Myocardial Strain Imaging in Asian Competitive Athletes – A Single Centre Study

To date there has been limited literature pertaining to Athlete’s Heart Syndrome in Asian athletes, especially for those in South East Asia. We performed a single center cross-sectional case-control study of elite athletes and controls, using current speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. We reanalyzed previous data to further characterize the biomechanical changes in exercise induced cardiac remodeling elite athletes and controls at a tertiary hospital in Singapore. The Left Ventricular (LV) strain of the athletes’ group was significantly lower as compared to the control group (-19.0±2.0 vs -20.3±1.8, p=0.011). Furthermore, both LV torsion (14.3±17.8°/s vs 14.4±6.7°/s, p=0.031) and Lateral S’ (7.21±1.4 vs 8.7±1.6, p=0.001) showed small but statistically significant decreases in the athletes’ group versus the controls. The athletes group demonstrated a significantly lower Basal Right Ventricular (RV) free wall strain as compared to the controls (-19.8±5.5 vs -26.5±6.4 P < 0.001). The mid RV strain was marginally higher in the athletes’ group versus the controls (-25.0±4.3 vs -24.7±15.3 P=0.023). Our findings of impaired LV strain and torsion as well basal RV free walls strain in the South East Asian athletes group mirror studies done in Western cohorts. The higher mid RV free wall strain could represent compensatory response to the impaired basal RV function in athletes.