{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T16:43:16Z","timestamp":1786293796088,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study investigated standard and advanced echocardiographic parameters in endurance athletes with different training profiles, and their association with exercise performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive endurance athletes undergoing cardiological screening or orthopedic evaluation for knee injuries at Campus Bio\u2010Medico University Hospital underwent advanced echocardiography and cardiopulmonary exercise testing. Athletes were categorized into three groups: (1) Long\u2010Distance (marathon and ultramarathon runners,\n                      <jats:italic>n<\/jats:italic>\n                      = 30); (2) Mid\u2010Distance (middle\u2010distance runners,\n                      <jats:italic>n<\/jats:italic>\n                      = 27); and (3) Detrained (\u2265 6 months training interruption,\n                      <jats:italic>n<\/jats:italic>\n                      = 31).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Left ventricular ejection fraction did not differ among groups. The Long\u2010Distance group had the highest stroke volume index, followed by the Mid\u2010Distance and Detrained groups (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Long\u2010Distance athletes showed lower left ventricular global longitudinal strain (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003) and left atrial reservoir strain (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003) compared to the other groups, with no differences in right ventricular free wall strain. Myocardial work analysis showed higher work index and constructive work, and lower wasted work, leading to greater global work efficiency in the Long\u2010Distance group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). In multivariable linear regression analysis, stroke volume index (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 1.02,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and global work efficiency (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 1.00,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) were independently associated with Peak VO\n                      <jats:sub>2<\/jats:sub>\n                      , whereas global longitudinal strain was not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Advanced echocardiography provides additional insights into the athlete's heart. Myocardial work indices reflect training\u2010related cardiac adaptations, and left atrial reservoir strain is influenced by training status. These findings, together with the association of stroke volume index and global work efficiency with Peak VO\n                      <jats:sub>2<\/jats:sub>\n                      , support the integration of advanced echocardiographic parameters into athlete evaluation and monitoring.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70505","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:26:27Z","timestamp":1778858787000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Echocardiographic Parameters and Athlete Performance: Associations and Training Profile Comparisons"],"prefix":"10.1111","volume":"43","author":[{"given":"Emiliano","family":"Guerra","sequence":"first","affiliation":[{"name":"Cardiac Rehabilitation Unit, Cardiac Thoracic and Vascular Department Carlo Poma Hospital  Mantova 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