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Left atrial dyssynchrony in veteran endurance athletes with and without paroxysmal atrial fibrillation

Sørensen, Eivind ; Myrstad, Marius ; Solberg, Magnar Gangås ; Øie, Erik ; Platonov, Pyotr G. LU ; Carlson, Jonas LU orcid ; Tveit, Arnljot and Aarønæs, Marit (2023) In Echocardiography 40(7). p.679-686
Abstract

Background: Prolonged endurance exercise increase the risk of atrial fibrillation (AF) in men. Functional parameters may help separate physiological from pathological atrial remodeling in athletes. LA mechanical dispersion (LA MD) is associated with AF in the general population, but the associations between prolonged exercise, LA MD and AF are not known. Purpose: To describe LA MD in veteran athletes with and without paroxysmal AF (pAF) and to investigate LA MD's ability to identify veteran athletes with pAF. Methods: Two hundred and ninety-three men, skiers with (n = 57) and without (n = 87) pAF, and controls with (n = 61) and without pAF (n = 88) underwent an echocardiographic exam in sinus rhythm. LA reservoir strain (LASr) was... (More)

Background: Prolonged endurance exercise increase the risk of atrial fibrillation (AF) in men. Functional parameters may help separate physiological from pathological atrial remodeling in athletes. LA mechanical dispersion (LA MD) is associated with AF in the general population, but the associations between prolonged exercise, LA MD and AF are not known. Purpose: To describe LA MD in veteran athletes with and without paroxysmal AF (pAF) and to investigate LA MD's ability to identify veteran athletes with pAF. Methods: Two hundred and ninety-three men, skiers with (n = 57) and without (n = 87) pAF, and controls with (n = 61) and without pAF (n = 88) underwent an echocardiographic exam in sinus rhythm. LA reservoir strain (LASr) was measured, and LA MD defined as the standard deviation of time-to-peak strain (SD-TPS). Results: Skiers (mean age 70.7 ± 6.7 years) reported an average of 40–50 years of endurance exercise. LA volumes were associated with pAF and athletic status (p <.001). SD-TPS was associated with pAF (p <.001) but not athletic status (p =.173). We found no significant trend between years of exercise and SD-TPS in individuals without AF (p =.893). SD-TPS did not add incremental value in identifying athletes with pAF in addition to clinical markers, QRS width, LA volume, and LASr (p =.056). Conclusion: LA MD was associated with pAF regardless of athletic status but not related to years of endurance exercise, suggesting LA MD could be a promising marker of pathological atrial remodeling in athletes. However, we found no incremental value of LA MD identifying athletes with pAF when LASr was included in the model.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
athletes heart, atrial fibrillation, exercise, left atrium, strain
in
Echocardiography
volume
40
issue
7
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:37279187
  • scopus:85161562070
ISSN
0742-2822
DOI
10.1111/echo.15634
language
English
LU publication?
yes
id
96a038ab-e668-446e-ab9a-0c6435cf1fbf
date added to LUP
2023-08-22 15:07:33
date last changed
2024-04-20 01:17:04
@article{96a038ab-e668-446e-ab9a-0c6435cf1fbf,
  abstract     = {{<p>Background: Prolonged endurance exercise increase the risk of atrial fibrillation (AF) in men. Functional parameters may help separate physiological from pathological atrial remodeling in athletes. LA mechanical dispersion (LA MD) is associated with AF in the general population, but the associations between prolonged exercise, LA MD and AF are not known. Purpose: To describe LA MD in veteran athletes with and without paroxysmal AF (pAF) and to investigate LA MD's ability to identify veteran athletes with pAF. Methods: Two hundred and ninety-three men, skiers with (n = 57) and without (n = 87) pAF, and controls with (n = 61) and without pAF (n = 88) underwent an echocardiographic exam in sinus rhythm. LA reservoir strain (LASr) was measured, and LA MD defined as the standard deviation of time-to-peak strain (SD-TPS). Results: Skiers (mean age 70.7 ± 6.7 years) reported an average of 40–50 years of endurance exercise. LA volumes were associated with pAF and athletic status (p &lt;.001). SD-TPS was associated with pAF (p &lt;.001) but not athletic status (p =.173). We found no significant trend between years of exercise and SD-TPS in individuals without AF (p =.893). SD-TPS did not add incremental value in identifying athletes with pAF in addition to clinical markers, QRS width, LA volume, and LASr (p =.056). Conclusion: LA MD was associated with pAF regardless of athletic status but not related to years of endurance exercise, suggesting LA MD could be a promising marker of pathological atrial remodeling in athletes. However, we found no incremental value of LA MD identifying athletes with pAF when LASr was included in the model.</p>}},
  author       = {{Sørensen, Eivind and Myrstad, Marius and Solberg, Magnar Gangås and Øie, Erik and Platonov, Pyotr G. and Carlson, Jonas and Tveit, Arnljot and Aarønæs, Marit}},
  issn         = {{0742-2822}},
  keywords     = {{athletes heart; atrial fibrillation; exercise; left atrium; strain}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{679--686}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Echocardiography}},
  title        = {{Left atrial dyssynchrony in veteran endurance athletes with and without paroxysmal atrial fibrillation}},
  url          = {{http://dx.doi.org/10.1111/echo.15634}},
  doi          = {{10.1111/echo.15634}},
  volume       = {{40}},
  year         = {{2023}},
}