Left Ventricular Untwisting in Athlete%26apos;s Heart: Key Role in Early Diastolic Filling?

作者：Kovacs A^*; Apor A; Nagy A; Vago H; Toth A; Nagy A I; Kovats T; Sax B; Szeplaki G; Becker D; Merkely B

来源：International Journal of Sports Medicine, 2014, 35(3): 259-264.

DOI：10.1055/s-0033-1349076

• athlete%26apos
• s heart
• speckle tracking
• echocardiography
• MRI
• untwist

Untwisting contributes to left ventricular filling through suction generation. We sought to investigate diastolic function and untwisting dynamics in different forms of left ventricular hypertrophy: in athlete%26apos;s heart and hypertrophic cardiomyopathy. Elite athletes in kayaking, canoeing and rowing (n=28), patients with hypertrophic cardiomyopathy (HCM, n=15) and healthy sedentary volunteers (n=13) were compared. Left ventricular volumes, wall thickness-to-volume ratio were assessed by cardiac MRI. Following conventional and tissue Doppler measurements, untwist and untwist rate were determined by speckle tracking echocardiography. Wall thickness-to-volume ratio describing remodelling was significantly higher in HCM, but similar in athletes and controls (athlete vs. HCM vs. control: 0.107 +/- 0.019 vs. 0.271 +/- 0.091 vs. 0.104 +/- 0.012 mmxm(2)/ml, mean +/- SD, p%26lt;0.001). Mitral lateral annulus e%26apos; velocity referred to diastolic dysfunction in HCM (15.3 +/- 3.6 vs. 7.9 +/- 3.3 vs. 15.0 +/- 3.0 cm/s, p%26lt;0.01). At time point of mitral valve opening, untwist and untwist rate were significantly different: the highest values were measured in athletes, while the lowest were found in HCM (untwist: 51.3 +/- 19.1 vs. 11.6 +/- 10.4 vs. 35.9 +/- 16.3%; untwist rate: -32.5 +/- 13.0 vs. -10.6 +/- 10.8 vs. -23.0 +/- 7.7 degrees/s, p%26lt;0.05). Untwisting correlated with E/A, e%26apos; and E/e%26apos;. Athlete%26apos;s heart is characterized by increased untwist and untwist rate, which can aid diastolic function. Evaluation of untwisting dynamics may help to distinguish pathological hypertrophy.

• 出版日期2014-3