Left atrial geometric and functional remodeling in athletes.

The aim of this study was to evaluate left atrial (LA) volume and its changes with the phases of atrial filling, and to examine the effect of exercise capacity on these parameters. Using two-dimensional echocardiography, LA volumes were measured in 30 male endurance runners and 30 age-matched sedentary men (controls). Maximal oxygen consumption (VO2max) was measured using a metabolic chart during exercise. LA reservoir, pump, and conduit functions, kinetic energy and force were calculated. We found that athletes had higher LA volume and volume index (except the conduit volume), LA passive emptying fraction, and LA total emptying fraction compared to control subjects. We observed positive correlations between: VO2max and LA passive emptying fraction (r=0.49, p<0.05); VO2max and LA active emptying fraction (r=0.54, p<0.05); VO2max and LA kinetic energy (r=0.61, p<0.05); and VO2max and LA force (r=0.57, p<0.05). These findings suggest that atrial function reflects exercise capacity in athletes.

Aortic distensibility and left ventricular diastolic functions in endurance athletes.

Aortic elastic properties are important determinants of left ventricular function. The aim of this study was to determine left ventricular diastolic function and aortic distensibility in endurance athletes. Thirty male runners and thirty age-matched healthy male controls took part in the study. All subjects underwent echocardiographic examination and cardiopulmonary exercise testing. Measurements included LV cavity dimension, standard and tissue Doppler parameters, and aortic diameter, 3 cm above aortic valve, at systole and diastole. Maximal oxygen uptake in athletes was higher than in controls. The aortic distensibility index was found to be higher in athletes compared with controls (5.37 +/- 1.50 vs. 3.37 +/- 1.48 cm (2) . dynes (-1) . 10 (-6), p < 0.001). While the aortic stiffness index in athletes was significantly lower than in controls (2.77 +/- 0.28 vs. 3.43 +/- 0.41, p < 0.001). Furthermore, transmitral early peak velocity (E) and late peak velocity (A), peak velocity of myocardial systolic wave (S (m)), early (E (m)) and atrial (A (m)) diastolic waves in athletes were higher than in controls. It seemed that the association of E (m) velocity with aortic distensibility was stronger than that of other LV parameters (coefficient = 0.74, p < 0.001) by using multiple linear regression. Increased aortic distensibility in endurance-trained athletes may cause better diastolic function as a physiological cardiovascular adaptation factor.

Qt dispersion in soccer players during exercise testing.

Screening for cardiac health should involve relevant parameters or indices that are easy and inexpensive to obtain. Various cardiac adaptation mechanisms develop during regular exercise that are affected by many factors, and these are reflected on a surface electrocardiogram. QT dispersion has been considered a surrogate for heterogeneity of repolarization, leading to ventricular arrhythmias. We compared QT parameters between athletes and sedentary subjects. A total of 225 men were assessed, comprising a group of professional soccer players and sedentaries. Each subject underwent supine 12-lead electrocardiographic examinations and exercise testing by ergospirometry. QT parameters were taken at rest and at peak exercise. Peak oxygen consumption was considerably higher in the athletes than in the controls (59.3 +/- 5.6 vs. 44.3 +/- 2.4 ml/kg/min, mean +/- SD, p < 0.001). QT parameters at rest: There were significant differences in heart-rate-corrected rest maximal QT duration (413.9 +/- 50.5 vs. 445.3 +/- 45.7 ms, p < 0.001) and in heart-rate-corrected rest minimum QT duration (380.5 +/- 51.2 vs. 409.5 +/- 46.7 ms, p < 0.001). QT parameters at peak exercise: maximal QT duration at peak exercise (253.9 +/- 20.8 vs. 261.7 +/- 26.2, p = 0.02), QT dispersion at peak exercise (25.2 +/- 9.1 vs. 29.5 +/- 15.8 ms, p = 0.04), heart-rate-corrected QT dispersion at peak exercise (44.6 +/- 16.4 vs. 52.6 +/- 28.3 ms, p = 0.03) differed significantly between professional soccer players and controls. QT dispersion and corrected QT dispersion at peak exercise are lower in athletes than in controls. Athletes and other subjects identified with a long QT interval should be examined at regular intervals.

[The evaluation of the severity of mitral regurgitation using color Doppler echocardiographic methods]. / Renkli Doppler ekokardiyografi yöntemleri ile mitral yetersizligi ciddiyetinin degerlendirilmesi.

OBJECTIVE: This study was planned to assess the vena contracta (VC), flow convergence area (PISA) and jet area (JA) methods in evaluating the severity of mitral regurgitation (MR) and to test the accuracy of a proposed algorithm using these methods. METHODS: Eighty-seven patients with chronic MR were enrolled in the study. VC of < 0.3 cm, maximal MR flow rate calculated by PISA (Qmax) of < 72 cm3/sn and JA of < 4 cm2 were classified as mild MR. VC of > 0.5 cm, Qmax of > 240 cm3/sn and JA of > 8 cm2 were classified as severe MR. Whereas the values between these ranges were called to be moderate MR. The algorithm was planned as follows: In the first step, VC width was measured. If a patient has VC = 0.3-0.5 cm, it was used Qmax in the eccentric jets and JA in the central jets in the second step. The severity of MR were considered as severe, moderate and mild for > 50%, 21-49% and 20% of the regurgitant fraction calculated by the reference method (the quantitative Doppler method depending on aortic and mitral stroke volumes), respectively. RESULTS: The sensitivity of VC was low in differentiating between moderate and severe MR (63%). In eccentric jets, the regurgitant volume calculated by PISA was higher than that of reference method (70 +/- 49 vs. 59 +/- 29 cm3) and the JA was found to be less than that of central jets despite similar regurgitant fraction (6.8 +/- 3.2 vs. 8.5 +/- 3.3 cm2). The algorithm agreed well with the reference method and it was better than those of each tree methods (Cappa coefficients 0.89 vs. 0.65, 0.63 and 0.45 for VC, Qmax and JA; respectively). The accuracies of the algorithm in discriminating between mild and moderate MR or severe and non-severe MR were high (98% and 95%, respectively). CONCLUSIONS: The severity of MR can be determined accurately and simply by using VC, PISA and JA methods together.