ABC | Volume 115, Nº1, July 2020

Viewpoint Silva Diastolic function in athletes Arq Bras Cardiol. 2020; 115(1):134-138 Diastolic function in athletes and in highly active people should be normal or increased, and any pieces of diastolic disfunction evidence should alert us for any pathology. 13 Large metanalysis data pointed that exercises promote an increase in diastolic function through the combination of a more effective early diastolic relaxation and increased ventricular compliance. 14 The type of physical activity is also related to the changes observed in athletes’ diastolic function. Dynamic exercises lead to a more effective ventricular relaxation besides biventricular enlargement, while static exercises may be related to a certain degree of diastolic disfunction, 15 which usually happens with an increase in wall thickness and left ventricular concentric hypertrophy. Therefore, it is essential while evaluating ventricular function in athletes, whether they are professionals, amateurs or only “weekend players,” that we use all available tools in the echocardiographic arsenal. Ejection fraction should always be quantified by 3D echo, and evaluation of myocardial deformation (strain measurement) should be taken with the speckle tracking technique. Strain quantification can show incipient impairment in systolic function much earlier than any change in ejection fraction or 2D echocardiographic contractile abnormality could be verified. Routine evaluation of myocardial deformation would allow the detection of some underlying myocardial injury in this population. In addition, a comprehensive analysis of diastolic function must be done according to the recent guideline. It is quite common to find athletes on formulas and anabolic androgenic steroids without any prescription or medical advice, and a complete echocardiographic evaluation could detect early ventricular systolic and diastolic disfunction, thus allowing correct treatment to avoid any larger myocardial damage.  Author contributions Conception and design of the research, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Silva CES Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. Figure 2 – A) mitral annular tissue Doppler; B) apical four-chamber view on 2D echo bidimensional; C) continuous Doppler of tricuspid regurgitation; D) apical two-chamber view on 2D echo. LAA: left atrial appendage; RA: right atrium; LA: left atrium; E’L: lateral e’ velocity; E’S: septal e’ velocity; RV: right ventricle; LV: left ventricle; Vol AE: left atrium indexed volume. Vol AE = 27,9 mL/m 2 Vel RT = 1,33 m/s LV LV RV LA LA RA LAA LAA A B C D 136