Concentric and Eccentric Remodelling of the Left Ventricle and Its Association to Function in the Male Athletes Heart: An Exploratory Study

Abstract

Aims: To compare (1) conventional left ventricular (LV) functional parameters, (2) LV peak strain and strain rate and (3) LV temporal strain and strain rate curves in age, ethnicity and sport-matched athletes with concentric, eccentric and normal LV geometry. Methods: Forty-five male athletes were categorised according to LV geometry including concentric remodelling/hypertrophy (CON), eccentric hypertrophy (ECC) or normal (NORM). Athletes were evaluated using conventional echocardiography and myocardial speck tracking, allowing the assessment of myocardial strain and strain rate; as well as twist mechanics. Results: Concentric remodelling was associated with an increased ejection fraction (EF) compared to normal geometry athletes (64% (48–78%) and 56% (50–65%), respectively; p < 0.04). No differences in peak myocardial strain or strain rate were present between LV geometry groups including global longitudinal strain (GLS; CON −16.9% (−14.9–20.6%); ECC −17.9% (−13.0–22.1%); NORM −16.9% (−12.8–19.4%)), global circumferential strain (GCS; CON −18.1% (−13.5–24.5%); ECC −18.7% (−15.6–22.4%); NORM −18.0% (−13.5–19.7%)), global radial strain (GRS; CON 42.2% (30.3–70.5%); ECC 50.0% (39.2–60.0%); NORM 40.6 (29.9–57.0%)) and twist (CON 14.9° (3.7–25.3°); ECC 12.5° (6.3–20.8°); NORM 13.2° (8.8–24.2°)). Concentric and eccentric remodelling was associated with alterations in temporal myocardial strain and strain rate as compared to normal geometry athletes. Conclusion: Physiological concentric and eccentric remodelling in the athletes heart is generally associated with normal LV function; with concentric remodelling associated with an increased EF. Physiological concentric and eccentric remodelling in the athletes heart has no effect on peak myocardial strain but superior deformation and untwisting is unmasked when assessing the temporal distribution.

Keywords

• athletes heart
• left ventricle
• echocardiography
• speckle tracking echocardiography
• strain imaging