Physiological Cyclic Variation of the Myocardial Integrated Backscatter Signal in Athlete's Heart

Background: Left ventricular hypertrophy which realizes in athlete's heart could create some problems of acoustic reflection related to the increase of myocytic and not-myocytic elements of the heart. The aim of the present study was to analyze the ultrasonic backscatter myocardial indexes both as peak end-diastolic signal intensity and as its cardiac-cyclic variation in athlete's heart, compared to healthy sedentary controls. Methods: Two groups of ten subjects each, all males of mean age (31.6 ± 3.5), and of comparable weight and height were analyzed: group (A) comprised ten cyclists of good professional level and group (C) included ten healthy subjects acting as controls. A 2D-color Doppler echocardiography with a digital echograph Agilent Technologies (AT) Sonos 5500 was carried out on all subjects in the study for the conventional analysis of the left ventricular mass and function. The ultrasonic myocardial integrated backscatter signal (IBS) was analyzed with an “Acoustic Densitometry” module implemented on an AT echograph. The signal was also sampled with a R.O.I. placed at interventricular septum and at posterior left ventricular wall level. The systo-diastolic variation of the backscatter was also considered as Cyclic Variation Index (CVl_ibs). Results: The left ventricular mass was significantly higher in athletes in comparison with controls (LVM_bs: A: 154.5 ± 18.7; C: 101.4 ± 12.4; p < 0.001). The end diastolic IBS signal did not show significant statistical differences between the two groups. The CVl_ibs both at septum (A: 30.5 ± 5.3; C: 27.2 ± 7.3; p < 0.002) and posterior wall level (A: 43.7 ± 9.1; C: 40.7 ± 9.1; p < 0.001) though was comparable in both groups. Conclusion: The conclusions reached in the present study confirmed the physiology of the left ventricular hypertrophy of the athlete's heart evaluated with an ultrasonic integrated backscatter tissue characterization, in particular through the cyclic variation of integrated backscatter myocardial signal. This finding is probably the expression of a preserved intramural myocardial function in the athlete's heart despite the increase of left ventricular mass induced by physical training.

Ultrasonic tissue characterization, integrated backscatter, athlete's heart.

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