Endurance athletes with left ventricular hypertrophy had deformation values within normal limits, based on echocardiographic findings from 182 adults who participated in a study.
Because hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death in athletes, it's important to distinguish between HCM and left ventricular hypertrophy (LVH), the changes in heart cavity size and wall thickness that often occur in endurance athletes, according to Dr. Arco J. Teske of the University Medical Center in Utrecht, the Netherlands.
Dr. Teske and colleagues compared imaging data from 120 athletes and 62 nonathletic controls aged 18–40 years who had a normal electrocardiogram and no history of cardiovascular disease, diabetes, or hypertension. The study population included 57 amateur athletes who trained at least 9 hours but not more than 18 hours each week, 63 Olympic-level athletes who trained more than 18 hours each week, and 62 healthy controls who exercised less than 3 hours each week. Overall, 62% of the athletes and 58% of the controls were men.
The athletes participated in endurance sports including rowing, triathlons, cycling, and running. The study did not include individuals with HCM or hypertension-induced LVH (doi:10.1136/bjsm.2008.054346).
The researchers performed a standard echocardiographic exam and measured left ventricular dimensions, and they identified LVH in 33 athletes (28%). LVH was defined as an LV mass greater than 132 g/m
Tissue Doppler imaging showed no differences in strain or strain-rate values among athletes with LVH, compared with controls and athletes who did not have LVH. In a regional deformation analysis, a barely significant correlation appeared between anteroseptal wall thickness and both strain and strain-rate in athletes with LVH, which suggested a slight reduction in septal longitudinal function when the septal wall was thicker. But the correlations remained similar to those of the entire study group, and no significant correlations appeared between posterior wall thickness and regional deformation values.
Previous studies have identified cutoff values of −10.6% for peak systolic strain and a septal/posterior ratio greater than 1.3 as signs of HCM, and none of the patients in this study met those criteria, despite the gradual reduction associated with the increased wall thickness, the researchers noted.
These findings indicate that a moderate reduction in regional septal deformation shouldn't be considered problematic in an endurance athlete with “echocardiographic LVH of unknown origin,” they concluded.
Dr. Teske and his colleagues had no financial conflicts to report.