PhD Scientific Days 2021

CL_II_P: Clinical Medicine II. Posters

Training- and sex-related alterations of global feature-tracking strain values in young, highly trained elite athletes using cardiac magnetic resonance imaging

Text of the abstract

Introduction: Strain analysis can detect mechanical features and subtle functional alterations of the heart. In athletes, differentiating early pathological signs from physiological adaptation has an emerging role in the risk stratification for sudden cardiac death. However, data is scarce regarding the strain values of elite athletes using cardiac magnetic resonance (CMR).
Aims: We aimed to study the strain characteristics of the athlete’s heart using CMR imaging.
Methods: Overall, 228 (149 male, 24±5 y) athletes (≥10h/w training) who underwent CMR examination as part of their sports cardiology screening were included. Left- and right ventricular (LV, RV) volumes, ejection fraction, and muscle masses were measured. Feature-tracking strain analyses were performed, global LV longitudinal, circumferential and radial strain, and RV longitudinal strain were calculated. CMR parameters of athletes were compared to sex- and age-matched sedentary volunteers (n=105).
Results: Elite athletes performed high levels of sports activity (21±5 h/w), all of them competing in power(n=30), mixed (n=99), or endurance (n=99) sports disciplines. Regarding standard CMR parameters, we found pronounced sports adaptation in both male and female athletes compared to sex- and age-matched controls including lower LV and RV ejection fraction (p<0.05), elevated LV and RV volumes, and masses (p<0.001). Strain analysis also revealed differences between the two groups: LV- GLS, GCS, GRS values were lower in athletes compared to controls, regardless of their sex (p<0.05). RV-GLS was slightly lower in male athletes compared to controls. Training hours showed a positive correlation with LV-GLS and GCS values (p<0.001). We found more pronounced cardiac adaptation among male athletes moreover, their LV-GLS and GRS values were lower (GLS: -20±2 vs -22±2 %; p<0.001) compared to females.
Conclusion: Our results suggest that in addition to standard CMR parameters, global strain values also show a small but consistent change during sport adaptation. Moreover, our results support the use of sex-specific strain normal values in highly trained athletes.
Funding: LS was supported by the ÚNKP-20-3-II-SE-61 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund, and the EFOP-3.6.3-VEKOP-16-2017-00009 project.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine