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PurposeVolume indices and left ventricular ejection fraction (LVEF) are routinely used to assess cardiac function. Ventricular strain values may provide additional diagnostic information, but their reproducibility is unclear. This study therefore compares the repeatability and reproducibility of volumes, volume fraction, and regional ventricular strains, derived from cardiovascular magnetic resonance (CMR) imaging, across three software packages and between readers.MethodsSeven readers analysed 16 short-axis CMR stacks of a porcine heart. Endocardial contours were manually drawn using OsiriX and Simpleware ScanIP and repeated in both softwares. The images were also contoured automatically in Circle CVI42. Endocardial global, apical, mid-ventricular, and basal circumferential strains, as well as end-diastolic and end-systolic volume and LVEF were compared.ResultsBland-Altman analysis found systematic biases in contour length between software packages. Compared to OsiriX, contour lengths were shorter in both ScanIP (-1.9 cm) and CVI42 (-0.6 cm), causing statistically significant differences in end-diastolic and end-systolic volumes, and apical circumferential strain (all pConclusionOsiriX and CVI42 gave consistent results for all strain and volume metrics, with no statistical differences found between OsiriX and ScanIP for mid-ventricular, global or basal strains, or left ventricular ejection fraction. However, volumes were influenced by the choice of contouring software, suggesting care should be taken when comparing volumes across different software.

AIMS: Right ventricular (RV) adaptation is a common finding in the athlete's heart. The aim of this study was to establish the extent of RV structural and functional adaptation in elite and academy professional footballers compared to age-matched controls.METHODS AND RESULTS: A total of 100 senior and 100 academy elite footballers and 20 senior and 19 academy age-matched controls were recruited. All participants underwent 2D, Doppler, tissue Doppler, and strain (ε) echocardiography of the right heart. Structural indices were derived and indexed allometrically for individual differences in body surface area. Standard RV function was assessed alongside peak RV ε and strain rate (SR). Senior football players had larger scaled RV structural parameters than academy players for the RV outflow (RVOTplax ) (32.7 ± 4.2 and 29.5 ± 4.0 mm(m2 )0.326 , P < 0.001), the proximal RV outflow (RVOT1 ) (26.6 ± 3.5 and 24.7 ± 3.9 mm(m2 )0.335 , P < 0.001), the basal RV inflow (RVD1 ) (33.1 ± 4.1 and 30.7 ± 3.2 mm(m2 )0.404 , P = 0.020), RV length (RVD3 ) (66.5 ± 6.1 and 62.9 ± 5.1 mm(m2 )0.431 , P < 0.001), and RV diastolic area (RVDarea ) (16.9 ± 2.6 and 15.7 ± 2.6 mm(m2 )0.735 , P < 0.001). Both academy and senior football players demonstrated larger scaled structural RV parameters in comparison with age-matched controls. Systolic SR (SRS) was lower in the senior players compared to academy players in the mid (-1.52 ± 0.49 and -1.41 ± 0.34 L/s, P = 0.019) and apical (-1.97 ± 0.74 and -1.72 ± 0.42 L/s, P = 0.025) wall regions, respectively.CONCLUSION: Right ventricular structural adaptation occurs in both senior and academy football players with senior players having larger RV dimensions. Although senior players have slightly lower peak SRS than academy players, all global ε and SR are within normal ranges.