Speckle tracking for left ventricle performance in young athletes with bicuspid aortic valve and mild aortic regurgitation

Longitudinal peak systolic strain (LPSS) quantifies regional and global heart function. Few data are available on left ventricle (LV) performance in young athletes with bicuspid aortic valve (BAV), where a pattern of mild aortic insufficiency is relatively frequent, and the ejection fraction (EF) is often normal for a long time. We report the measurement of LV strain in young BAV athletes. Three groups (20 athletes with BAV, 20 healthy athletes, and 20 sedentary healthy subjects, all aged 25 +/- 3 years) underwent standard echo examination to evaluate LPSS at the basal and medium-apical segments of the lateral wall (LW) and interventricular septum (IVS) of the LV. LPSS was within the normal range; however, in BAV athletes, the LPSS of the basal segments tended to be lower (S%IVSbasal, -17.7 +/- 2.7; S%LWbasal, -14.2 +/- 2.2; S%IVSmed-apic, -21 +/- 3.5; S%LWmed-apic, -18.8 +/- 4.2), producing a gradient from basal to apical regions. The EF was normal in all subjects. Young trained BAV athletes have normal LV performance. Nevertheless, these athletes tend to have lower strain than healthy subjects in the LV basal segments. The clinical implications of this finding are uncertain and require further investigation.