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Different involvement of right ventricular myocardial function in either physiologic or pathologic left ventricular
Antonello D'Andrea1, Pio Caso, Sergio Severino
1Department of Cardiology, Second University of Naples and Monaldi Hospital, Italy. adandrea@synapsis.it
Summary
Right ventricular (RV) myocardial function differs between endurance athletes and hypertrophic cardiomyopathy patients. Doppler tissue imaging can help differentiate these conditions, showing distinct RV involvement in physiologic versus pathologic left ventricular hypertrophy.
Area of Science:
- Cardiology
- Sports Medicine
- Medical Imaging
Background:
- Left ventricular (LV) hypertrophy can result from athletic training or hypertrophic cardiomyopathy (HC).
- Distinguishing between physiologic (athlete's heart) and pathologic LV hypertrophy is clinically important.
- Right ventricular (RV) myocardial function may be affected differently in these conditions.
Purpose of the Study:
- To analyze RV myocardial function in athletes and HC patients with similar LV hypertrophy.
- To investigate the utility of Doppler tissue imaging in differentiating these groups.
Main Methods:
- Doppler echocardiography and pulsed Doppler tissue imaging were used.
- 32 male endurance athletes (AT) and 27 male HC patients were studied.
- Measurements included mitral and tricuspid annulus velocities and LV mass index.
Main Results:
- LV mass index was comparable between AT and HC groups.
- RV myocardial early-diastolic (Em) peak velocities were lower in HC patients.
- RV Em peak velocity < 0.16 m/s showed high sensitivity (89%) and specificity (93%) in differentiating AT from HC.
Conclusions:
- RV myocardial function is influenced by preload in athletes and inversely correlated with septal thickness in HC.
- Doppler tissue imaging is a valuable tool for differentiating athlete's heart from HC.
- RV myocardial involvement differs significantly between physiologic and pathologic LV hypertrophy.