Echocardiographic Doppler Evaluation of Left Ventricular Diastolic Function in Athletes' Hypertrophied Hearts

Abstract

It is well known that one of the most evident effects of prolonged and intense physical training is an increase of left ventricular mass. This increase could have a great influence on the diastolic properties of the heart, which can now be accurately evaluated by use of pulsed- and continuous-wave of Doppler echocardiography. The aim of this study was to evaluate the diastolic function of a group of auperendurance athletes (professional. bicyclists, exercising more than forty hours a week). Sixteen athletes (A), aged between twenty and thirty-one years, during the period of maximal training, and 16 age-matched controls (C) were studied. All subjects were evaluated at rest with mono-dimensional, two-dimensional, and Doppler echocardiography. Diastolic (DD) and systolic. (SD) diameter, posterior wall (PW), and interventricular septum (IVS) thickness were also measured. The ventricular mass (LVM) was calculated. Diastolic function was evaluated by calculating isovolumetric relaxation time (IVR) with continuous-wave Doppler, and deceleration time (DT), rapid filling flow peak (Ep), and atrial filling (Ap) were evaluated with pulsed Doppler echocardiography. The LVM (A: 354±47 g vs C: 170.6±33.4, p<0.05), DD (A:57.7±3.9 mm C: 50.5±2.7, p < 0.01), PW thickness (A: 11:9±0:7 mm vs C: 8.4±0.6, p<0.05), and IVS thickness (A: 12.3±1 mm vs C: 8.2±0.9, p<0.05) were significantly greater in the athletes than in the controls. The IVR (A: 69±12 msec vs C: 76±11, p<0.05) and DT (A: 171±52 msec vs C: 203±31, p<0.01) were significantly shorter in the athletes than in the controls; the Ep velocity was similar in the two groups (A: 84.3±12 cm/sec vs C: 85.1±19, p=NS), while the Ap velocity was lower in the athletes' group (A: 41.5±8 cm/sec vs C: 56±15, p<0.01). It may be concluded that prolonged and intense physical training, while causing an increase of left ventricular mass, is able to induce favorable modifications of the diastolic properties of the left ventricle.