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. 2021 Dec 18;23(1):137-146.
doi: 10.1093/ehjci/jeab248.

Left atrial function in male veteran endurance athletes with paroxysmal atrial fibrillation

Eivind Sørensen  1   2 , Marius Myrstad  3   4 , Magnar Gangås Solberg  2   3   4 , Erik Øie  1 , Arnljot Tveit  3   4 , Marit Aarønæs  1
Affiliations

Left atrial function in male veteran endurance athletes with paroxysmal atrial fibrillation

Eivind Sørensen et al. Eur Heart J Cardiovasc Imaging. .

Abstract

Aims: To assess left atrial (LA) function in sinus rhythm in veteran athletes with a history of paroxysmal atrial fibrillation (AF) exposed to prolonged endurance exercise compared with veteran athletes without AF and controls with and without paroxysmal AF from a non-athletic population.

Methods and results: Three hundred and two male participants from four groups, veteran recreational skiers with paroxysmal AF (n = 62), veteran skiers without AF (n = 89), and controls from a non-athletic population with (n = 62) and without paroxysmal AF (n = 89) underwent an echocardiographic examination in sinus rhythm to evaluate LA anatomy and function. The skiers (mean age 70.8±6.7 years) reported an average exposure to regular endurance exercise for 40-50 years. LA maximum and minimum volumes were larger in skiers (P < 0.001). LA volumes differed within the athletic and non-athletic groups with larger volumes in the AF groups ( P < 0.001). We observed a considerable overlap in LA volumes among non-athletes with AF and athletes without AF. LA reservoir strain (33.6% ± 4.8% vs. 28.3% ± 6.7% P < 0.001) and contractile strain (18.3% ± 4.0% vs. 15.0% ± 5.2% P < 0.001) were lower in both AF groups regardless of athletic status. LA reservoir strain was superior to volumetric measurements at identifying participants with AF (area under the curve 0.740 ±0.041).

Conclusion: Male veteran athletes had significantly larger LA volumes than non-athletes. In contrast, LA strain values were similar in athletes and non-athletes with paroxysmal AF, and significantly lower than in subjects without AF.

Keywords: athlete; atrial fibrillation; atrium; diastolic function; exercise; strain.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Left atria strain curves from apical four-chamber view. The six different segments were measured individually, and the average of accepted segments computed.
Figure 2
Figure 2
Recruitment of the study sample. AF, atrial fibrillation; SVT, supraventricular tachycardia.
Figure 3
Figure 3
Independent and incremental value of LASr at identifying athletes with AF on top of clinical characteristics (CHA2DS2-VASc score, height, and weight) and standard echocardiographic parameters (E/e′, mitral inflow velocity and mitral annular early diastolic velocity; GLS, global longitudinal strain; LAVImax, maximal left atrial volume indexed; LVMI, left ventricular mass index) in a hierarchical logistic regression model.
Figure 4
Figure 4
Scatter plot of left atrial reservoir strain (LASr) in athletes based on AF status.
See this image and copyright information in PMC

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