[Left ventricular mass in endurance-athletes with athlete's heart and untrained subjects--comparison between...

The echocardiographic determination of left ventricular mass (LVM) and volume is of importance for the interpretation of cardiac adaptations and risk-stratification. In pathologically hypertrophied hearts, conventional one- and two-dimensional echocardiographic methods tend to overestimate LVM. For the athlete's heart, a comparison between different echocardiographic methods and magnetic resonance imaging (MRI) has not been performed so far. 23 healthy male endurance-athletes (28+/-4 yr) with athlete's heart (A) and 26 healthy untrained males (U; 26+/-4 yr) were examined by MRI and the following echocardiographic methods: ASE-Cube (ASE), Devereux (DEV), Troy (TRO), Teichholz (TEI), Reichek (REI) and Dickhuth (DIC). Indexed LVM were: MRI: 107+/-6 g/m(2) (A), 79+/-7 g/m(2) (U); ASE: 170+/-20 g/m(2) (A), 119+/-14 g/m(2) (U); DEV: 134+/-16 g/m(2) (A), 95+/-11 g/m(2) (U); TRO: 134+/-16 g/m(2) (A), 92+/-12 g/m(2) (U); TEI: 115+/-10 g/m(2) (A), 91+/-8 g/m(2) (U); REI: 114+/-14 g/m(2) (A), 89+/-11 g/m(2) (U); DIC: 110+/-14 g/m(2) (A); 80+/-9 g/m(2) (U). In A and U, LVM is significantly overestimated by ASE, DEV, TRO, TEI, and REI compared to MRI (p<0.05), but not by DIC. Although coefficients of correlation were similar, only DIC revealed acceptable limits of agreement (ASE: +20 to +172 g; DEV: -13 to +93 g; TRO: -18 to +92 g; TEI: -17 to +53 g; REI: -25 to +57 g; DIC: -37 to +45 g). Depending on the used method, LVM upper limits range between 93 (MRT) and 146 g/m(2) (ASE) in U, and 119 (MRT) and 209 g/m(2) (ASE) in A.

Compared to MRI, DIC is the most accurate conventional echocardiographic method to determine LVM in U and A. For a correct interpretation of LVM, differences of the echocardiographic methods have to be considered.