A novel insight into the athlete's heart. hemodynamic forces evaluation by cardiovascular magnetic resonance

Background: Hemodynamic forces (HDFs) data on elite athletes are scarce. Thus, we aimed to assemble HDFs on a large cohort of Olympic athletes. Methods: Three hundred and twenty Olympic athletes and 42 sedentary individuals with normal cardiovascular evaluation voluntarily underwent CMR without contrast administration. Global longitudinal strain (GLS) and HDFs were computed with dedicated software using the three long-axis cine-images. Data were compared between athletes of different sports categories based on ESC sports classification; comparisons between male and female athletes were also provided. A comparison between sedentaries and athletes' HDFs parameters was also performed. Results: No differences in ejection fraction (EF) were found between athletes of different sports categories (p = 0.211). LV-GLS was slightly lower among endurance athletes, with significant differences found only between them and skill athletes (p = 0.020). HDFs in the entire cardiac cycle, systole and diastole, showed no differences between athletes of different sports categories. Female athletes showed higher EF and GLS than males (p < 0.001); no differences in HDFs longitudinal components between male and female athletes were observed. However, males showed a slightly higher HDFs-LS systolic component and a higher systolic ratio (p = 0.001 for both). No differences in HDFs were found between athletes and sedentaries, except for HDFs diastolic longitudinal component being slightly higher in sedentary individuals (p = 0.010). Conclusions: In this study, we provided HDFs values of male and female Olympic athletes of all ESC sports categories for the first time. We observed no significant differences among different sports disciplines, supporting that physiologic remodelling related to sports does not negatively affect systolic function.