Echocardiographic evaluation of the athlete's heart: From morphological adaptations to myocardial function;Lo studio ecocardiografico del cuore d'atleta: Dagli adattamenti morfologici alla funzione miocardica

Giornale Italiano di Cardiologia

Volumn 10, Issue 8, 2009, Pages 533-544

  D'Andrea, Antonello ^a   Galderisi, Maurizio ^a   Sciomer, Susanna ^a   Nistri, Stefano ^a   Agricola, Eustachio ^a   Ballo, Piercarlo ^a   Buralli, Simona ^a   D'Errico, Arcangelo ^a   Losi, Maria Angela ^a   Mele, Donato ^a   Mondillo, Sergio ^a  

^a NONE

Author keywords

Athlete's heart; Doppler echocardiography; Hypertrophic cardiomyopathy; Left ventricular hypertrophy; Strain rate imaging; Tissue Doppler

Indexed keywords

ADAPTATION; ATHLETE; COLOR ULTRASOUND FLOWMETRY; DIAGNOSTIC IMAGING; DOPPLER ECHOCARDIOGRAPHY; ECHOCARDIOGRAPHY; EXERCISE; HEART FUNCTION; HEART LEFT VENTRICLE HYPERTROPHY; HEART VENTRICLE HYPERTROPHY; HEART VENTRICLE WALL; HUMAN; HYPERTENSION; HYPERTROPHIC CARDIOMYOPATHY; MEDICAL TECHNOLOGY; REVIEW; TISSUE DOPPLER IMAGING; TRAINING; TWO DIMENSIONAL ECHOCARDIOGRAPHY;

BLOOD FLOW VELOCITY; ECHOCARDIOGRAPHY; ECHOCARDIOGRAPHY, DOPPLER, COLOR; HEART; HEART FUNCTION TESTS; HUMANS; HYPERTROPHY, LEFT VENTRICULAR; MYOCARDIAL CONTRACTION; MYOCARDIUM; PREDICTIVE VALUE OF TESTS; SPORTS;

EID: 69149087332     PISSN: 18276806     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (82)

