Remodelado auricular adverso en atletas de alto rendimiento: Estudio de deformación auricular con speckle tracking 2D

background: highly trained athletes are at increased risk of atrial fibrillation (af) and flutter. atrial dilatation and dysfunction might be the underlying substrate for the increased risk. the aim of the present study was to relate atrial size and deformation in a selected group of highly trained athletes and patients with paroxysmal atrial fibrillation (paf). methods: 20 professional male hand-ball players, 18 patients with paf and 20 healthy age-matched, non-sportive males were compared. all subjects underwent a transthoracic echocardiogram with evaluation of left atrial (la) dimensions. left atrial strain (lasa) and strain rate (lasra) derived from speckle tracking were used to evaluate la deformation post atrial contraction. results: la volumes were significantly larger in athletes and paf patients compared to controls (36 + 1.7 ml/m2; 36 ± 2.3 ml/m2 and 24 + 1 ml/m2, respectively, p < 0.01;). lasa and lasra during active atrial contraction were decreased in paf patients compared to athletes and controls (-10.6 ± 0.2 %; -12.2 ± 0.4 % and -14.5 ± 0.5 %, p < 0.01 for lasa and -1.2 ± 0.08 sec-1; -1.5 ± 0.12 sec-1; -1.7 ± 0.13 sec-1, p= 0.04 for lasra respectively). athletes with la volume > 40 ml/m2 (n=7) showed reduced lasa compared to athletes with la volume < 40 ml/m2 (-10.3 ± 0.4% versus -13.0 ± 0.5%, p < 0.01). paf patients had lasa values similar to those of subjects with normal la volume. conclusion: athletes with increased la volume exhibit lower strain parameters compared to subjects with paf. it is postulated that measurement of la strain may be used to predict development of af in highly trained athletes.