Conventional and Advanced Echocardiographic Findings in a Group of Egyptian Athletes of a Football Team
Mohammed Abdullah Shahbah;
Abstract
Athlete is a person possessing the natural or acquired traits, such as strength, agility, and endurance that are necessary for physical exercise or sports, especially those performed in competitive contexts.
Long term physical activities can cause some structural and functional changes in heart and this is called athlete’s heart. General morphological changes consist of left ventricular (LV) dilatation, wall thickening, and increase in left ventricular mass.
Doppler tissue imaging (TDI) is a new technique that enhances low-velocity; high amplitude signals of myocardial motion and allows direct quantification of myocardial velocities and assessment of regional and myocardial systolic and diastolic function.
Strain (S) and Strain Rate (SR) imaging methods that were used recently and derived from the colored Doppler myocardial imaging technique have a clinically important capacity to find out global and regional myocardial functions rapidly and accurately.
The aim of this work is to study physiologic exercise induced adaptation of heart with subsequent electrocardiographic and echocardiographic changes in a group of Egyptian athletes of a football team using conventional echocardiography, Pulsed Wave Doppler, Tissue velocity Imaging and strain and strain rate, and to compare the results with healthy sedentary individuals.
Our study included 62 subjects aging from 18 to 35 years divided into 2 groups:
• GroupI:31 male young adult athletes of a football team recruited from sports club.
• Group II: 31 age and sex matched healthy sedentary controls.
Exclusion criteria were presence of ischemic heart disease, 3rd degree heart block, WPW syndrome, atrial flutter, atrial fibrillation, right or left ventricular tachycardia more than 110 bpm, regional and/or global systolic ventricular dysfunction, pulmonary hypertension, pericardial and/or significant valvular heart disease and other major cardiovascular disease, and the presence of moderate to severe hypertension in medical history or check-in clinic, will be considered exclusion criteria.
All participants subjected to thorough History taking, careful general, local clinical examination includes twelve leads surface ECG, conventional echocardiography examination, traditional Doppler including E/A ratio, color Tissue Doppler Imaging, tissue velocity imaging and strain/strain rate imaging.
The data were collected and analyzed using SPSS 15,0 and the Mean and standard deviation (x'± SD) of the measured values was computed and compared between the two groups of the study.
Athletes were associated with significantly lower heart rate, prolonged PR interval and wider QRS. LVH and BBB were significantly prevalent in athletes compared to controls. No significant difference in corrected QT interval between athletes and controls.
Regarding conventional echocardiography, there was significant difference in prevalence of increased LV dimensions, volume, thickness and mass in athletes. LA diameter and volume were significantly larger too.
Regarding pulsed Doppler, E/A ratio were significantly higher in athletes compared to controls.
Athletes were having significantly higher septal annular early diastolic velocity and lateral annular systolic velocity.
Lateral wall systolic tissue velocities, basal and mid septal wall early diastolic tissue velocities and lateral apical late diastolic velocities.
There was significantly higher Strain in basal, mid and apical segments of LV lateral wall in athletes however; there was no significant difference in strain rate between two groups.
The athletes have structural and morphological cardiac adaptation that differs from pathological changes by preserved systolic and diastolic function obtained by conventional and advanced echocardiography.
Long term physical activities can cause some structural and functional changes in heart and this is called athlete’s heart. General morphological changes consist of left ventricular (LV) dilatation, wall thickening, and increase in left ventricular mass.
Doppler tissue imaging (TDI) is a new technique that enhances low-velocity; high amplitude signals of myocardial motion and allows direct quantification of myocardial velocities and assessment of regional and myocardial systolic and diastolic function.
Strain (S) and Strain Rate (SR) imaging methods that were used recently and derived from the colored Doppler myocardial imaging technique have a clinically important capacity to find out global and regional myocardial functions rapidly and accurately.
The aim of this work is to study physiologic exercise induced adaptation of heart with subsequent electrocardiographic and echocardiographic changes in a group of Egyptian athletes of a football team using conventional echocardiography, Pulsed Wave Doppler, Tissue velocity Imaging and strain and strain rate, and to compare the results with healthy sedentary individuals.
Our study included 62 subjects aging from 18 to 35 years divided into 2 groups:
• GroupI:31 male young adult athletes of a football team recruited from sports club.
• Group II: 31 age and sex matched healthy sedentary controls.
Exclusion criteria were presence of ischemic heart disease, 3rd degree heart block, WPW syndrome, atrial flutter, atrial fibrillation, right or left ventricular tachycardia more than 110 bpm, regional and/or global systolic ventricular dysfunction, pulmonary hypertension, pericardial and/or significant valvular heart disease and other major cardiovascular disease, and the presence of moderate to severe hypertension in medical history or check-in clinic, will be considered exclusion criteria.
All participants subjected to thorough History taking, careful general, local clinical examination includes twelve leads surface ECG, conventional echocardiography examination, traditional Doppler including E/A ratio, color Tissue Doppler Imaging, tissue velocity imaging and strain/strain rate imaging.
The data were collected and analyzed using SPSS 15,0 and the Mean and standard deviation (x'± SD) of the measured values was computed and compared between the two groups of the study.
Athletes were associated with significantly lower heart rate, prolonged PR interval and wider QRS. LVH and BBB were significantly prevalent in athletes compared to controls. No significant difference in corrected QT interval between athletes and controls.
Regarding conventional echocardiography, there was significant difference in prevalence of increased LV dimensions, volume, thickness and mass in athletes. LA diameter and volume were significantly larger too.
Regarding pulsed Doppler, E/A ratio were significantly higher in athletes compared to controls.
Athletes were having significantly higher septal annular early diastolic velocity and lateral annular systolic velocity.
Lateral wall systolic tissue velocities, basal and mid septal wall early diastolic tissue velocities and lateral apical late diastolic velocities.
There was significantly higher Strain in basal, mid and apical segments of LV lateral wall in athletes however; there was no significant difference in strain rate between two groups.
The athletes have structural and morphological cardiac adaptation that differs from pathological changes by preserved systolic and diastolic function obtained by conventional and advanced echocardiography.
Other data
| Title | Conventional and Advanced Echocardiographic Findings in a Group of Egyptian Athletes of a Football Team | Other Titles | المظاهرالموجودةباستخدام الموجات فوق الصوتيةالتقليدية والمتقدمةعلى القلب فى مجموعة من الرياضيين المصريين من فريق كرة القدم | Authors | Mohammed Abdullah Shahbah | Issue Date | 2015 |
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