1. Zeppilli P. Adattamenti cardiocircolatori nelle diverse discipline sportive. In: Zeppilli P, ed. Cardiologia dello Sport. Roma: CESI, 2008: 41-83. Testo di riferimento nello studio del cuore d'atleta.
2. Rost R, Hollmann W. Athlete's heart. A review of its historical assessment and new aspects. Int J Sports Med 1983; 4: 147-155
3. Atchley AE Jr, Douglas PS. Left ventricular hypertrophy in athletes: morphologic features and clinical correlates. Cardiol Clin 2007; 25: 371-382
4. Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the "Morganroth hypothesis". Sports Med 2008; 38: 69-90.
5. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med 1975; 82: 521-4. Lavoro che diede origine all'ipotesi "bimodale" degli adattamenti cardiovascolari nel cuore d'atleta.
6. Maron BJ. Structural features of the athlete heart as defined by echocardiography. J Am Coll Cardiol 1986; 7: 190-203.
7. Zeppilli P, D'Andrea A, Gaddi O, Romano S, Penco M. L'ecocardiogramma nell'atleta. In: Zeppilli P, ed. Cardiologia dello Sport. Roma:CESI, 2008: 197-269.
8. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991; 324: 295-301.
9. Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol 1994;74: 802-806
10. Pelliccia A, Culasso F, Di Paolo FM, Maron BJ. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med 1999; 130: 23-31. (Pubitemid 29019445)
11. Fisman EZ, Embon P, Pines A, et al. Comparison of left ventricular function using isometric exercise Doppler echocardiography in competitive runners and weightlifters versus sedentary individuals. Am J Cardiol 1997; 79: 355-359 (Pubitemid 27093314)
12. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart. A meta-analysis of cardiac structure and function. Circulation 2000; 101: 336-344 Metanalisi degli adattamenti cardiovascolari nel cuore d'atleta valutati con ecocardiografia.
13. Delise P, Guiducci U, Zeppilli P, et al. Cardiological guidelines for competitive sports eligibility. Ital Heart J 2005; 6: 661-702. Protocolli cardiologici italiani sull'idoneità all'attività sportiva agonistica.
14. Isaaz K, Thompson A, Ethevenot G, Cloez JL, Brembilla B, Pernot C. Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall. Am J Cardiol 1989; 64: 66-75. (Pubitemid 19166211)
15. McDicken WN, Sutherland GR, Moran CM, Gordon LN. Colour Doppler velocity imaging of the myocardium. Ultrasound Med Biol 1992; 18: 651-654
16. Shan K, Bick RJ, Poindexter BJ, et al. Relation of tissue Doppler derived myocardial velocities to myocardial structure and beta-adrenergic receptor density in humans. J Am Coll Cardiol 2000; 36: 891-896 Lavoro di validazione bioptica del Doppler tissutale. (Pubitemid 30681615)
17. Caso P, D'Andrea A, Caso I, et al. The athlete's heart and hypertrophic cardiomyopathy: two conditions which may be misdiagnosed and coexistent. Which parameters should be analysed to distinguish one disease from the other? J Cardiovasc Med 2006; 7: 257-266
18. D'Andrea A, D'Andrea L, Caso P, et al. The usefulness of Doppler myocardial imaging in the study of the athlete's heart and in the differential diagnosis between physiological and pathological ventricular hypertrophy. Echocardiography 2006; 23: 149-157
19. Caso P, D'Andrea A, Galderisi M, et al. Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function. Am J Cardiol 2000; 85: 1131-1136 Il primo lavoro sul Doppler tissutale pulsato nel cuore d'atleta di resistenza. (Pubitemid 30214262)
20. D'Andrea A, Caso P, Galderisi M, et al. Assessment of myocardial response to physical exercise in endurance competitive athletes by pulsed Doppler tissue imaging. Am J Cardiol 2001; 87: 1226-1230 (Pubitemid 32453254)
21. D'Andrea A, Caso P, Severino S, et al. Effects of different training protocols on left ventricular myocardial function in competitive athletes: a Doppler tissue imaging study. Ital Heart J 2002; 3: 34-40. (Pubitemid 34269551)
22. Zoncu S, Pelliccia A, Mercuro G. Assessment of regional systolic and diastolic wall motion velocities in highly trained athletes by pulsed wave Doppler tissue imaging. J Am Soc Echocardiogr 2002; 15: 900-905
