Key result
Elite athletes exhibit impaired global LA longitudinal strain and lower late diastolic strain rate versus controls.
Why the study?
Left atrial volume, function, and strain in elite athletes remained to be systematically investigated using volumetric and two-dimensional speckle tracking echocardiographic strain analysis.
Does elite athletic training alter left atrial volume and function compared to untrained controls?
Meta-Analysis
Does elite athletic training alter left atrial volume and function compared to untrained controls?
Absolute Event Rate: 37% vs 38.3%
p-value: p=0.044
Elite athletes show increased left atrial volume and impaired reservoir and contractile functions compared to untrained controls, potentially predisposing them to arrhythmias.
May warrant arrhythmia surveillance in elite athletes; leaves open whether training causes LA impairment or reflects selection.
BACKGROUND: We sought to investigate left atrial (LA) volume, function, and strain in elite athletes by a meta-analysis including echocardiographic studies that provided volumetric and strain analysis of LA phasic function. METHODS: The OVID-MEDLINE, PubMed, and Cochrane CENTRAL databases were searched for English-language articles without time restriction up to February 2018 through focused and high sensitive search strategies. Studies were identified by crossing the following search terms: "athletes," "left atrial size," "left atrial volume," "atrial function," "atrial strain," "atrial strain rate," "echocardiography," "2D speckle echocardiography." RESULTS: , P < 0.001). Global LA longitudinal strain, showing LA reservoir function, was lower in the athletes than in healthy controls with borderline significance (37.0 ± 1.2 vs 38.3 ± 1.5%, P = 0.044). Late diastolic LA strain rate, resembling LA contractile function, was also lower in elite athletes than in control group (-1.56 ± 0.08 vs -1.74 ± 0.09 seconds -1, P = 0.007). CONCLUSIONS: Our meta-analysis shows that LA volume is higher, while LA reservoir and contractile functions are impaired in elite athletes during active training compared to untrained controls. Whether these changes persist during deconditioning periods remains to be determined. These alterations may be related to the higher risk of arrhythmias, in particular atrial fibrillation, reported among middle/old aged athletes.
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Cuspidi et al. (2019) conducted a meta-analysis in Elite athletes. Elite athletic training vs. Untrained healthy controls was evaluated on Global left atrial longitudinal strain (p=0.044). Elite athletes exhibited impaired global left atrial longitudinal strain compared to healthy controls (37.0% vs 38.3%, P=0.044) and lower late diastolic LA strain rate (P=0.007).
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