Objectives Although most of the adaptive changes in the heart induced by intense and prolonged sporting activity have now been thoroughly described, especially with regard to the left ventricle, variation over time requires clarification, particularly in terms of the response of the myocardium to seasonal variation in training intensity and duration.
The aim of this study was to examine whether preparticipation physical examination and echocardiographic screening related to left ventricle (LV) remodellingremodeling in elite international level athletes change during three consequence 6 months follow-up periods.
Methods 140 men elite international level athletes were screened in accordance with the recommendations of the ESC with a history and physical examination, electrocardiography (ECG), followed by standard transthoracic echocardiogram. All examination (resting, maximal and recovery heart rate-HR and blood pressure-BP) and echocardiographic parameters related to left ventricle remodellingremodeling (left ventricle mass index-LVMI; endsystolic dimension-ESD; enddyastolic dimension-EDD; septum-IVS; posterior wall-PW and relative wall thickness-RWT) were compared throught three consequence preparticipation check-ups every six months. All echocardiographic findings were adjusted to BSA.
Results The players mean age was 23.3 ± 3.2 years. Durring the follow-up period, all athletes had no evidence of cardiovascular disease in medical hystory, physical examination and ECG on preparticipation check-ups. Resting and recovery HR were signifficantly lower after 1.5 yr follow-up (p < 0.01). Also, there was no significant difference in echocardiographic parameters after 6 months follow-up period, but the data indicate signifficant differences in absolute values of LV dimensions after one year period (IVS, PW) (p = 0.02, Wilks Lambda 0.42, Eta squared 0.58). Upon body size adjustements, even more signifficant differences were also observed after one year period: not only PW (p < 0.001; Wilks lambda 0,65; eta squared 0.35) and IVS (p = 0.04; Wilks Lambda 0.61; Eta squared 0.39) increased, but also LVMI (p = 0.02; Wilks lambda 0.56; eta squared 0.44) and RWT (p = 0.03; Wilks lambda 0,58; eta squared 0.42).
Conclusions Our data demonstrated that the differences between the first and second assessments are slight, and only after after one year follow-up period there is a signifficant LV remodelling, which can be documented through IVS, PW diameters and LVMI and RWT.
Another important conclusion that can be drawn from the study is that additional adaptive changes take place independently from the course of the season, and mostly depending on cumulative effect of previous physical activity.
Periodical one year physical and echocardiographical screening of elite athletes is a non-invasive and recommended tool with the potential to increase the screening accuracy for detection of changes in heart dimensions during competitive season.
Ghani S, Papadakis M, Kemp S, Zaidi A, Sheikh N, Gati S, et al. Results of a nationally implemented de novo cardiac screening programme in elite rugby players in England. Br J Sports Med 2016 Jun. [Epub ahead of print]
Lavie CJ, Harmon KG. Routine ECG Screening of Young Athletes: Can This Strategy Ever Be Cost Effective? J Am Coll Cardiol 2016 Aug;68(7):712–4.
- cardiovascular abnormalities
- elite athletes
- preparticipation screening
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