Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study

Objective Our objective was to evaluate the effects of long-term reduced training on the left atrium (LA) in elite endurance athletes and to elucidate sex-specific differences in LA detraining patterns.Methods In this long-term longitudinal echocardiographic study of 50 active elite endurance athlet...

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Main Authors: Ahmad Sajadieh, Robin Christensen, Jens Jakob Thune, Mikkel Aaroee, Susanne Glasius Tischer, Christian Have Dall, Hanne Rasmusen
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open Sport & Exercise Medicine
Online Access:https://bmjopensem.bmj.com/content/11/2/e002379.full
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author Ahmad Sajadieh
Robin Christensen
Jens Jakob Thune
Mikkel Aaroee
Susanne Glasius Tischer
Christian Have Dall
Hanne Rasmusen
author_facet Ahmad Sajadieh
Robin Christensen
Jens Jakob Thune
Mikkel Aaroee
Susanne Glasius Tischer
Christian Have Dall
Hanne Rasmusen
author_sort Ahmad Sajadieh
collection DOAJ
description Objective Our objective was to evaluate the effects of long-term reduced training on the left atrium (LA) in elite endurance athletes and to elucidate sex-specific differences in LA detraining patterns.Methods In this long-term longitudinal echocardiographic study of 50 active elite endurance athletes a follow-up examination was performed 7 years after retirement from the elite programme. All echocardiographic measurements were indexed for body surface area. We analysed the changes between baseline and follow-up measures using analysis of covariance models adjusted for baseline level, sex and enrolment age as covariates. Results are reported as least squares means with two-sided 95% CIs.Results LA enlargement (left atrial maximum volume index) remained unchanged from baseline (change from baseline: 1.4mL/m2, 95% CI: −0.7 to 3.5 mL/m2) despite significant reductions in VO2max (change from baseline: −864mL/min, 95% CI: −1091 to −637 mL/min). In contrast, left ventricular (LV) end-diastolic volume was reduced (change from baseline: −8mL/m2, 95% CI: −11 to −5 mL/m2), consistent with reduced VO2max. LA contraction strain was increased (change from baseline: 1.4%, 95% CI: 0.4% to 2.5%), while LV filling pressure increased (E/e’ change from baseline: 0.4, 95% CI: 0.1 to 0.7).Conclusions 7 years of reduced training does not reverse exercise-induced LA enlargement in former elite endurance athletes. LA contractile function improved with higher LV filling pressure, suggesting that age-related LV pressure increases may contribute to chronic LA dilation, though irreversible adaptations like fibrosis cannot be ruled out.Trial registration number NCT05555849.
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spelling doaj-art-0adebeeaff4041d3a2e03eaef9648ad22025-08-20T03:07:28ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472025-04-0111210.1136/bmjsem-2024-002379Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational studyAhmad Sajadieh0Robin Christensen1Jens Jakob Thune2Mikkel Aaroee3Susanne Glasius Tischer4Christian Have Dall5Hanne Rasmusen6Department of Cardiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital, Amager-Hvidovre Hospital, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, DenmarkObjective Our objective was to evaluate the effects of long-term reduced training on the left atrium (LA) in elite endurance athletes and to elucidate sex-specific differences in LA detraining patterns.Methods In this long-term longitudinal echocardiographic study of 50 active elite endurance athletes a follow-up examination was performed 7 years after retirement from the elite programme. All echocardiographic measurements were indexed for body surface area. We analysed the changes between baseline and follow-up measures using analysis of covariance models adjusted for baseline level, sex and enrolment age as covariates. Results are reported as least squares means with two-sided 95% CIs.Results LA enlargement (left atrial maximum volume index) remained unchanged from baseline (change from baseline: 1.4mL/m2, 95% CI: −0.7 to 3.5 mL/m2) despite significant reductions in VO2max (change from baseline: −864mL/min, 95% CI: −1091 to −637 mL/min). In contrast, left ventricular (LV) end-diastolic volume was reduced (change from baseline: −8mL/m2, 95% CI: −11 to −5 mL/m2), consistent with reduced VO2max. LA contraction strain was increased (change from baseline: 1.4%, 95% CI: 0.4% to 2.5%), while LV filling pressure increased (E/e’ change from baseline: 0.4, 95% CI: 0.1 to 0.7).Conclusions 7 years of reduced training does not reverse exercise-induced LA enlargement in former elite endurance athletes. LA contractile function improved with higher LV filling pressure, suggesting that age-related LV pressure increases may contribute to chronic LA dilation, though irreversible adaptations like fibrosis cannot be ruled out.Trial registration number NCT05555849.https://bmjopensem.bmj.com/content/11/2/e002379.full
spellingShingle Ahmad Sajadieh
Robin Christensen
Jens Jakob Thune
Mikkel Aaroee
Susanne Glasius Tischer
Christian Have Dall
Hanne Rasmusen
Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
BMJ Open Sport & Exercise Medicine
title Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
title_full Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
title_fullStr Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
title_full_unstemmed Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
title_short Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study
title_sort long term left atrial adaptations to reduced training load in former elite athletes a long term follow up longitudinal observational study
url https://bmjopensem.bmj.com/content/11/2/e002379.full
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