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[Extreme cardiac hypertrophy in athletes. Morphological and functional echographic study]
A Spataro1, A Pelliccia, E Amici
1Dipartimento di Medicina dello Sport, Comitato Olimpico Nazionale Italiano, Roma.
Giornale Italiano Di Cardiologia
|March 1, 1988
Summary
Athlete cardiac hypertrophy, often seen in endurance athletes, can mimic hypertrophic cardiomyopathy. Echocardiography revealed athletes had a significantly lower interventricular septum to posterior wall thickness ratio compared to hypertrophic cardiomyopathy patients.
Area of Science:
- Cardiology
- Sports Medicine
- Diagnostic Imaging
Background:
- Athlete's heart involves cardiac hypertrophy as an adaptation to increased hemodynamic load, primarily in endurance athletes.
- This physiological hypertrophy can be challenging to differentiate from pathological hypertrophic cardiomyopathy (HC), especially when septal hypertrophy is prominent.
Purpose of the Study:
- To evaluate diagnostic features differentiating cardiac hypertrophy in athletes from hypertrophic cardiomyopathy using echocardiography and clinical examination.
- To compare echocardiographic parameters between elite athletes and patients diagnosed with non-obstructive hypertrophic cardiomyopathy.
Main Methods:
- Echocardiography (M-Mode and 2D) and clinical examinations were performed on 23 elite athletes (1984 Olympic Games participants) with marked interventricular septum (IVS) thickness (≥15 mm).
- A comparison group of 11 sportsmen with non-obstructive hypertrophic cardiomyopathy (HC), diagnosed via clinical, echocardiographic, and angio-scintigraphic findings, was studied.
- Key measurements included IVS thickness (IVST) and posterior wall thickness (PWT), with calculation of the IVST/PWT ratio.
Main Results:
- Athletes exhibited marked IVS hypertrophy (IVST: 15.7 ± 0.6 mm) and posterior wall hypertrophy (PWT: 13.7 ± 1.1 mm).
- The HC group showed similar IVS hypertrophy (IVST: 16.2 ± 3.5 mm) but less posterior wall hypertrophy (PWT: 11.3 ± 1.5 mm).
- Crucially, the IVST/PWT ratio was significantly lower in athletes (1.14 ± 0.02) compared to the HC group (1.4 ± 0.3) (p < 0.01).
Conclusions:
- Echocardiographic assessment, particularly the IVST/PWT ratio, can help distinguish physiological cardiac hypertrophy in elite athletes from hypertrophic cardiomyopathy.
- A lower IVST/PWT ratio suggests athlete's heart, while a higher ratio may indicate hypertrophic cardiomyopathy, especially with localized septal hypertrophy.