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Updated: Apr 26, 2026
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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
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3D Strain helps relating LV function to LV and structure in athletes.
Laura Stefani1, Alessio De Luca, Loira Toncelli
1Sport Medicine Center, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. laura.stefani@unifi.it.
Cardiovascular Ultrasound
|August 13, 2014
Summary
Three-dimensional (3D) strain analysis reveals enhanced cardiac performance in athletes, particularly in those with bicuspid aortic valve (BAV). This advanced technique highlights how physical activity improves left ventricular (LV) function through synchronized helical fiber recruitment.
Area of Science:
- Cardiology
- Biomedical Engineering
- Sports Medicine
Background:
- Cardiac contraction evaluation can be improved by considering the helical structure of cardiac fibers.
- Athletes, whether healthy or with conditions like Bicuspid Aortic Valve (BAV), present a unique model for studying cardiac function.
- 3D strain analysis offers a novel approach to understand left ventricular (LV) function modifications due to physical activity.
Purpose of the Study:
- To explore the role of 3D strain analysis in understanding LV function in healthy athletes and those with BAV.
- To compare cardiac function using 3D strain analysis across healthy individuals, athletes, and athletes with BAV.
- To investigate how physical activity influences cardiac mechanics and LV function.
Main Methods:
- Prospective enrollment of three age-matched groups: healthy subjects (n=15), healthy athletes (n=15), and athletes with BAV (n=20).
- All participants underwent echocardiographic examination, including 2D and 3D strain analysis.
- 3D strain analysis was extended to include principal strain (PS) and secondary strain (SS) measurements.
Main Results:
- While standard echo parameters and global 2D/3D longitudinal and circumferential strain were similar across groups, 3D analysis revealed significant differences.
- Global secondary strain (SS) was significantly higher in athletes and showed a modified time course compared to healthy subjects.
- Comparative analysis of strain patterns suggested that enhanced LV function in athletes involves more synchronous recruitment of left- and right-handed helical fibers.
Conclusions:
- 3D strain analysis provides deeper physiological insights into LV contraction in various athlete populations.
- Secondary strain, a metric unique to 3D analysis, indicates performance enhancement in athletes due to physical activity.
- The improved cardiac performance appears to result from the synergistic activation of endocardial and epicardial fibers.
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