23. D'Andrea A, Caso P, Scarafile R, et al. Biventricular myocardial adaptation to different training protocols in competitive master athletes. Int J Cardiol 2007; 115: 342-349 (Pubitemid 46185635)
24. D'Andrea A, Caso P, Sarubbi B, et al. Right ventricular adaptation to different training protocols in top-level athletes. Echocardiography 2003; 20: 329-336 (Pubitemid 36606440)
25. Caso P, Galderisi M, D'Andrea A et al. Analysis by pulsed Doppler tissue imaging of ventricular interaction in long-distance competitive swimmers. Am J Cardiol 2002; 90: 193-197 (Pubitemid 34775138)
26. Sutherland GR, Di Salvo G, Claus P, D'hooge J, Bijnens B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 2004; 17: 788-802. (Pubitemid 38858032)
27. Langeland S, D'hooge J, Wouters PF, et al. Experimental validation of a new ultrasound method for the simultaneous assessment of radial and longitudinal myocardial deformation independent of insonation angle. Circulation 2005; 112: 2157-2162
28. Notomi Y, Lysyansky P, Setser RM, et al. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 2005; 45: 2034-2041 (Pubitemid 40814128)
29. Weidemann F, Mertens L, Gewillig M, Sutherland GR. Quantitation of localized abnormal deformation in asymmetric nonobstructive hypertrophic cardiomyopathy: a velocity, strain rate, and strain Doppler myocardial imaging study. Pediatr Cardiol 2001; 22: 534-537 (Pubitemid 33131593)
30. Weidemann F, Eyskens B, Mertens L, et al. Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes in Friedreich's ataxia. Am J Cardiol 2003 1; 91: 622-626 (Pubitemid 36263274)
31. Claessens P, Claessens C, Claessens J, Claessens M. Strain imaging: key to the specific left ventricular diastolic properties in endurance trained athletes. J Clin Basic Cardiol 2003; 6: 35-40. (Pubitemid 37526697)
32. Richand V, Lafitte S, Reant P, et al. An ultrasound speckle tracking (two-dimensional strain) analysis of myocardial deformation in professional soccer players compared with healthy subjects and hypertrophic cardiomyopathy. Am J Cardiol 2007; 100: 128-132 (Pubitemid 46961909)
33. Poh KK, Ton-Nu TT, Neilan TG, Tournoux FB, Picard MH, Wood MJ. Myocardial adaptation and efficiency in response to intensive physical training in elite speedskaters. Int J Cardiol 2008; 126: 346-351
34. Sahn D, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-1083 (Pubitemid 9091990)
35. de Simone G, Daniels SR, Devereux RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992; 20: 1251-1260
36. Gaasch WH, Zile MR, Hoshino PK, Apstein CS, Blaustein AS. Stress-shortening relations and myocardial blood flow in compensated and failing canine hearts with pressure-overload hypertrophy. Circulation 1989; 79: 872-883
37. Lang RM, Bierig M, Devereux RB et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18: 1440-1463 (Pubitemid 41821197)
38. Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin 2007; 25: 399-414.
39. Pelliccia A, Maron BJ, De Luca R, Di Paolo FM, Spataro A, Culasso F. Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation 2002; 105: 944-949
40. Urhausen A, Albers T, Kindermann W. Are the cardiac effects of anabolic steroid abuse in strength athletes reversible? Heart 2004; 90: 496-501.
41. Di Bello V, Giorgi D, Bianchi M, et al. Effects of anabolic-androgenic steroids on weight-lifters'myocardium: an ultrasonic videodensitometric study. Med Sci Sports Exerc 1999; 31: 514-521 (Pubitemid 29173742)
42. Dubin J, Wallerson DC, Cody RJ, Devereux RB. Comparative accuracy of Doppler echocardiographic methods for clinical stroke volume determination. Am Heart J 1990; 120: 116-23. (Pubitemid 20210235)
43. Severino S, Caso P, Galderisi M, et al. Use of pulsed Doppler tissue imaging to assess regional left ventricular diastolic dysfunction in hypertrophic cardiomyopathy. Am J Cardiol 1998; 82: 1394-1398 (Pubitemid 28565329)
44. Matsumura Y, Elliott PM, Virdee MS, Sorajja P, Doi Y, McKenna WJ. Left ventricular diastolic function assessed using Doppler tissue imaging in patients with hypertrophic cardiomyopathy: relation to symptoms and exercise capacity. Heart 2002; 87: 247-251
