Left atrial geometric and functional remodeling in athletes

Area of Science:

• Cardiology
• Sports Physiology
• Echocardiography

Background:

• Left atrial (LA) size and function are crucial indicators of cardiovascular health.
• The impact of chronic endurance exercise on specific LA functional parameters remains an area of interest.

Purpose of the Study:

• To evaluate left atrial (LA) volume and its dynamic changes during atrial filling phases.
• To investigate the relationship between exercise capacity, specifically maximal oxygen consumption (VO2max), and LA functional parameters.

Main Methods:

• Two-dimensional echocardiography was used to measure LA volumes in male endurance runners and age-matched sedentary controls.
• Maximal oxygen consumption (VO2max) was determined via metabolic testing during exercise.
• Calculations included LA reservoir, pump, and conduit functions, kinetic energy, and force.

Main Results:

• Endurance athletes demonstrated significantly higher LA volume and volume index (excluding conduit volume) compared to controls.
• Athletes also showed increased LA passive emptying fraction and LA total emptying fraction.
• Significant positive correlations were observed between VO2max and LA passive emptying fraction, LA active emptying fraction, LA kinetic energy, and LA force.

Conclusions:

• Endurance training leads to favorable adaptations in left atrial (LA) volume and function.
• Atrial functional parameters, including emptying fractions and kinetic energy, are positively associated with exercise capacity (VO2max).
• Left atrial function serves as a potential physiological marker reflecting an individual's exercise capacity in athletes.