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Wierzbowska-Drabik K, Kasprzak JD, Haberka M, Peteiro J, Re F, D'Alfonso MG, Mori F, Palinkas ED, Agoston G, Varga A, Djordjevic-Dikic A, Tesic M, Zagatina A, Rodriguez-Zanella H, Simova I, Merli E, Morrone D, D'Andrea A, Camarozano AC, Reisenhofer B, Prota C, Citro R, Celutkiene J, Boshchenko A, Ciampi Q, Picano E. Left atrial volume changes during exercise stress echocardiography in heart failure and hypertrophic cardiomyopathy: Exercise echocardiography and left atrial changes. Hellenic J Cardiol 2022; 67:9-18. [PMID: 35123008 DOI: 10.1016/j.hjc.2022.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND We assessed feasibility and functional correlates of LAVI (left atrial volume index) changes during exercise stress echocardiography (ESE). METHODS ESE on bike or treadmill was performed in 363 patients with heart failure with preserved ejection fraction (HFpEF, n = 173), reduced ejection fraction (HFrEF, n = 59) or hypertrophic cardiomyopathy (HCM, n=131). LAVI stress-rest increase ≥ 6.8 ml/m2 was defined as dilation. RESULTS LAVI measurements were feasible in 100%. LAVI did not change in HFrEF being at rest 32 (25-45) vs. at stress 36 (24 - 54) ml/m2, P = NS and in HCM at rest 35 (26 - 48) vs. at stress 38 (28 - 48) ml/m2, P = NS whereas it decreased in HFpEF from 30 (24 -40) to 29 (21 - 37) ml/m2 at stress, P = 0.007. LA dilation occurred in 107 (30%) patients (27% with treadmill vs. 33% with bike ESE, P = NS): 26 with HFpEF (15%), 26 with HFrEF (44%) and 55 with HCM (42%) with P < 0.001 for HFrEF and HCM vs. HFpEF. Multivariate analysis revealed as the predictors for LAVI dilation E/e' > 14 at rest with OR 4.4, LVEF < 50% with OR 2.9, and LAVI at rest < 35 ml/m2 with OR 2.7. CONCLUSION LAVI assessment during ESE was highly feasible and dilation equally frequent with treadmill or bike. LA dilation was threefold more frequent in HCM and HFrEF and could be predicted by increased resting E/e' and impaired EF as well as smaller baseline LAVI.
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Affiliation(s)
| | | | - Maciej Haberka
- Department of Cardiology, SHS, Medical University of Silesia, Katowice, Poland
| | | | | | | | - Fabio Mori
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Eszter D Palinkas
- Careggi University Hospital, Florence, Italy; Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary; Division of Noninvasive Cardiology, Department of Internal Medicine, Albert Szent-Gyorgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergely Agoston
- University of Szeged, Department of Family Medicine, Szeged, Hungary
| | - Albert Varga
- University of Szeged, Department of Family Medicine, Szeged, Hungary
| | - Ana Djordjevic-Dikic
- Clinic for Cardiology, University Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milorad Tesic
- Clinic for Cardiology, University Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Angela Zagatina
- Cardiology Department, Saint Petersburg State University Hospital, Saint Petersburg, Russian Federation
| | | | - Iana Simova
- Heart and Brain Center of Excellence, University Hospital, Pleven, Bulgaria
| | | | | | | | - Ana C Camarozano
- Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà, Curitiba, Brazil
| | | | - Costantina Prota
- University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Rodolfo Citro
- University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Jelena Celutkiene
- Centre of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University Hospital, Vilnius, Lithuania; State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Alla Boshchenko
- Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation
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Hammami N, Frih B, Rahali H, Mkacher W, Rezgui T, Čular D, Bouassida A. Effects of taekwondo style practice on cardiac remodeling and isokinetic thigh strength in elite women players. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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(Cardiovascular adaptations to competitive sports - athlete's heart). COR ET VASA 2020. [DOI: 10.33678/cor.2020.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gungor H, Kartal A, Babu A, Çayırlı S, Ergin E. Effect of exercise on left atrial mechanical functions in professional wrestlers. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2020. [DOI: 10.4103/ijca.ijca_62_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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D’Andrea A, Radmilovic J, Caselli S, Carbone A, Scarafile R, Sperlongano S, Tocci G, Formisano T, Martone F, Liccardo B, D’Alto M, Bossone E, Galderisi M, Golino P. Left atrial myocardial dysfunction after chronic abuse of anabolic androgenic steroids: a speckle tracking echocardiography analysis. Int J Cardiovasc Imaging 2018; 34:1549-1559. [DOI: 10.1007/s10554-018-1370-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Popielarz-Grygalewicz A, Gąsior JS, Konwicka A, Grygalewicz P, Stelmachowska-Banaś M, Zgliczyński W, Dąbrowski M. Heart in Acromegaly: The Echocardiographic Characteristics of Patients Diagnosed with Acromegaly in Various Stages of the Disease. Int J Endocrinol 2018; 2018:6935054. [PMID: 30123265 PMCID: PMC6079421 DOI: 10.1155/2018/6935054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 02/21/2018] [Accepted: 05/17/2018] [Indexed: 01/20/2023] Open
Abstract
To determine whether the echocardiographic presentation allows for diagnosis of acromegalic cardiomyopathy. 140 patients with acromegaly underwent echocardiography as part of routine diagnostics. The results were compared with the control group comprising of 52 age- and sex-matched healthy volunteers. Patients with acromegaly presented with higher BMI, prevalence of arterial hypertension, and glucose metabolism disorders (i.e., diabetes and/or prediabetes). In patients with acromegaly, the following findings were detected: increased left atrial volume index, increased interventricular septum thickness, increased posterior wall thickness, and increased left ventricular mass index, accompanied by reduced diastolic function measured by the following parameters: E'med., E/E', and E/A. Additionally, they presented with abnormal right ventricular systolic pressure. All patients had normal systolic function measured by ejection fraction. However, the values of global longitudinal strain were slightly lower in patients than in the control group; the difference was statistically significant. There were no statistically significant differences in the size of the right and left ventricle, thickness of the right ventricular free wall, and indexed diameter of the ascending aorta between patients with acromegaly and healthy volunteers. None of 140 patients presented systolic dysfunction, which is the last phase of the so-called acromegalic cardiomyopathy. Some abnormal echocardiographic parameters found in acromegalic patients may be caused by concomitant diseases and not elevated levels of GH or IGF-1 alone. The potential role of demographic parameters like age, sex, and/or BMI requires further research.
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Affiliation(s)
- Agata Popielarz-Grygalewicz
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Jakub S Gąsior
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Aleksandra Konwicka
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Grygalewicz
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Maria Stelmachowska-Banaś
- Department of Endocrinology, The Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
| | - Wojciech Zgliczyński
- Department of Endocrinology, The Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
| | - Marek Dąbrowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielanski Hospital, Warsaw, Poland
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Carbone A, D’Andrea A, Riegler L, Scarafile R, Pezzullo E, Martone F, America R, Liccardo B, Galderisi M, Bossone E, Calabrò R. Cardiac damage in athlete’s heart: When the “supernormal” heart fails! World J Cardiol 2017; 9:470-480. [PMID: 28706583 PMCID: PMC5491465 DOI: 10.4330/wjc.v9.i6.470] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/05/2017] [Accepted: 04/10/2017] [Indexed: 02/07/2023] Open
Abstract
Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete’s blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete’s heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.
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D'Andrea A, Formisano T, Riegler L, Scarafile R, America R, Martone F, di Maio M, Russo MG, Bossone E, Galderisi M, Calabrò R. Acute and Chronic Response to Exercise in Athletes: The "Supernormal Heart". ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 999:21-41. [PMID: 29022255 DOI: 10.1007/978-981-10-4307-9_2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
During last decades, most studies have examined the exercise-induced remodeling defined as "athlete's heart". During exercise, there is an increased cardiac output that causes morphological, functional, and electrical modification of the cardiac chambers. The cardiac remodeling depends also on the type of training, age, sex, ethnicity, genetic factors, and body size. The two main categories of exercise, endurance and strength, determine different effects on the cardiac remodeling. Even if most sport comprise both strength and endurance exercise, determining different scenarios of cardiac adaptation to the exercise. The aim of this paper is to assemble the current knowledge about physiologic and pathophysiologic response of both the left and the right heart in highly trained athletes.
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Affiliation(s)
- Antonello D'Andrea
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy.
| | - Tiziana Formisano
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Lucia Riegler
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Raffaella Scarafile
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Raffaella America
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Francesca Martone
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Marco di Maio
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Maria Giovanna Russo
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
| | - Eduardo Bossone
- Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio, Salern, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Raffaele Calabrò
- Luigi Vanvitelli, University of Naples Monaldi Hospital, AORN Ospedali dei Colli, Corso Vittorio Emanuele 121, 80121, Naples, Italy
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