Left ventricular speckle tracking-derived cardiac strain and cardiac twist mechanics in athletes: a systematic review and meta-analysis of controlled studies
Richards, Joanna C.
speckle tracking echocardiography
left ventricular twisting mechanics
C600 Sports Science
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AbstractBackground The athlete’s heart is associated with physiological remodelling as a consequence of repetitive cardiac loading. Exercise training effect on left ventricular (LV) cardiac strain and twist mechanics are equivocal and no meta-analysis has been conducted to date. Objective The objective of this systematic review and meta-analysis is, (1) to review the literature pertaining to different forms of athletic training on cardiac strain and twist mechanics; (2) to determine the influence of traditional and contemporary sporting classifications on cardiac strain and twist mechanics. Design Systematic review and meta-analysis. Data Sources PubMed/MEDLINE, Web of Science and ScienceDirect. Inclusion criteria Controlled studies of aged matched male participants aged 18-45years that used 2-D speckle tracking with a defined athlete sporting discipline and a control group not engaged in training programmes. Data Extraction and Analysis Data were extracted independently by two reviewers. Random effects meta-analyses, subgroup analyses and meta-regressions. Results Thirteen studies of 955 participants; (controls n=355; athletes n=600) were included. Meta-analyses showed no athlete-control differences in LV strain or twist mechanics. However, moderator analyses showed greater LV twist in high static, low dynamic athletes (d= -0.76, 95% CI -1.32 to -0.20, p<0.01) compared with controls. Peak untwisting velocity (PUV) was greater in high static, low dynamic athletes (d= -0.43, 95% CI -0.84 to -0.03, p<0.05) but less than controls in high dynamic, high static athletes (d= 0.79, 95% CI 0.002 to 1.58, p=0.05). Elite endurance athletes had significantly less twist and apical rotation than controls (d= 0.63, 95% CI 0.17 to 1.09, p<0.01; d= 0.64, 95% CI 0.27 to 1.00, p=0.001, respectively) yet no differences in basal rotation compared with controls. Meta-regressions showed LV mass index was positively associated with global longitudinal (b= 0.01, 95% CI 0.002 to 0.02, p<0.05) and apical circumferential strain (b= 0.01, 95% CI -0.001 to 0.01, p=0.05), while systolic blood pressure was negatively associated with PUV (b= -0.06, 95% CI -0.13 to -0.001, p=0.05). Conclusion Echocardiographic 2-D speckle tracking can identify subtle physiological adaptations to cardiac strain and twist mechanics between athletes and healthy controls. Differences in STE derived parameters can be identified using suitable sporting categorisations.
CitationBeaumont A, Grace F, Richards J, Hough J, Oxborough D, Sculthorpe N (2017) 'Left ventricular speckle tracking-derived cardiac strain and cardiac twist mechanics in athletes: a systematic review and meta-analysis of controlled studies', Sports Medicine, 47 (6), pp.1145-1170.
PubMed Central IDPMC5432587
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