120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes

David Oxborough, Annemieke Heemels, Lynsey Forsythe, Gavin McClean, Punit Mistry, Rachel Lord, Victor Utomi, Nigel Jones, Dick Thijssen, John Somauroo, Sanjay Sharma, Rebecca Osborne, Nicholas Sculthorpe

Research output: Contribution to journalMeeting Abstract

Abstract

Introduction It is well established that left ventricular (LV) adaption occurs in response to chronic physiological conditioning. There is also evidence highlighting functional differences in myocardial strain imaging between athletes from sporting disciplines. This difference may be a consequence of the vague classification of sport i.e. not taking into account relative static and dynamic components and/or merely a consequence of chamber enlargement. We sought to utilise a novel simultaneous assessment of longitudinal strain and LV volume in athletes classified in the 4 corners of Mitchell’s classification of sporting disciplines. The primary aim was to determine relative longitudinal strain throughout the cardiac cycle and its specific contribution to LV volume change in these athletes. Methods 92 elite male athletes were studied and sub classified based on sporting discipline in accordance with the Mitchell’s classification. (Group IA low static-low dynamic n = 20, Group IC low static-high dynamic n = 25, Group IIIA high static-low dynamic n = 21, Group IIIC high static-high dynamic n = 26). Conventional echocardiography of the LV was undertaken. The raw temporal global longitudinal strain values were exported and divided into 5% time increments across the cardiac cycle. Concomitant LV volumes were traced at each 5% time increment to provide simultaneous strain-volume loops. The strain-volume relationship was assessed by applying a polynomial regression analysis for each systolic and diastolic curve to derive absolute values for% end diastolic volumes (EDV). Results Conventional and peak strain indices are presented in table 1. Athletes in group IC and IIIC had larger LV end diastolic volumes (EDV) compared to athletes in groups IA and IIIA (50 ± 6 and 54 ± 8 ml/(m2)1.5 vs. 42 ± 7 and 43 ± 2 ml/(m2)1.5 respectively). Group IIIC also had significantly larger mean wall thickness (MWT) compared to all groups. Peak strain was variable between groups but once normalised for EDV all groups, with exception of IIIC, required similar strain to generate the same% reduction in EDV (see Figures 1 and 2). Conversely group IIIC required greater longitudinal strain for any given% volume which correlated to MWT (r = 0.4, p < 0.0001).
Original languageEnglish
Pages (from-to)A85-A86
JournalHeart
Volume102
Issue numberSuppl 6
DOIs
Publication statusPublished - 1 Jun 2016
EventBCS Annual Conference. ‘Prediction and Prevention’ - Manchester, United Kingdom
Duration: 6 Jun 20168 Jun 2017
http://heart.bmj.com/content/102/Suppl_6

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Athletes
Stroke Volume
Sports
Echocardiography
Regression Analysis

