Francois Simard1,2, María Sanz-de la Garza3,4, Antonia Vaquer-Seguí3,5, Isabel Blanco3,6,4, Felip Burgos6, Xavier Alsina6, Susanna Prat-González3, Marta Sitges3,4. 1. Hospital Clinic, Cardiovascular Institute, Barcelona, Spain. francois.simard.med@ssss.gouv.qc.ca. 2. Montreal Heart Institute, Université de Montréal, Belanger Street, Montreal, QC, 5000, Canada. francois.simard.med@ssss.gouv.qc.ca. 3. Hospital Clinic, Cardiovascular Institute, Barcelona, Spain. 4. Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Barcelona, Spain. 5. Hospital San Juan de La Cruz, Úbeda, Jaén, Spain. 6. Pulmonary Medicine Department, Hospital Clinic, Barcelona, Spain.
Abstract
PURPOSE: Athlete's heart encompasses multiple physiological cardiac adaptations, although less is known at atrial level. How sex may influence the type and extent of atrial adaptations to exercise stimuli is also unknown. Our objective was to compare gender differences of echocardiographic atrial function indices in response to exercise in endurance athletes (EAs). METHODS: Highly trained (> 10 h/week) endurance athletes performed a maximal cardiopulmonary exercise test (CPET). Echocardiographic evaluation was performed at rest and immediately after exercise. Atria analysis consisted of standard and speckle-tracking echocardiographic assessment of atrial dimensions and contractile, reservoir, and conduit functions with myocardial deformation. RESULTS: 80 EAs (55% women) were enrolled and performed excellent CPET (129.6% of predicted VO2 maximal consumption). At rest, left atrial (LA) volumes and strain were similar between men and women. Women had lower right atrial (RA) volumes (26.7 vs 32.9 ml/m2, p < 0.001) and higher reservoir and conduit strain absolute values. After exercise, women exhibited a larger improvement in reservoir and conduit LA strain, and the same trend was observed for the RA. In EAs with LA dilatation on baseline (~ 50%), women persistently showed higher increase in reservoir and conduit strain profile with exercise compared to men. CONCLUSION: In highly trained EAs, women have similar or even lower atrial dimensions remodelling compared to men, but better function based on reservoir and conduit strain values both at rest and in response to exercise. This phenomenon should be confirmed in larger studies and its potential role in the development of supraventricular arrhythmias, addressed in a specifically designed protocol.
PURPOSE: Athlete's heart encompasses multiple physiological cardiac adaptations, although less is known at atrial level. How sex may influence the type and extent of atrial adaptations to exercise stimuli is also unknown. Our objective was to compare gender differences of echocardiographic atrial function indices in response to exercise in endurance athletes (EAs). METHODS: Highly trained (> 10 h/week) endurance athletes performed a maximal cardiopulmonary exercise test (CPET). Echocardiographic evaluation was performed at rest and immediately after exercise. Atria analysis consisted of standard and speckle-tracking echocardiographic assessment of atrial dimensions and contractile, reservoir, and conduit functions with myocardial deformation. RESULTS: 80 EAs (55% women) were enrolled and performed excellent CPET (129.6% of predicted VO2 maximal consumption). At rest, left atrial (LA) volumes and strain were similar between men and women. Women had lower right atrial (RA) volumes (26.7 vs 32.9 ml/m2, p < 0.001) and higher reservoir and conduit strain absolute values. After exercise, women exhibited a larger improvement in reservoir and conduit LA strain, and the same trend was observed for the RA. In EAs with LA dilatation on baseline (~ 50%), women persistently showed higher increase in reservoir and conduit strain profile with exercise compared to men. CONCLUSION: In highly trained EAs, women have similar or even lower atrial dimensions remodelling compared to men, but better function based on reservoir and conduit strain values both at rest and in response to exercise. This phenomenon should be confirmed in larger studies and its potential role in the development of supraventricular arrhythmias, addressed in a specifically designed protocol.
Authors: Aaron L Baggish; Francis Wang; Rory B Weiner; Jason M Elinoff; Francois Tournoux; Arthur Boland; Michael H Picard; Adolph M Hutter; Malissa J Wood Journal: J Appl Physiol (1985) Date: 2007-12-20
Authors: Barbara E Ainsworth; William L Haskell; Stephen D Herrmann; Nathanael Meckes; David R Bassett; Catrine Tudor-Locke; Jennifer L Greer; Jesse Vezina; Melicia C Whitt-Glover; Arthur S Leon Journal: Med Sci Sports Exerc Date: 2011-08 Impact factor: 5.411
Authors: Luigi P Badano; Theodore J Kolias; Denisa Muraru; Theodore P Abraham; Gerard Aurigemma; Thor Edvardsen; Jan D'Hooge; Erwan Donal; Alan G Fraser; Thomas Marwick; Luc Mertens; Bogdan A Popescu; Partho P Sengupta; Patrizio Lancellotti; James D Thomas; Jens-Uwe Voigt Journal: Eur Heart J Cardiovasc Imaging Date: 2018-06-01 Impact factor: 6.875