The effect of exercise training on left ventricular function in young elite athletes

<p>Abstract</p> <p>Background</p> <p>Regular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters (strain, rotation and twist). Aim of study is to assess the role of rotation and twist parameters for better characterize the heart performance in trained elite young athletes from different kind of sports. Eventually, verify early on any possible impact due to the regular sport activity not revealed by the standard parameters.</p> <p>Methods</p> <p>50 young athletes (16 cyclists, 17 soccer players, 17 basket players) regularly trained at least three times a week for at least 9 months a year and 10 young controls (mean age 18.5 ± 0.5 years) were evaluated either by to 2D echocardiography or by a Speckle Tracking (ST) multi-layer approach to calculate Left Ventricle (LV) endocardial and epicardial rotation, twist, circumferential strain (CS) and longitudinal strain (LS). Data were compared by ANOVA test.</p> <p>Results</p> <p>All the found values were within the normal range. Left Ventricle Diastolic Diameter (LVDD 51.7 ± 2.6 mm), Cardiac Mass index (CMi 114.5 ± 18.5 g/m²), epi-CS, epi-LS, epicardial apex rotation and the Endo/Epi twist were significantly higher only in cyclists. In all the groups, a physiological difference of the Endo/Epi basal circumferential strain and twist values have been found. A weak but not significant relationship between the Endo and twist values and LVDD (r²= 0.44, p = .005) and CMi was also reported in cyclists.</p> <p>Conclusions</p> <p>Progressive increase of apical LV twist may represent an important component of myocardial remodelling. This aspect is particularly evident in the young cyclists group where the CMi and the LVDD are higher. ST multilayer approach completes the LV performance evaluation in young trained athletes showing values similar to adults.</p

Real-time evaluation of longitudinal peak systolic strain (speckle tracking measurement) in left and right ventricles of athletes

<p>Abstract</p> <p>Background</p> <p>Strain, and particularly Longitudinal Peak Systolic Strain (LPSS), plays a role in investigating the segmental and overall contractility of the heart which is a particularly interesting feature in athletes in whom regular training determines several morphological and functional modifications in both the ventricles, that normally work at different loads. Speckle tracking techniques assess the LPSS of LV and RV from B-mode imaging in real time, with uniform accuracy in all segments, and can verify the possible dissimilar segmental contributions of the two chambers to overall myocardial contraction. The aim of the study is to quantify the LPSS in real time in both the ventricles in order to estimate any possible different deformation properties in them during a systolic period.</p> <p>Methods</p> <p>32 subjects (20 athletes and 18 controls) were submitted to a standard echocardiographic examination at rest and after a Hand Grip (HG) stress. From a four-chamber-view image, the LPSS parameter was measured with Speckle Tracking analysis in the basal and medium-apical segments of the two ventricles, at rest and after HG.</p> <p>Results</p> <p>In both athletes and controls, LPSS values were significantly higher in the RV of athletes (RV LPSS ^{medium-apical}-23.87 ± 4.94; ^{basalfreewall}-25.04 ± 4.12 at rest) and controls (RV LPSS^{medium-apical}-25.21 ± 4.97; ^{basalfreewall}-28.69 ± 4.62 at rest) than in the LV of both (athletes LV LPSS ^{medium-apical}-18.14 ± 4.16; ^{basallateralwall}-16.05 ± 12.32; controls ^{medium-apical}-18.81 ± 2.64; ^{basallateralwall}-19.74 ± 3.84) With the HG test a significant enhancement of the LPSS(with P < .05) in the medium-apical segments of LV and RV was evident, but only in athletes; there was no modification of the standard echo-parameters in either group.</p> <p>Conclusion</p> <p>ST analysis is an easy method for investigating the contractility of the RV through deformation parameters, showing greater involvement of the RV than LV at rest. In athletes only, after isometric stress the two ventricles show particular myocardial deformation properties of the regions around the apex where the curvature of the wall is more marked. The clinical application of this new approach in athletes and normal subjects requires further investigation.</p

“New Alien Mediterranean Biodiversity Records” (March 2021)

This article includes twenty (20) new records of alien and cryptogenic species in the Mediterranean Sea, belonging to six (6) Phyla (Rhodophyta, Tracheophyta, Mollusca, Arthropoda, Bryozoa, and Chordata) distributed from the Eastern Mediterranean to the Sea of Alboran. The records are reported from nine (9) countries and can be classified into two categories: new records for the Mediterranean Sea and new records of non-indigenous species expanding within the Mediterranean Sea. The first category includes the gastropod Turbo radiatus from Lebanon coasts, the portunid crab Charybdis (Charybdis) natator from Tunis southern lagoon, the mollusc Thuridilla mazda from South Spain, and the nudibranch Okenia picoensis from the Alboran coasts of Spain and from Malta. The second category includes the bivalve Nudiscintilla cf. glabra from the Aegean coast of Turkey, the rhodophyte Colaconema codicola from the North Aegean coasts of Greece, the naked band gaper Champsodon nudivittis from the Sea of Marmara, Turkey. Also, the brachyuran Gonioinfradens giardi from the Greek Ionian waters, the codlet Bregmaceros nectabanus from the Croatian coasts of the Adriatic Sea, and the bryozoan Arbopercula tenella and copepod Parvocalanus crassirostris both from the Gulf of Trieste, Slovenian and Italian coasts, respectively. New records were also reported for the ascidian Distaplia bermudensis from brackish the Gulf of Naples, Italy, the damselfish Abudefduf cf. saxatilis and the seagrass Halophila stipulacea from Sardinia, Tyrrhenian Sea, and for the fish Paranthias furcifer from the harbour of Almeria, Alboran Sea, Spain. Through these records, an understanding of the expanding mechanisms and processes and, if possible, the development of mitigation measures within the region will be further facilitated

Tissue Doppler Imaging can be useful to distinguish pathological from physiological left ventricular hypertrophy: a study in master athletes and mild hypertensive subjects

<p>Abstract</p> <p>Background</p> <p>Transthoracic echocardiography left ventricular wall thickness is often increased in master athletes and it results by intense physical training. Left Ventricular Hypertrophy can also be due to a constant pressure overload. Conventional Pulsed Wave (PW) Doppler analysis of diastolic function sometimes fails to distinguish physiological from pathological LVH.</p> <p>The aim of this study is to evaluate the role of Pulsed Wave Tissue Doppler Imaging in differentiating pathological from physiological LVH in the middle-aged population.</p> <p>Methods</p> <p>we selected a group of 80 master athletes, a group of 80 sedentary subjects with essential hypertension and an apparent normal diastolic function at standard PW Doppler analysis. The two groups were comparable for increased left ventricular wall thickness and mass index (134.4 ± 19.7 vs 134.5 ± 22.1 gr/m2; p > .05). Diastolic function indexes using the PW technique were in the normal range for both.</p> <p>Results</p> <p>Pulsed Wave TDI study of diastolic function immediately distinguished the two groups. While in master athletes the diastolic TDI-derived parameters remained within normal range (E' 9.4 ± 3.1 cm/sec; E/E' 7.8 ± 2.1), in the hypertensive group these parameters were found to be constantly altered, with mean values and variation ranges always outside normal validated limits (E' 7.2 ± 2.4 cm/sec; E/E' 10.6 ± 3.2), and with E' and E/E' statistically different in the two groups (p < .001).</p> <p>Conclusion</p> <p>Our study showed that the TDI technique can be an easy and validated method to assess diastolic function in differentiating normal from pseudonormal diastolic patterns and it can distinguish physiological from pathological LVH emphasizing the eligibility certification required by legal medical legislation as in Italy.</p