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Oxborough, D., Heemels, A., Forsythe, L., McClean, G., Mistry, P., Lord, R., ... Sculthorpe, N. (2016). 120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes. Heart, 102(Suppl 6), A85-A86. https://doi.org/10.1136/heartjnl-2016-309890.120
Oxborough, David ; Heemels, Annemieke ; Forsythe, Lynsey ; McClean, Gavin ; Mistry, Punit ; Lord, Rachel ; Utomi, Victor ; Jones, Nigel ; Thijssen, Dick ; Somauroo, John ; Sharma, Sanjay ; Osborne, Rebecca ; Sculthorpe, Nicholas. / 120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes. In: Heart. 2016 ; Vol. 102, No. Suppl 6. pp. A85-A86.
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abstract = "Introduction It is well established that left ventricular (LV) adaption occurs in response to chronic physiological conditioning. There is also evidence highlighting functional differences in myocardial strain imaging between athletes from sporting disciplines. This difference may be a consequence of the vague classification of sport i.e. not taking into account relative static and dynamic components and/or merely a consequence of chamber enlargement. We sought to utilise a novel simultaneous assessment of longitudinal strain and LV volume in athletes classified in the 4 corners of Mitchell’s classification of sporting disciplines. The primary aim was to determine relative longitudinal strain throughout the cardiac cycle and its specific contribution to LV volume change in these athletes. Methods 92 elite male athletes were studied and sub classified based on sporting discipline in accordance with the Mitchell’s classification. (Group IA low static-low dynamic n = 20, Group IC low static-high dynamic n = 25, Group IIIA high static-low dynamic n = 21, Group IIIC high static-high dynamic n = 26). Conventional echocardiography of the LV was undertaken. The raw temporal global longitudinal strain values were exported and divided into 5{\%} time increments across the cardiac cycle. Concomitant LV volumes were traced at each 5{\%} time increment to provide simultaneous strain-volume loops. The strain-volume relationship was assessed by applying a polynomial regression analysis for each systolic and diastolic curve to derive absolute values for{\%} end diastolic volumes (EDV). Results Conventional and peak strain indices are presented in table 1. Athletes in group IC and IIIC had larger LV end diastolic volumes (EDV) compared to athletes in groups IA and IIIA (50 ± 6 and 54 ± 8 ml/(m2)1.5 vs. 42 ± 7 and 43 ± 2 ml/(m2)1.5 respectively). Group IIIC also had significantly larger mean wall thickness (MWT) compared to all groups. Peak strain was variable between groups but once normalised for EDV all groups, with exception of IIIC, required similar strain to generate the same{\%} reduction in EDV (see Figures 1 and 2). Conversely group IIIC required greater longitudinal strain for any given{\%} volume which correlated to MWT (r = 0.4, p < 0.0001).",
author = "David Oxborough and Annemieke Heemels and Lynsey Forsythe and Gavin McClean and Punit Mistry and Rachel Lord and Victor Utomi and Nigel Jones and Dick Thijssen and John Somauroo and Sanjay Sharma and Rebecca Osborne and Nicholas Sculthorpe",
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Oxborough, D, Heemels, A, Forsythe, L, McClean, G, Mistry, P, Lord, R, Utomi, V, Jones, N, Thijssen, D, Somauroo, J, Sharma, S, Osborne, R & Sculthorpe, N 2016, '120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes' Heart, vol. 102, no. Suppl 6, pp. A85-A86. https://doi.org/10.1136/heartjnl-2016-309890.120

120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes. / Oxborough, David; Heemels, Annemieke; Forsythe, Lynsey; McClean, Gavin; Mistry, Punit; Lord, Rachel; Utomi, Victor; Jones, Nigel; Thijssen, Dick; Somauroo, John; Sharma, Sanjay; Osborne, Rebecca; Sculthorpe, Nicholas.

In: Heart, Vol. 102, No. Suppl 6, 01.06.2016, p. A85-A86.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - 120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes

