How does physical exercise with health purposes or recreational sports affect the left atrium? Meta-analysis of observational and experimental studies.

Authors

DOI: https://doi.org/10.6018/sportk.535001
Keywords: Physical exercise , Left atrium

Abstract

Introduction: Physical exercise affects the morphology and function of the left atrium. Elite athletes have increased volume without increasing stiffness. The effect of exercise on the atria of the general population is less well known.

Objective: To evaluate the effect of aerobic exercise on the anatomy and function of the left atrium. Main objective: compare left atrial volume indexed to body surface area; secondaries: to compare ejection fraction and left atrial peak longitudinal strain, E/e´ ratio and new atrial fibrillation in a population that practices aerobic exercise for at least 4 weeks vs non-active.

Method: Meta-analysis of observational or experimental studies. Excluded: subjects with baseline atrial fibrillation, non-aerobic exercise; elite/professional athletes. Keywords: “physical exercise AND left atrial function”, until 2/21/2022 in Pubmed, Scielo, clinicaltrials.gov and hand-search.

Results: Eleven studies included in main outcome; 789 subjects, median age 52 years; female sex 24%. Main outcome (only statistically significant): left atrial index volume 2.65 ml/m2 ˃ in the exercise group (p=0.006). No results were found for incidence of atrial fibrillation.

Conclusions: In the general population, aerobic exercise favors dilation of the left atrium. The relevance is doubtful due to contradictory and non-significant results on atrial stiffness.

Downloads

Download data is not yet available.

References

Barczuk-Falęcka, M., Małek, Ł. A., Krysztofiak, H., Roik, D., & Brzewski, M. (2018). Cardiac Magnetic Resonance Assessment of the Structural and Functional Cardiac Adaptations to Soccer Training in School-Aged Male Children. Pediatric cardiology, 39(5), 948–954. https://doi.org/10.1007/s00246-018-1844-5

Corrado, D., Basso, C., Rizzoli, G., Schiavon, M., & Thiene, G. (2003). Does sports activity enhance the risk of sudden death in adolescents and young adults? Journal of the American College of Cardiology, 42(11), 1959–1963. https://doi.org/10.1016/j.jacc.2003.03.002

D'Ascenzi, F., Pelliccia, A., Natali, B. M., Cameli, M., Andrei, V., Incampo, E., Alvino, F., Lisi, M., Padeletti, M., Focardi, M., Bonifazi, M., & Mondillo, S. (2015). Increased left atrial size is associated with reduced atrial stiffness and preserved reservoir function in athlete's heart. The international journal of cardiovascular imaging, 31(4), 699–705. https://doi.org/10.1007/s10554-015-0600-7

D'Ascenzi, F., Pelliccia, A., Natali, B. M., Cameli, M., Lisi, M., Focardi, M., Padeletti, M., Palmitesta, P., Corrado, D., Bonifazi, M., Mondillo, S., & Henein, M. (2015). Training-induced dynamic changes in left atrial reservoir, conduit, and active volumes in professional soccer players. European journal of applied physiology, 115(8), 1715–1723. https://doi.org/10.1007/s00421-015-3151-7

Edelmann, F., Gelbrich, G., Düngen, H. D., Fröhling, S., Wachter, R., Stahrenberg, R., Binder, L., Töpper, A., Lashki, D. J., Schwarz, S., Herrmann-Lingen, C., Löffler, M., Hasenfuss, G., Halle, M., & Pieske, B. (2011). Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. Journal of the American College of Cardiology, 58(17), 1780–1791. https://doi.org/10.1016/j.jacc.2011.06.054

Egelund, J., Jørgensen, P. G., Mandrup, C. M., Fritz-Hansen, T., Stallknecht, B., Bangsbo, J., Nyberg, M., & Hellsten, Y. (2017). Cardiac Adaptations to High-Intensity Aerobic Training in Premenopausal and Recent Postmenopausal Women: The Copenhagen Women Study. Journal of the American Heart Association, 6(8), e005469. https://doi.org/10.1161/JAHA.117.005469

Engvall, J. E., Aneq, M. Å., Nylander, E., Brudin, L., & Maret, E. (2021). Moderately trained male football players, compared to sedentary male adults, exhibit anatomical but not functional cardiac remodelling, a cross-sectional study. Cardiovascular ultrasound, 19(1), 36. https://doi.org/10.1186/s12947-021-00263-0

Fan, J. L., Su, B., Zhao, X., Zhou, B. Y., Ma, C. S., Wang, H. P., Hu, S. D., Zhou, Y. F., Ju, Y. J., & Wang, M. H. (2020). Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with normal left ventricular ejection fraction. The international journal of cardiovascular imaging, 36(9), 1659–1666. https://doi.org/10.1007/s10554-020-01869-7

