Left ventricular myocardial velocities and deformation indexes in top-level athletes

J Am Soc Echocardiogr. 2010 Dec;23(12):1281-8. doi: 10.1016/j.echo.2010.09.020.


Background: The aim of this study was to define the range of left ventricular (LV) velocities and deformation indexes in highly trained athletes, analyzing potential differences induced by different long-term training protocols.

Methods: Standard echocardiography, pulsed-wave tissue Doppler echocardiography, and two-dimensional strain echocardiography of the interventricular septum and lateral wall were performed in 370 endurance athletes and 280 power athletes. Using pulsed-wave tissue Doppler, the following parameters of myocardial function were assessed: systolic peak velocities (S(m)), early (E(m)) and late (A(m)) diastolic velocities, and the E(m)/A(m) ratio. By two-dimensional strain echocardiography, peaks of regional systolic strain and LV global longitudinal strain were calculated.

Results: LV mass index and ejection fraction did not significantly differ between the two groups. However, power athletes showed an increased sum of wall thicknesses (P < .01) and relative wall thickness, while LV stroke volume and LV end-diastolic diameter (P < .001) were greater in endurance athletes. By pulsed-wave tissue Doppler analysis, E(m) and E(m)/A(m) at both the septal and lateral wall levels were higher in endurance athletes. By two-dimensional strain echocardiography, myocardial deformation indexes were comparable between the two groups. E(m)/A(m) ratios ≥ 1 were found in the overall population, while 90 % of athletes had an E(m) ≥ 16 cm/sec, S(m) ≥ 10 cm/sec, and global longitudinal strain ≤ -16%. Multivariate analyses evidenced independent positive association between Em peak velocity and LV end-diastolic volume (P < .001) and an independent correlation of global longitudinal strain with the sum of LV wall thicknesses (P < .005).

Conclusions: This study describes the full spectrum of systolic and diastolic myocardial velocities and deformation indexes in a large population of competitive athletes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Athletes*
  • Biomechanical Phenomena
  • Blood Pressure / physiology
  • Diastole / physiology
  • Echocardiography / methods*
  • Echocardiography, Doppler, Pulsed*
  • Exercise / physiology
  • Heart Rate / physiology
  • Heart Septum / physiology
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / physiopathology
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Multivariate Analysis
  • Myocardial Contraction / physiology*
  • Physical Endurance / physiology
  • Physical Fitness / physiology*
  • Reference Values
  • Resistance Training
  • Software*
  • Stroke Volume / physiology
  • Systole / physiology
  • Ventricular Function, Left / physiology*
  • Young Adult