AU - Oxborough, David

AU - Heemels, Annemieke

AU - Forsythe, Lynsey

AU - McClean, Gavin

AU - Mistry, Punit

AU - Lord, Rachel

AU - Utomi, Victor

AU - Jones, Nigel

AU - Thijssen, Dick

AU - Somauroo, John

AU - Sharma, Sanjay

AU - Osborne, Rebecca

AU - Sculthorpe, Nicholas

N1 - Published in BMJ Heart, Vol 102 Suppl 6,

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Introduction It is well established that left ventricular (LV) adaption occurs in response to chronic physiological conditioning. There is also evidence highlighting functional differences in myocardial strain imaging between athletes from sporting disciplines. This difference may be a consequence of the vague classification of sport i.e. not taking into account relative static and dynamic components and/or merely a consequence of chamber enlargement. We sought to utilise a novel simultaneous assessment of longitudinal strain and LV volume in athletes classified in the 4 corners of Mitchell’s classification of sporting disciplines. The primary aim was to determine relative longitudinal strain throughout the cardiac cycle and its specific contribution to LV volume change in these athletes. Methods 92 elite male athletes were studied and sub classified based on sporting discipline in accordance with the Mitchell’s classification. (Group IA low static-low dynamic n = 20, Group IC low static-high dynamic n = 25, Group IIIA high static-low dynamic n = 21, Group IIIC high static-high dynamic n = 26). Conventional echocardiography of the LV was undertaken. The raw temporal global longitudinal strain values were exported and divided into 5% time increments across the cardiac cycle. Concomitant LV volumes were traced at each 5% time increment to provide simultaneous strain-volume loops. The strain-volume relationship was assessed by applying a polynomial regression analysis for each systolic and diastolic curve to derive absolute values for% end diastolic volumes (EDV). Results Conventional and peak strain indices are presented in table 1. Athletes in group IC and IIIC had larger LV end diastolic volumes (EDV) compared to athletes in groups IA and IIIA (50 ± 6 and 54 ± 8 ml/(m2)1.5 vs. 42 ± 7 and 43 ± 2 ml/(m2)1.5 respectively). Group IIIC also had significantly larger mean wall thickness (MWT) compared to all groups. Peak strain was variable between groups but once normalised for EDV all groups, with exception of IIIC, required similar strain to generate the same% reduction in EDV (see Figures 1 and 2). Conversely group IIIC required greater longitudinal strain for any given% volume which correlated to MWT (r = 0.4, p < 0.0001).

AB - Introduction It is well established that left ventricular (LV) adaption occurs in response to chronic physiological conditioning. There is also evidence highlighting functional differences in myocardial strain imaging between athletes from sporting disciplines. This difference may be a consequence of the vague classification of sport i.e. not taking into account relative static and dynamic components and/or merely a consequence of chamber enlargement. We sought to utilise a novel simultaneous assessment of longitudinal strain and LV volume in athletes classified in the 4 corners of Mitchell’s classification of sporting disciplines. The primary aim was to determine relative longitudinal strain throughout the cardiac cycle and its specific contribution to LV volume change in these athletes. Methods 92 elite male athletes were studied and sub classified based on sporting discipline in accordance with the Mitchell’s classification. (Group IA low static-low dynamic n = 20, Group IC low static-high dynamic n = 25, Group IIIA high static-low dynamic n = 21, Group IIIC high static-high dynamic n = 26). Conventional echocardiography of the LV was undertaken. The raw temporal global longitudinal strain values were exported and divided into 5% time increments across the cardiac cycle. Concomitant LV volumes were traced at each 5% time increment to provide simultaneous strain-volume loops. The strain-volume relationship was assessed by applying a polynomial regression analysis for each systolic and diastolic curve to derive absolute values for% end diastolic volumes (EDV). Results Conventional and peak strain indices are presented in table 1. Athletes in group IC and IIIC had larger LV end diastolic volumes (EDV) compared to athletes in groups IA and IIIA (50 ± 6 and 54 ± 8 ml/(m2)1.5 vs. 42 ± 7 and 43 ± 2 ml/(m2)1.5 respectively). Group IIIC also had significantly larger mean wall thickness (MWT) compared to all groups. Peak strain was variable between groups but once normalised for EDV all groups, with exception of IIIC, required similar strain to generate the same% reduction in EDV (see Figures 1 and 2). Conversely group IIIC required greater longitudinal strain for any given% volume which correlated to MWT (r = 0.4, p < 0.0001).

U2 - 10.1136/heartjnl-2016-309890.120

DO - 10.1136/heartjnl-2016-309890.120

M3 - Meeting Abstract

VL - 102

SP - A85-A86

JO - Heart

JF - Heart

SN - 1355-6037

IS - Suppl 6

ER -

Oxborough D, Heemels A, Forsythe L, McClean G, Mistry P, Lord R et al. 120 Left Ventricular Longitudinal Strain-Volume Relationships in Elite Athletes. Heart. 2016 Jun 1;102(Suppl 6):A85-A86. https://doi.org/10.1136/heartjnl-2016-309890.120