Presentation Abstract

Title: P2-47 - Left Ventricular Twisting by Speckle Tracking: A Study on Master Athletes With Mitral Valve Prolapse
Authors: Alessio De Luca, Loira Toncelli, Laura Stefani, Roberta M. C. Vono, Giorgio Galanti. University of Florence - Careggi Hospital, Florence, Italy
Abstract Body: Background: Mitral valve prolapse (MVP) is often characterized by various symptoms (MVP syndrome, MVPS). Previous studies showed an increased adrenergic tone in MVPS established by epinephrine and norepinephrine urinary concentration. Regular training causes a reduction of adrenergic tone. Aim of study was to assess left ventricle (LV) twist by speckle-tracking (ST) in master athletes and sedentary controls with and without MVPS. Methods: Since March 2009 to May 2011, 115 sex and age-matched subjects were enrolled and divided in four groups: A-MVPS: 28 master athletes with MPVS (40.0±14 yrs), A-HLT: 30 masters athletes without PVM (43.4±15 yrs), S-MVPS: 27 sedentary with MVPS (45.1±14 yrs), S-HLT: 30 healthy sedentary (44.4±12.4 yrs). Master athletes were regularly trained cyclists (78%) and runners (22%) with mean 19.5±0.5 hours/week training for at least 8.0±0.5 yrs. Sedentary subjects don’t practice any kind of regular exercise for at least 12 months. All subjects underwent 2D echocardiography and ST analysis, calculating Left Ventricle (LV) rotation, twist, circumferential strain (CS) and longitudinal strain (LS). Results: Heart rate (HR) was significantly lower in athletes compared to sedentary. However, A-MVPS showed a slightly higher HR than A-HLT. LVMi was significantly increased in A-HLT compared to other groups. Left ventricular diastolic diameter (LVDD) was also significantly higher in athletes than sedentary subjects. Ejection fraction (EF) was not significantly different among the groups. In S-MVPS, basal CS was significantly higher than healthy athletes (p=.01). Basal rotation was significantly higher in S-MVPS than other groups (p=.01). Apical rotation was statistically higher in S-MVPS compared with people without MVPS both sedentary and athletes (p=.01), but not in A-MVPS athletes. LV Twist measured in S-MVPS (20,4±6,9°) was significantly higher than healthy sedentary (15,5±4,0°, p<.001) and athletes, both with MVPS (16,1±5,1°, p=.007) and without MVPS (15,3±4,0°, p=.0001). No significant correlation between LV Twist and age, HR, EF and LVMi and LVDD were found. Conclusions: LV twist increase in S-MVPS group is probably due to hyperadrenergic tone. It could also be an adaptive mechanism in response to an initial dysfunction to maintain a normal LV output. In A-MVPS this increase wasn’t statistically significant, maybe due to physiological reduction of adrenergic tone in response to regular training. Sport seems to be a protective factor to counteracts the LV remodelling due to MVPS.


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