45. Mishiro Y, Oki T, Yamada H, et al. Use of angiotensin II stress pulsed tissue Doppler imaging to evaluate regional left ventricular contractility in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 2000; 13: 1065-1073 (Pubitemid 32047828)
46. Vinereanu D, Florescu N, Schulthorpe N, Tweddel AC, Stephens MR, Fraser AG. Differentiation between pathologic and physiologic left ventricular hypertrophy by tissue Doppler assessment of long-axis function in patients with hypertrophic cardiomyopathy or systemic hypertension and in athletes. Am J Cardiol 2001; 88: 53-58 (Pubitemid 32553892)
47. D'Andrea A, Caso P, Cuomo S, et al. Prognostic value of intraleft ventricular electromechanical asynchrony in patients with mild hypertrophic cardiomyopathy compared with power athletes. Br J Sports Med 2006; 40: 244-250 Studio del valore prognostico della dissincronia intraventricolare nel cuore d'atleta. (Pubitemid 43384742)
48. D'Andrea A, Caso P, Severino S, et al. Prognostic value of intra-left ventricular electromechanical asynchrony in patients with hypertrophic cardiomyopathy. Eur Heart J 2006; 27: 1311-1318 (Pubitemid 43998104)
49. Nagueh SF, Bachinski LL, Meyer D, et al. Tissue Doppler imaging consistently detects myocardial abnormalities in patients with hypertrophic cardiomyopathy and provides a novel means for an early diagnosis before and independently of hypertrophy. Circulation 2001; 104: 128-130 Associazione tra funzione miocardica e genotipo nell'ipertrofia patologica della cardiomiopatia ipertrofica. (Pubitemid 32655824)
50. Ho CY, Sweitzer NK, McDonough B, et al. Assessment of diastolic function with Doppler tissue imaging to predict genotype in preclinical hypertrophic cardiomyopathy. Circulation 2002; 105: 2992-2997 (Pubitemid 34693832)
51. Galderisi M, Caso P, Severino S, et al. Myocardial diastolic impairment caused by left ventricular hypertrophy involves basal septum more than other walls: analysis by pulsed Doppler tissue imaging. J Hypertens 1999; 17: 685-693 (Pubitemid 29243502)
52. Saghir M, Areces M, Makan M. Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete's heart). J Am Soc Echocardiogr 2007; 20: 151-157 (Pubitemid 46176570)
53. D'Andrea A, Caso P, Salerno G, et al. Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis. Br J Sports Med 2007; 41: 149-155 (Pubitemid 46579900)
54. van Dockum WG, Kuijer JP, Götte MJ, et al. Septal ablation in hypertrophic obstructive cardiomyopathy improves systolic myocardial function in the lateral (free) wall: a follow-up study using CMR tissue tagging and 3D strain analysis. Eur Heart J 2006; 27: 2833-2839
55. Pelliccia A, Maron BJ, Di Paolo FM, et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol 2005; 46: 690-696 (Pubitemid 41132699)
56. Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol 2006; 47: 2357-2363
57. Nistri S, Olivotto I, Betocchi S, et al. Prognostic significance of left atrial size in patients with hypertrophic cardiomyopathy (from the Italian Registry for Hypertrophic Cardiomyopathy). Am J Cardiol 2006; 98: 960-965 (Pubitemid 44402269)
58. Di Salvo G, Caso P, Lo Piccolo R, et al. Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study. Circulation 2005; 112: 387-395 (Pubitemid 41022080)
59. Di Salvo G, Drago M, Pacileo G, et al. Atrial function after surgical and percutaneous closure of atrial septal defect: a strain rate imagingstudy. J Am Soc Echocardiogr 2005; 18: 930-933 (Pubitemid 41253943)
60. Sirbu C, Herbots L, D'hooge J, et al. Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur J Echocardiogr 2006; 7: 199-208. (Pubitemid 43670984)
61. Wang T, Wang M, Fung JW, et al. Atrial strain rate echocardiography can predict success or failure of cardioversion for atrial fibrillation: a combined transthoracic tissue Doppler and transesophageal imagingstudy. Int J Cardiol 2007; 114: 202-209 (Pubitemid 44802894)
