Atrial Size and Function in Athletes.

Area of Science:

• Cardiology
• Sports Medicine
• Cardiac Imaging

Background:

• Elite athletes often exhibit cardiac remodeling, including atrial enlargement.
• The functional implications of significant left atrial (LA) size variations in athletes are not fully understood.
• Atrioventricular valve regurgitation is a potential concern in athletes with cardiac adaptations.

Purpose of the Study:

• To investigate the relationship between changes in left atrial (LA) size and LA function in elite football players.
• To determine if increased LA size correlates with a higher incidence of atrioventricular valve regurgitation.
• To compare LA function and valve regurgitation between elite athletes and non-athletic controls.

Main Methods:

• Echocardiography was used to measure cardiac chamber dimensions, including end-systolic LA volume and end-diastolic LV volume.
• Pulsed and color Doppler assessed the severity of tricuspid and mitral regurgitation.
• Two-dimensional (2D) longitudinal strain analysis was performed on athletes with the largest and smallest LA volumes.

Main Results:

• Significant variations in LA volume were observed among athletes, with some tripling in size compared to others.
• Despite large variations in LA size, 2D strain analysis did not reveal impaired LA function in athletes with larger atria.
• Tricuspid regurgitation was significantly more prevalent in football players (58%) than controls (36%), while mitral regurgitation showed no significant difference.
• Athletes with tricuspid regurgitation had significantly larger right atrial (RA) areas.

Conclusions:

• Elite football players exhibit substantial variability in atrial size, but this does not compromise left atrial (LA) function.
• Tricuspid regurgitation is a common finding in elite football players and is associated with larger right atrial (RA) areas.
• The study highlights the need for further investigation into the mechanisms and clinical significance of tricuspid regurgitation in athletes.