Diastolic function and modifications of left ventricular architecture in ultraendurance athletes

Although diastolic function is altered in left ventricular hypertrophy due to aortic stenosis or systemic hypertension, it has been shown to be normal in athletes. To analyze the reason for this discrepancy, we have studied left ventricular masses and volumes and diastolic flow velocities in 13 ultraendurance athletes and in 8 sedentary subjects as a control group by M-mode (TM), two-dimensional (2D) and Doppler echocardiography. Significant differences in the measurements of mass and volume have been found depending upon the method used. Considering that two-dimensional echocardiography is more appropriate for estimations of LV mass and LV volume, especially when the shape of the left ventricle is modified, overestimation of LV mass and underestimation of LV volume in ultraendurance athletes by TM could be explained by an elongation of LV cavity in athletes. Doppler velocimetry showed similar results in athletes and control subjects. We suggest that those LV configurational changes partly explain the preservation of diastolic function in athletes by restoring in diastole the energy stored in systole.