Myocardial mechanics of athletic hearts in comparison with diseased hearts

Parameters of myocardial mechanics were measured by means of echocardiography in 31 competitive runners and 17 judo (Japanese wrestling) champions and were then compared with those in 25 normal control subjects, 15 patients with volume-overloaded (aortic regurgitation, AR) and 13 with pressure-overloaded (hypertension, HT) hearts, 14 patients with dilated cardiomyopathy (DCM), and 11 patients with hypertrophic cardiomyopathy (HCM). In runners, the ratio of left ventricular radius to wall thickness (R/Th) was maintained in the normal range, but fractional shortening (FS) and decreased slightly (p less than 0.01). Patients with decompensated DCM and AR had an increased R/Th (p less than 0.001) and a decreased FS (p less than 0.001). In judo champions, FS was maintained in the normal range, but R/Th had decreased (p less than 0.001). In patients with HT, R/Th had decreased slightly (p less than 0.05), but FS and peak systolic wall stress were maintained in the normal range. In patients with HCM, FS was maintained in the normal range, but R/Th had decreased (p less than 0.001). It is concluded that, at rest, hearts of runners are cardiomechanically similar to those of patients with compensated AR or DCM and probably have greater cardiac reserve, whereas hearts of judo champions are similar to those of HCM patients with inappropriate hypertrophy.