Supernormal functional reserve of apical segments in elite soccer players: an ultrasound speckle tracking handgrip stress study

<p>Abstract</p> <p>Background</p> <p>Ultrasound speckle tracking from grey scale images allows the assessment of regional strain derived from 2D regardless of angle intonation, and it is highly reproducible. The study aimed to evaluate regional left ventricular functional reserve in elite soccer players.</p> <p>Methods</p> <p>50 subjects (25 elite athletes and 25 sedentary controls), aged 26 ± 3.5, were submitted to an echo exam, at rest and after the Hand Grip (HG) test. Both standard echo parameters and strain were evaluated.</p> <p>Results</p> <p>Ejection fraction was similar in athletes and controls both at rest (athletes 58 ± 2 vs controls 57 ± 4 p ns) and after HG (athletes 60 ± 2 vs controls 58 ± 3 p ns). Basal (septal and anterior) segments showed similar strain values in athletes and controls both at rest (athletes S% -19.9 ± 4.2; controls S% -18.8 ± 4.9 p = ns) and after HG (athletes S% -20.99 ± 2.8; controls S% -19.46 ± 4.4 p = ns). Medium-apical segments showed similar strain values at rest (athletes S% -17.31 ± 2.3; controls S% -20.00 ± 5.3 p = ns), but higher values in athletes after HG (athletes S% -24.47 ± 2.8; controls S% -20.47 ± 5.4 p < 0.05)</p> <p>Conclusion</p> <p>In athletes with physiological myocardial hypertrophy, a brief isometric effort produces enhancement of the strain in medium-apical left ventricular segments, suggesting the presence of a higher regional function reserve which can be elicited with an inotropic challenge and suitable methods of radial function quantification such as 2D-derived strain.</p

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

Strain values show a slight but not significant increase from basal to apical segments in both situations

<p><b>Copyright information:</b></p><p>Taken from "Supernormal functional reserve of apical segments in elite soccer players: an ultrasound speckle tracking handgrip stress study"</p><p>http://www.cardiovascularultrasound.com/content/6/1/14</p><p>Cardiovascular Ultrasound 2008;6():14-14.</p><p>Published online 16 Apr 2008</p><p>PMCID:PMC2329600.</p><p></p

The endocardial border of the 2D left ventricular chamber is automatically followed in time frame by frame

There is no obvious differences in strain in basal and apical segments at rest, but a significant increase after HG.<p><b>Copyright information:</b></p><p>Taken from "Supernormal functional reserve of apical segments in elite soccer players: an ultrasound speckle tracking handgrip stress study"</p><p>http://www.cardiovascularultrasound.com/content/6/1/14</p><p>Cardiovascular Ultrasound 2008;6():14-14.</p><p>Published online 16 Apr 2008</p><p>PMCID:PMC2329600.</p><p></p