Jalaludeen, N., Bull, S. J., Taylor, K. A., Wiles, J. D., Coleman, D. A., Howland, L., Mukhtar, O., Cheriyan, J., Wilkinson, I. B., Sharma, R., & O'Driscoll, J. M. (2020). Left atrial mechanics and aortic stiffness following high intensity interval training: a randomised controlled study. European journal of applied physiology, 120(8), 1855–1864. https://doi.org/10.1007/s00421-020-04416-3

Long, L., Mordi, I. R., Bridges, C., Sagar, V. A., Davies, E. J., Coats, A. J., Dalal, H., Rees, K., Singh, S. J., & Taylor, R. S. (2019). Exercise-based cardiac rehabilitation for adults with heart failure. The Cochrane database of systematic reviews, 1(1), CD003331. https://doi.org/10.1002/14651858.CD003331.pub5

Mahjoub, H., Le Blanc, O., Paquette, M., Imhoff, S., Labrecque, L., Drapeau, A., Poirier, P., Bédard, É., Pibarot, P., & Brassard, P. (2019). Cardiac remodeling after six weeks of high-intensity interval training to exhaustion in endurance-trained men. American journal of physiology. Heart and circulatory physiology, 317(4), H685–H694. https://doi.org/10.1152/ajpheart.00196.2019

Mascia, G., Perrotta, L., Galanti, G., & Padeletti, L. (2013). Atrial fibrillation in athletes. International journal of sports medicine, 34(5), 379–384. https://doi.org/10.1055/s-0032-1321896

Opondo, M. A., Aiad, N., Cain, M. A., Sarma, S., Howden, E., Stoller, D. A., Ng, J., van Rijckevorsel, P., Hieda, M., Tarumi, T., Palmer, M. D., & Levine, B. D. (2018). Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation? A Longitudinal Study of Left Atrial Structure and Function. Circulation. Arrhythmia and electrophysiology, 11(5), e005598. https://doi.org/10.1161/CIRCEP.117.005598

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de cardiología (English ed.), 74(9), 790–799. https://doi.org/10.1016/j.rec.2021.07.010

Pandey, A., Parashar, A., Kumbhani, D., Agarwal, S., Garg, J., Kitzman, D., Levine, B., Drazner, M., & Berry, J. (2015). Exercise training in patients with heart failure and preserved ejection fraction: meta-analysis of randomized control trials. Circulation. Heart failure, 8(1), 33–40. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001615

Pelliccia, A., Maron, B. J., Di Paolo, F. M., Biffi, A., Quattrini, F. M., Pisicchio, C., Roselli, A., Caselli, S., & Culasso, F. (2005). Prevalence and clinical significance of left atrial remodeling in competitive athletes. Journal of the American College of Cardiology, 46(4), 690–696. https://doi.org/10.1016/j.jacc.2005.04.052

Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J. P., Corrado, D., Drezner, J. A., Halle, M., Hansen, D., Heidbuchel, H., Myers, J., Niebauer, J., Papadakis, M., Piepoli, M. F., Prescott, E., Roos-Hesselink, J. W., Graham Stuart, A., Taylor, R. S., … ESC Scientific Document Group (2021). 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. European heart journal, 42(1), 17–96. https://doi.org/10.1093/eurheartj/ehaa605

Sayegh, A., Dos Santos, M. R., Rondon, E., de Oliveira, P., de Souza, F. R., Salemi, V., Alves, M., & Mady, C. (2019). Exercise Rehabilitation Improves Cardiac Volumes and Functional Capacity in Patients with Endomyocardial Fibrosis: A RANDOMIZED CONTROLLED TRIAL. Journal of cardiopulmonary rehabilitation and prevention, 39(6), 373–380. https://doi.org/10.1097/HCR.0000000000000445

Sørensen, E., Myrstad, M., Solberg, M. G., Øie, E., Tveit, A., & Aarønæs, M. (2021). Left atrial function in male veteran endurance athletes with paroxysmal atrial fibrillation. European heart journal. Cardiovascular Imaging, 23(1), 137–146. https://doi.org/10.1093/ehjci/jeab248

Wuthiwaropas, P., Bellavia, D., Omer, M., Squires, R. W., Scott, C. G., & Pellikka, P. A. (2013). Impact of cardiac rehabilitation exercise program on left ventricular diastolic function in coronary artery disease: a pilot study. The international journal of cardiovascular imaging, 29(4), 777–785. https://doi.org/10.1007/s10554-012-0152-z

Published
02-10-2022
How to Cite
Florio, L., & Rivoir, S. . (2022). How does physical exercise with health purposes or recreational sports affect the left atrium? Meta-analysis of observational and experimental studies. SPORT TK-EuroAmerican Journal of Sport Sciences, 11, 1. https://doi.org/10.6018/sportk.535001
Issue
Section
Articles