J Echocardiogr 4:36–42PubMedCrossRef
Zurück zum Zitat Ofman P, Khawaja O, Rahilly-Tierney CR, Peralta A, Hoffmeister P, Reynolds MR, Gaziano JM, Djousse L (2013) Regular physical activity and risk of atrial fibrillation: a systematic review and meta-analysis. Circ Arrhythm Electrophysiol 6:252–256PubMedCrossRef Ofman P, Khawaja O, Rahilly-Tierney CR, Peralta A, Hoffmeister P, Reynolds MR, Gaziano JM, Djousse L (2013) Regular physical activity and risk of atrial fibrillation: a systematic review and meta-analysis. Circ Arrhythm Electrophysiol 6:252–256PubMedCrossRef
Zurück zum Zitat Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfiled MM, Tajik AJ (2000) Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 102:1788–1794PubMedCrossRef Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfiled MM, Tajik AJ (2000) Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 102:1788–1794PubMedCrossRef
Zurück zum Zitat Pelliccia A, Maron BJ, Di Paolo FM, Biffi A, Quattrini FM, Pisicchio C, Roselli A, Caselli S, Culasso F (2005) Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol 46:690–696PubMedCrossRef Pelliccia A, Maron BJ, Di Paolo FM, Biffi A, Quattrini FM, Pisicchio C, Roselli A, Caselli S, Culasso F (2005) Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol 46:690–696PubMedCrossRef
Zurück zum Zitat Pelouch V, Milerová M, Ostádal B, Hucín B, Samánek M (1995) Differences between atrial and ventricular protein profiling in children with congenital heart disease. Mol Cell Biochem 147:43–49PubMedCrossRef Pelouch V, Milerová M, Ostádal B, Hucín B, Samánek M (1995) Differences between atrial and ventricular protein profiling in children with congenital heart disease. Mol Cell Biochem 147:43–49PubMedCrossRef
Zurück zum Zitat 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 101:336–344PubMedCrossRef 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 101:336–344PubMedCrossRef
Zurück zum Zitat Prioli A, Marino P, Lanzoni L, Zardini P (1998) Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol 82:756–761PubMedCrossRef Prioli A, Marino P, Lanzoni L, Zardini P (1998) Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol 82:756–761PubMedCrossRef
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines of the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713PubMedCrossRef Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines of the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713PubMedCrossRef
Zurück zum Zitat Spencer KT, Mor-Avi V, Gorcsan J 3rd, DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K, Kwan OL, Glascock B, Hancock J, Baumann C, Lang RM (2001) Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart 85:272–277PubMedCentralPubMedCrossRef Spencer KT, Mor-Avi V, Gorcsan J 3rd, DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K, Kwan OL, Glascock B, Hancock J, Baumann C, Lang RM (2001) Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart 85:272–277PubMedCentralPubMedCrossRef
Zurück zum Zitat Thomas L, Levett K, Boyd A, Leung DY, Schiller NB, Ross DL (2002) Compensatory changes in atrial volumes with normal aging: is atrial enlargement inevitable? J Am Coll Cardiol 40:1630–1635PubMedCrossRef Thomas L, Levett K, Boyd A, Leung DY, Schiller NB, Ross DL (2002) Compensatory changes in atrial volumes with normal aging: is atrial enlargement inevitable? J Am Coll Cardiol 40:1630–1635PubMedCrossRef
Zurück zum Zitat Tükek T, Akkaya V, Atilgan D, Demirel E, Ozcan M, Güven O, Korkut F (2001) Effect of left atrial size and function on P-wave dispersion: a study in patients with paroxysmal atrial fibrillation. Clin Cardiol 24:676–680PubMedCrossRef Tükek T, Akkaya V, Atilgan D, Demirel E, Ozcan M, Güven O, Korkut F (2001) Effect of left atrial size and function on P-wave dispersion: a study in patients with paroxysmal atrial fibrillation. Clin Cardiol 24:676–680PubMedCrossRef
Zurück zum Zitat Utomi V, Oxborough D, Whyte GP, Somauroo J, Sharma S, Shave R, Atkinson G, George K (2013) Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete’s heart. Heart 99:1727–1733PubMedCrossRef Utomi V, Oxborough D, Whyte GP, Somauroo J, Sharma S, Shave R, Atkinson G, George K (2013) Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete’s heart. Heart 99:1727–1733PubMedCrossRef
Zurück zum Zitat Yu CM, Sanderson JE, Marwick OhJK (2007) Tissue Doppler imaging a new prognosticator for cardiovascular disease. J Am Coll Cardiol 49:1903–1914PubMedCrossRef Yu CM, Sanderson JE, Marwick OhJK (2007) Tissue Doppler imaging a new prognosticator for cardiovascular disease. J Am Coll Cardiol 49:1903–1914PubMedCrossRef
Metadaten
Titel
Training-induced dynamic changes in left atrial reservoir, conduit, and active volumes in professional soccer players
Publikationsdatum
01.08.2015
Erschienen in
European Journal of Applied Physiology / Ausgabe 8/2015
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-015-3151-7

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