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Background: Regular exercise in athletes is associated with cardiac acclimation in the form of functional and structural changes. Its effect on the cardiac functions still debated. Objective: The objective was to detect the impact of long-term regular physical exercise on the cardiac systolic and diastolic function of soccer players. Materials and Methods: Thirty professional soccer players were examined twice, the first examination was made during the passive resting period before the beginning of the season (measurement I) and the second during the peak of the season (measurement II). At both examinations, players underwent electrocardiogram (ECG), conventional Echo-Doppler, pulsed tissue Doppler imaging on both septal and lateral sides of the mitral annulus and lateral tricuspid annulus. The (propagation velocity [Vp]) values were measured. Paired t -test was used for comparison. Results: The following changes between measurement I and measurement II were found: ECG Changes; 80% of the entire group showed early repolarization, 93% had left ventricular hypertrophy (LVH) by voltage criteria, 20% showed right atrial abnormalities, 20% left atrial abnormalities, 40% showed inverted T-wave in leads V1-V4, 5% showed mobitz type I second degree heart block, and 5% showed incomplete right bundle branch block. Echo changes; The mitral E/E` ratio increased from 6.18 ± 1.27 to 6.91 ± 1.18; the Vp decreased from 56.3 ± 9.23 to 50.67 ± 8.6; the tricuspid valve Ratio between the early and late peak pulsed Doppler velocities on tricuspid valve decreased from 1.67 ± 0.23 to 1.54 ± 0.23 while the E`/A` ratio decreased from 1.67 ± 0.53 to 1.28 ± 0.49; the (isovolumetric relaxation time) of the right ventricle increased from 52.4 ± 11.33 to 58.17 ± 10.73; the (isovolumetric contraction time) decreased from 70.47 ± 9.9 to 65.2 ± 7.9. All changes were statistically significant at P Conclusions: Long-term regular exercise in soccer players is associated with cardiac alterations in the form of bradycardia, early repolarization, inverted T-wave, concentric LVH, and a tendency toward diastolic impairment of both ventricles.

BackgroundSmoking is an independent risk factor for coronary heart diseases and it increases all causes of cardiovascular morbidity and mortality.Aim of the workTo assess the acute effect of cigarette smoking on ventricular diastolic functions (LV and RV) in healthy, young, and slim smokers.MethodsThirty volunteers who had recently commenced smoking (less than one year) and who smoked 1–2 cigarettes per day, underwent ECG, 2D and M-mode echocardiography, standard Doppler echocardiography, pulsed TDI (tissue Doppler imaging) on septal and lateral side of mitral annulus and lateral tricuspid annulus. Vp values were measured. The investigator asked them to hold smoking for at least two days after which echocardiographic examination was conducted before smoking one cigarette and the second examination conducted immediately after smoking one cigarette containing at least 0.4mg of nicotine.ResultsDoppler findings over the mitral valve showed the E wave was significantly reduced from 82.7±10.4 to 74.6±10.4 after smoking; the A wave increased; the E/A ratio was reduced from 1.5±0.3 to 1.2±0.2; the E′ septal significantly decreased (15.3±2.4 vs. 11.2±1.1) after smoking, and the E/E′ ratio increased from 5.5±1.1 to 6.7±1.1. Doppler findings over the tricuspid valve showed the E wave was reduced from 60.6±9.7 to 52.7±9.6; the A wave increased from 42.2±6.5 to 50.1±6.6; and the E/A ratio decreased (1.45±0.25 vs. 1.06±0.19). The E′ significantly decreased from 14.1±1.8 to 10.9±2.4, while the A′ increased (10.2±2.4 vs. 12.7±3.6) after smoking; and the IVRT of the RV was significantly prolonged from 62.9±7.5 to 68.7±7.9 after smoking. The Vp was markedly reduced from 67.8±8 to 55.2±3.5 after smoking. These findings reflected on the LV filling pressure (LVFvp) which increased from 9.8±1.4 to 10.5±1.3 after smoking. All changes were statistically significant at P