Role of Doppler Diastolic Parameters in Differentiating Physiological Left Ventricular Hypertrophy from Hypertrophic Cardiomyopathy

Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved..

BACKGROUND: The association between athletic participation and alteration in diastolic function is not well established. The aims of this study were to determine the spectrum of Doppler parameters of left ventricular (LV) diastolic function in a large cohort of healthy athletes and to quantify the overlap between physiologic LV hypertrophy and hypertrophic cardiomyopathy (HCM).

METHODS: A retrospective analysis of indices of LV diastolic function was performed in 1,510 healthy athletes (mean age, 22 ± 5 years; range, 13-33 years; 72% men). The results were compared with those from 58 young patients with HCM.

RESULTS: Septal E' < 7 cm/sec and lateral E' < 10 cm/sec were found in five (0.3%) and eight (0.5%) athletes, respectively. Septal E' was >14.6 cm/sec in 170 (11%) and lateral E' was >19.9 cm/sec in 430 (28%) athletes. Athletes aged >25 years showed lower E' velocities compared with younger athletes (mean septal E', 11.8 ± 6.1 vs 12.9 ± 5.9 cm/sec [P < .001]; mean lateral E', 17.1 ± 3.6 vs 19.3 ± 4.1 cm/sec [P < .001]). Athletes with high indexed LV end-diastolic diameters (>32 mm/m2) exhibited lower septal E' compared with athletes with normal indexed LV end-diastolic diameters (mean septal E', 11.9 ± 6 vs 12.7 ± 6 cm/sec; P = .002). Septal E' < 10 cm/sec and lateral E' < 12 cm/sec showed the best accuracy in differentiating between HCM and athlete's heart.

CONCLUSIONS: Reduced septal and lateral E' are rarely observed in young elite athletes. Tissue Doppler velocities tend to decrease with increasing age and LV size, and values representative of supernormal diastolic function are found in less than one-third of young athletes. Cutoff thresholds for Doppler parameters of diastolic function should be corrected for multiple demographic and clinical variables to differentiate cardiac adaptation to exercise from HCM in young individuals.

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography - 31(2018), 5 vom: 15. Mai, Seite 606-613.e1

Sprache:

Englisch

Beteiligte Personen:

Finocchiaro, Gherardo [VerfasserIn]
Dhutia, Harshil [VerfasserIn]
D'Silva, Andrew [VerfasserIn]
Malhotra, Aneil [VerfasserIn]
Sheikh, Nabeel [VerfasserIn]
Narain, Rajay [VerfasserIn]
Ensam, Bode [VerfasserIn]
Papatheodorou, Stathis [VerfasserIn]
Tome, Maite [VerfasserIn]
Sharma, Rajan [VerfasserIn]
Papadakis, Michael [VerfasserIn]
Sharma, Sanjay [VerfasserIn]

Links:

Volltext

Themen:

Athlete's heart
Diastolic function
Hypertrophic cardiomyopathy
Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 19.11.2019

Date Revised 19.11.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.echo.2017.11.022

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM281409951