Pulsed Doppler tissue imaging in endurance athletes: Relation between leftventricular preload and myocardial regional diastolic function

The aim of this study was to assess the effects of endurance training on my ocardial regional systolic and diastolic function by pulsed Doppler tissue imaging (DTI). Twenty male water polo players and 20 male control subjects underwent standard Doppler echocardiography and pulsed DTI, performed in ap ical views by placing a sample volume on left ventricular (LV) basal septal and inferior walls. Age, body surface area, and blood pressure were compar able between the 2 groups, with lower heart rate in athletes (p < 0.001). T hey had significantly increased LV mass index (due to both higher wall thic kness and end-diastolic diameter), greater endocardial fractional shortenin g, higher transmitral early/atrial (E/A) peak velocities ratio. In athletes , DTI analysis showed significantly prolonged myocardial deceleration time and greater myocardial E/A peak velocity ratio of septal and inferior walls , whereas myocardial early peak velocity was increased (p < 0.01) only at t he inferior wall. In the overall group, we found univariate relations of se ptal and inferior E/A peak velocity ratio and myocardial deceleration time with LV mass levels, and, in particular, with the sum of wall thickness. By separate multivariate analyses, however, these relations disappeared, bein g dependent on heart rate degree. Another association found between LV end- diastolic diameter and myocardial early diastolic wave peak velocity of the inferior wall (r = 0.68, p < 0.0001) remained significant (standardized be ta coefficient 0.60, p < 0.00001), even after adjusting for heart rate, bod y surface area, age, and stroke volume (R-2 = 0.71, p < 0.00001). In conclu sion, DTI is a useful tool for detecting regional changes in myocardial fun ction induced by training, because athletes present with an improvement in diastolic passive properties of myocardium. The higher early diastolic velo city of the inferior wall and its relation to increased preload may represe nt an indicator of aerobic training, allowing quantification of the degree of LV adaptation to endurance exercise. (C) 2000 by Excerpta Medico, Inc.