TY - JOUR

T1 - Atrial remodelling associated with sporting discipline, sex and duration in elite sports

T2 - a cross-sectional echocardiographic study among Danish elite athletes

AU - Aaroee, Mikkel

AU - Tischer, Susanne Glasius

AU - Christensen, Robin

AU - Dall, Christian Have

AU - Thune, Jens Jakob

AU - Rasmusen, Hanne

N1 - Publisher Copyright: © 2019 Utafiti: Journal of African Perspectives. All rights reserved.

PY - 2024

Y1 - 2024

N2 - Background Elite endurance training is characterised by a high-volume load of the heart and has been associated with atrial fibrillation (AF) in middle-aged men. We compared left atrial (LA) remodelling among elite athletes engaged in sports, categorised as having low, intermediate, and high cardiac demands. Methods This cross-sectional echocardiographic study of healthy elite athletes evaluated LA size and function measured as LA maximum volume (maxLAVi) and contraction strain. Athletes were grouped according to the cardiac demands of their sport (low, intermediate, high). Morphological measures were indexed to body surface area and reported as least square means; differences between groups were reported with 95% CIs. Results We included 482 elite athletes (age 21±5 years (mean±SD), 39% women). MaxLAVi was larger in the high group (28.4 mL/m 2) compared with the low group (20.2 mL/m 2; difference: 8.2, CI 5.3 to 11.1 mL/m 2; p<0.001), where measurements in men exceed those in women (26.4 mL/m 2 vs 24.7 mL/m 2; difference 1.6 mL/m 2; CI 0.3 to 2.9 mL/m 2; p=0.0175). In the high group, LA contraction strain was lower compared with the low group (-10.1% vs -12.9%; difference: 2.8%; CI 1.3 to 4.3%; p<0.001), and men had less LA contraction strain compared with women (-10.3% vs -11.0%; difference 0.7%; CI 0.0 to 1.4%; p=0.049). Years in training did not affect maxLAVi or LA contraction strain. Conclusion MaxLAVi was higher while LA contraction strain was lower with increased cardiac demands. MaxLAVi was larger, and LA contraction was lower in men compared with women. Whether these sex-based differences in LA remodelling are a precursor to pathological remodelling in male athletes is unknown.

AB - Background Elite endurance training is characterised by a high-volume load of the heart and has been associated with atrial fibrillation (AF) in middle-aged men. We compared left atrial (LA) remodelling among elite athletes engaged in sports, categorised as having low, intermediate, and high cardiac demands. Methods This cross-sectional echocardiographic study of healthy elite athletes evaluated LA size and function measured as LA maximum volume (maxLAVi) and contraction strain. Athletes were grouped according to the cardiac demands of their sport (low, intermediate, high). Morphological measures were indexed to body surface area and reported as least square means; differences between groups were reported with 95% CIs. Results We included 482 elite athletes (age 21±5 years (mean±SD), 39% women). MaxLAVi was larger in the high group (28.4 mL/m 2) compared with the low group (20.2 mL/m 2; difference: 8.2, CI 5.3 to 11.1 mL/m 2; p<0.001), where measurements in men exceed those in women (26.4 mL/m 2 vs 24.7 mL/m 2; difference 1.6 mL/m 2; CI 0.3 to 2.9 mL/m 2; p=0.0175). In the high group, LA contraction strain was lower compared with the low group (-10.1% vs -12.9%; difference: 2.8%; CI 1.3 to 4.3%; p<0.001), and men had less LA contraction strain compared with women (-10.3% vs -11.0%; difference 0.7%; CI 0.0 to 1.4%; p=0.049). Years in training did not affect maxLAVi or LA contraction strain. Conclusion MaxLAVi was higher while LA contraction strain was lower with increased cardiac demands. MaxLAVi was larger, and LA contraction was lower in men compared with women. Whether these sex-based differences in LA remodelling are a precursor to pathological remodelling in male athletes is unknown.

KW - Athlete

KW - Cardiology

KW - Heart

KW - Sports & exercise medicine

U2 - 10.1136/bmjsem-2023-001880

DO - 10.1136/bmjsem-2023-001880

M3 - Journal article

C2 - 38756698

AN - SCOPUS:85193286559

VL - 10

JO - BMJ Open Sport & Exercise Medicine

JF - BMJ Open Sport & Exercise Medicine

SN - 2055-7647

IS - 2

M1 - e001880

ER -