Heart failure & cardiomyopathies
Myocardial work indexes in elite athletes: An emerging echocardiographic tool to confirm physiologic cardiac remodeling in elite athletes with mildly reduced systolic function
Authors' conclusion
MWI could be used as additive tool to characterize the physiologic nature of mildly reduced EF of endurance athletes, presenting with better functional parameters but preserved MWI values. MWI may be helpful in differential diagnosis of athlete's heart from DCM.
Study context
- Population
- Olympic athletes practicing endurance and mixed disciplines who underwent cardio-pulmonary exercise test (CPET) and transthoracic echocardiogram55.5% males, mean age 26.3 ± 4.3 years
- Participants
- 306 athletes
- Exposure
- Athletes with lower vs normal left ventricular ejection fraction (LVEF)
- LVEF<55%n = Twenty-seven
- Outcome
- LVEDVi
Main finding
As reported in the abstract
P = 0.035
Observational data: associations, not effects.
Further findings
| Outcome | LVEF<55% | LVEF≥55% |
|---|---|---|
| Myocardial work indexes (GWI, GCW, GWW, GWE) | ||
| GWI | 1,757.9 ± 242 mmHg% | 1,839.8 ± 255.6 mmHg% |
| GCW | 2,121.6 ± 269.3 mmHg% | 2,209.3 ± 281 mmHg% |
| GWW | 95.2 ± 40.7 mmHg% | 87.1 ± 47.4 mmHg% |
| GWE | 95.2 ± 1.7% | 95.7 ± 2% |
| CPET parameters (Watts, VO2 mL/min/Kg, O2 pulse) | ||
| Watts | 340.0 ± 83.7 | 291.6 ± 84.8 |
| VO2 mL/min/Kg | 51.0 ± 13.5 | 46.0 ± 10.1 |
| O2 pulse | 23.5 ± 4.6 | 21 ± 5.3 |
- LV mass and LAVi · LV mass, larger with EF < 55%
- P = 0.049
- LV mass and LAVi · LAVi, larger with EF < 55%
- P = 0.016
- Myocardial work indexes (GWI, GCW, GWW, GWE): GWI P = .112
- Myocardial work indexes (GWI, GCW, GWW, GWE): GCW P = .124
- Myocardial work indexes (GWI, GCW, GWW, GWE): GWW P = .394
- Myocardial work indexes (GWI, GCW, GWW, GWE): GWE P = .181
- CPET parameters (Watts, VO2 mL/min/Kg, O2 pulse): Watts P = .004
- CPET parameters (Watts, VO2 mL/min/Kg, O2 pulse): VO2 P = .020
- CPET parameters (Watts, VO2 mL/min/Kg, O2 pulse): O2 pulse P = .020
Myocardial work indexes (GWI, GCW, GWW, GWE)
- No differences in GWI, GCW, GWW or GWE
CPET parameters (Watts, VO2 mL/min/Kg, O2 pulse)
- Higher with EF < 55%
Original publication
Myocardial work indexes in elite athletes: An emerging echocardiographic tool to confirm physiologic cardiac remodeling in elite athletes with mildly reduced systolic function. Am Heart J. Published 8 September 2025. doi:10.
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