Assessment of the left ventricular chamber stiffness in athletes

Area of Science:

• Cardiology
• Sports Medicine
• Physiology

Background:

• Diastolic dysfunction is an early indicator of heart disease.
• The chamber stiffness index (E/e')/LVDd was hypothesized to differentiate physiological from pathological left ventricular hypertrophy in athletes.
• Previous research suggested this index is reduced in athletes, but this remained unconfirmed across all athletic populations.

Purpose of the Study:

• To investigate cardiac diastolic function in elite athletes compared to sedentary individuals.
• To evaluate the utility of the standard chamber stiffness index (E/e')/LVDd and novel indices in assessing adaptive cardiac changes in athletes.
• To determine if these indices can distinguish between physiological and pathological cardiac hypertrophy.

Main Methods:

• Standard and tissue Doppler echocardiography were used to assess cardiac parameters at rest in elite male wrestlers, water polo players, and sedentary controls.
• Novel indices including (E/e')/LVV and (E/e')/RVe'lat were calculated.
• Maximal treadmill exercise testing was performed to measure functional capacity (VO2 max).

Main Results:

• Athletes exhibited higher VO2 max, left ventricular dimensions (LVDd, LVV), and left ventricular mass indexed to body size (LVM/BH(2.7)).
• The standard (E/e'lat)/LVDd index did not differ significantly between athletes and controls.
• A novel index, (E/e's)/RVe'lat, effectively distinguished between the athletic groups and controls and was the sole predictor of VO2 max.

Conclusions:

• Intensive athletic training does not consistently reduce the (E/e'lat)/LVDd index.
• The novel index (E/e's)/RVe'lat shows promise for detecting adaptive diastolic changes in athletes and warrants further investigation.
• This new index may be a valuable tool for differentiating training-induced adaptations from pathological conditions.