Sports and Exercise Cardiology sT ruc Tural and func Tional differences in p hysiological versus p aThological p aTTerns of lefT aTrial r emodeling: a s peckle Tracking sT rain echocardiography sT udy

methods: A total of 143 subjects were studied in two groups: 91 healthy volunteers included 77 athletes, and 52 patients with diastolic dysfunction including 27 patients with AF. LAVi was correlated with diastolic function and speckle tracking derived global LA Ɛ and LV Ɛ . r esults: For patients, LA Ɛ and LV Ɛ (Fig. A and B) independently predicted LAVi (R2=0.51, P=0.04 for both). In contrast, volunteers showed higher LA Ɛ (40±10 vs. 23±12%, P<0.01) despite similar LAVi (P=0.21). LAƐ in volunteers correlated with LV early (r=0.36; P<0.01), late diastolic (r=0.39; P<0.01) annular velocities and end-diastolic volume (r=0.27; P=0.02). LA Ɛ showed diagnostic value in differentiating pathologic and physiologic LA remodeling (Fig. C; AUC, 0.84, P< 0.01). conclusions: In patients with diastolic dysfunction, an increase in LA size is accompanied with reduced LA and LV deformation. LA size in athletes, however, is associated with dynamic diastolic flux of blood volume due to enhanced LV lengthening mechanics. This relationship may be useful for distinguishing patients with pathological and physiological pattern of LA remodeling.