62. Kokubu N, Yuda S, Tsuchihashi K, et al. Noninvasive assessment of left atrial function by strain rate imagingin patients with hypertension: a possible beneficial effect of renin-angiotensin system inhibition on left atrial function. Hypertens Res 2007; 30: 13-21. (Pubitemid 46259794)
63. D'Andrea A, Caso P, Romano S, et al. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: A two-dimensional speckle strain study. Int J Cardiol, in press.
64. D'Andrea A, Caso P, Romano S, et al. Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy: a two-dimensional speckle strain study. Eur Heart J 2007; 28: 2738-2748 (Pubitemid 350135540)
65. D'Andrea A, De Corato G, Scarafile R, et al. Left atrial myocardial function in either physiologic or pathologic left ventricular hypertrophy: a two-dimensional speckle strain study. Br J Sports Med 2008; 42: 696-702.
66. Sciomer S, Vitarelli A, Penco M, et al. Anatomico-functional changes in the right ventricle of the athlete. Cardiologia 1998; 43: 1215-1220
67. Henriksen E, Landelius J, Kangro T, et al. An echocardiographic study of right and left ventricular adaptation to physical exercise in elite female orienteers. Eur Heart J 1999; 20: 309-316 (Pubitemid 29082152)
68. Hauser AM, Dressendorfer RH, Vos M, et al. Symmetric cardiac enlargement in highly trained endiurance athletes: a two-dimensional echocardiographic study. Am Heart J 1985;109: 1038-1044 (Pubitemid 15053264)
69. Douglas PS, O'Toole ML, Hiller WDB, et al. Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol 1990; 15: 64-69
70. Foale R, Nihoyannopoulos P, McKenna W. Echocardiographic measurement of normal adult right ventricle. Br Heart J 1986; 56: 33-44. (Pubitemid 16064091)
71. Goldhammer E, Mesnick N, Abinader EG, Sagiv M. Dilated inferior vena cava: a common echocardiographic finding in highly trained elite athletes. J Am Soc Echocardiogr 1999; 12: 988-993 (Pubitemid 29533953)
72. Zeppilli P, Vannicelli R, Santini C, et al. Echocardiographic size of conductance vessels in athletes and sedentary people. Int J Sports Med 1995; 16: 38-44.
73. Kaul S, Tei C, Hopkins JM, Shah PM. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 1984; 107: 526-531 (Pubitemid 14167729)
74. Sandrock M, Schmidt-Trucksäss A, Schmitz D, et al. Influence of physiologic cardiac hypertrophy on the prevalence of heart valve regurgitation. J Ultrasound Med 2008; 27: 85-93.
75. McKenna WJ, Thiene G, Nava A, et al. Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyopathies of the International Society and Federation of Cardiology. Br Heart J 1994; 71: 215-218 (Pubitemid 24113523)
76. Vitale G, Galderisi M, Colao A, et al. Circulating insulin-like growth factor-I levels are associated with increased biventricular contractility in top level rowers. Clin Endocrinol 2008; 69: 231-236
77. Severino S, Caso P, Cicala A, et al. Involvement of right ventricle in left ventricular hypertrophic cardiomyopathy: analysis by pulsed tissue imaging. Eur J Echocardiogr 2000; 1: 281-288
78. D'Andrea A, Caso P, Severino S, et al. Different involvement of right ventricular myocardial function in either physiologic or pathologic left ventricular hypertrophy: a Doppler tissue study. J Am Soc Echocardiogr 2003; 16: 154-161 (Pubitemid 36302232)
79. Cicala S, Galderisi M, Caso P, et al. Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by pulsed tissue Doppler. Eur J Echocardiogr 2002; 3: 135-142 (Pubitemid 34893550)
80. Palka P, Lange A, Fleming AD, et al. Differences in myocardial velocity gradient measured throughout the cardiac cycle in patients with hypertrophic cardiomyopathy, athletes and patients with left ventricular hypertrophy due to hypertension. J Am Coll Cardiol 1997; 30: 760-768 (Pubitemid 27397658)
81. Derumeaux G, Douillet R, Troniou A, et al. Distinguishing between physiologic hypertrophy and primary hypertrophic cardiomyopathy. Importance of tissue color Doppler. Arch Mal Coeur Vaiss 1999; 92: 201-210
82. Galderisi M, D'Andrea A, Caso P, et al. Pulsed tissue Doppler distinguishes difference of longitudinal myocardial function between athletic and hypertensive left ventricular hypertrophy. [abstract] J Am Coll Cardiol 2002; 39 (Suppl): 255A.