Left ventricular diastolic function in elite athletes with physiologic cardiac hypertrophy

Area of Science:

• Cardiology
• Exercise Physiology
• Cardiac Imaging

Background:

• Left ventricular hypertrophy (LVH) from conditions like aortic stenosis and hypertension is linked to impaired diastolic function.
• It remains unclear if these diastolic abnormalities are intrinsic to hypertrophy or caused by other pathological factors.

Purpose of the Study:

• To determine if diastolic dysfunction in pathological hypertrophy is an inherent consequence of cardiac muscle thickening or due to additional disease-related factors.
• To compare left ventricular early diastolic function between highly trained athletes and healthy controls.

Main Methods:

• Echocardiography was used to assess left ventricular early diastolic function in athletes and age-matched controls.
• Athletes were divided into swimmers (normal wall thickness to dimension ratio) and power lifters (increased ratio).
• Diastolic function indexes were analyzed, considering ventricular size and systolic performance.

Main Results:

• Athletes exhibited increased peak rates of left ventricular dimension increase and wall thinning compared to controls, despite higher LV mass.
• These enhanced diastolic indexes in athletes correlated with larger ventricular size and better systolic function.
• After adjusting for ventricular size and systolic function, differences in diastolic function between athletes and controls disappeared.

Conclusions:

• Physiological left ventricular hypertrophy in athletes is associated with normal diastolic function when accounting for ventricular size and systolic performance.
• Abnormalities in diastolic function observed in pathological hypertrophy likely result from factors beyond the hypertrophy itself.
• This suggests that diastolic dysfunction in conditions like aortic stenosis and hypertension is not solely due to the thickened heart muscle.