ABSTRACT Objective To assess left atrial (LA) structure and function in marathon runners using two‐dimensional speckle tracking echocardiography (2D‐STE) and real‐time three‐dimensional echocardiography (RT‐3DE). Methods This study enrolled 50 healthy volunteers (control group) and 132 marathon runners, and collected their general information. 2D‐STE and RT‐3DE were performed to obtain LA structural and functional parameters and left ventricular mass index (LVMI). According to the LVMI criteria for diagnosing left ventricular hypertrophy (LVH), all marathon runners were divided into an LVMI normal group and an LVH group. A comparative analysis was performed among the three groups. Multivariate logistic regression was used to analyze the association, and curve fitting was used to show the change trends. Results Compared with the control group, LA total ejection fraction (LATEF) and LA passive ejection fraction (LAPEF) were higher in the LVMI normal group ( p < 0.05). Compared with the control group and the LVMI normal group, LA maximal volume index (LAVImax), LA presystolic volume index (LAVIpre), and LA stiffness index (LASI) were higher in the LVH group, whereas LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contraction strain (LASct) were lower ( p < 0.05). Multivariate logistic regression analysis showed that LAVImax, LAScd, and LASct were significantly associated with LVH in marathon runners. Curve fitting showed that LAVImax increased with the increase of LVMI, whereas LAScd and LASct decreased. Conclusion 2D‐STE and RT‐3DE can effectively assess LA structure and function in marathon runners. Marathon runners with normal LVMI exhibit normal LA structure and function, and even some functional enhancement, while those with LVH exhibit increased LA volume and decreased LA strain function.
Yang et al. (2025) studied this question.