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Differential atrial performance at rest and exercise in athletes: Potential trigger for developing atrial dysfunction?
Author(s) -
Gabrielli L.,
Bijnens B. H.,
Brambila C.,
Duchateau N.,
Marin J.,
SitgesSerra I.,
Mont L.,
Brugada J.,
Sitges M.
Publication year - 2016
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.12610
Subject(s) - medicine , athletes , cardiology , atrial fibrillation , population , contraction (grammar) , physical therapy , environmental health
Highly trained athletes show an increased risk of atrial arrhythmias. Little is known about atrial volumes and function during exercise in this population. Our aim was to analyze atrial size and contractile function during exercise. Fifty endurance athletes with 11 ± 8 h of training per week and 30 sedentary control subjects were included. Echocardiography was performed at baseline and during exercise. Left ( LA ) and right atrial ( RA ) size and function were assessed by two‐dimensional echocardiography. Peak negative strain (Sa) during atrial contraction and active atrial emptying volume ( AEV ) were measured. Athletes and control subjects showed a significant increment of deformation and AEV of both atria with exercise ( P < 0.01 vs baseline for LA and RA ). Among athletes, a subgroup with significant LA ( n = 8)/ RA ( n = 15) dilatation (≥40 mL/m 2 ) showed a significantly lower increment in AEV with exercise ( LA ∆ AEV : 1.4 ± 1.1 mL/m 2 vs 2.1 ± 0.9 mL/m 2 , P = 0.04; RA ∆ AEV : 0.9 ± 0.8 mL/m 2 vs 2.3 ± 1.1 mL/m 2 , P < 0.01) and lower increment in deformation vs other athletes ( LA ∆Sa: −3.2 ± 2.9% vs −9.5 ± 4.4%, P < 0.01; RA ∆Sa: −2.5 ± 3.3% vs. −9.8 ± 3.3%, P < 0.01). During exercise, active atrial strain increases, but less in athletes compared to controls, but due to larger atrial volumes, they reached similar increases in atrial emptying volume. However, this overall lesser deformation increases from a subgroup with significant atrial dilatation showing impairment in atrial contractile reserve.