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Updated: Aug 9, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Ultrasonographic study of left ventricular function at rest in a group of highly trained black African handball
Anastase Dzudie1, Alain Menanga, Ba Hamadou
1Laboratory of Cardiac Doppler Ultrasound, General Hospital, Yaoundé - Cameroon. aitdzudie@yahoo.com
Insights
Elite Cameroonian handball players exhibit increased heart wall thickness and left ventricular dimensions. These cardiac adaptations in athletes are normal and not supranormal, reflecting training demands.
Area of Science:
- Cardiology
- Sports Medicine
- Exercise Physiology
Background:
- Most athlete's heart studies focus on Caucasian populations, potentially overlooking racial differences in cardiac response.
- Racial variations in cardiac response to conditions like hypertension are suggested, necessitating diverse study populations.
Purpose of the Study:
- To investigate morphologic cardiac adaptations in elite Cameroonian handball players.
- To compare cardiac structure and function between trained athletes and sedentary controls.
Main Methods:
- Echocardiography was used to assess cardiac morphology and function at rest.
- Twenty-one asymptomatic elite handball players were compared with 21 matched sedentary controls.
Main Results:
- Handball players showed significantly greater relative wall thickness (h/R), left ventricular (LV) mass, LV end-diastolic diameter (LVEDD), and left atrial diameter compared to controls.
- No athlete exceeded a wall thickness of 12 mm.
- Ejection fraction (EF) and mitral Doppler patterns were similar between athletes and controls.
Conclusions:
- Elite Cameroonian handball players demonstrate increased LVEDD and wall thickness, along with elevated h/R.
- LV ejection fraction in these athletes is normal, not supranormal.
- These cardiac changes represent physiological adaptations to combined endurance and resistance training.
Aims:
Most of the studies of athlete's heart have been performed on Caucasian and yet, evidence suggests that there are racial differences in the response of the heart to certain pathological conditions such as hypertension. This study aimed to evaluate the morphologic cardiac changes in a group of highly trained Cameroonian handball players.
Methods And Results:
We studied cardiac morphology and function as assessed by echocardiography at rest in 21 asymptomatic international level handball players and 21 age-, sex-, height- and weight-matched sedentary controls. Echocardiographic variables were compared between groups using unpaired t-test. Compared with controls, wall thickness, relative wall thickness (h/R), left ventricular (LV) mass, LV end diastolic diameter (LVEDD) and left atrial diameter were significantly greater in athletes. None of the athlete exhibited a wall thickness above 12 mm. The ejection fraction (EF) and the mitral pattern on pulsed wave Doppler did not differ in the two groups.
Conclusions:
Both LVEDD and wall thickness of elite Cameroonian handball players are increased. There is an increased h/R. The LV EF was normal and not supranormal, as is sometimes believed. These cardiac changes are consistent with cardiac adaptation required in this type of sportsmen who are submitted both in endurance and resistance training.
