Background: Left ventricular hypertrophy (LVH) is often observed in athletes which should be differentiated from hypertrophic cardiomyopathy (HCM). The aim of the study was to explore the functional changes measured using tissue Doppler imaging (TDI) deformation analysis in athletes fulfilling LVH criteria participating in different endurance sports.
Methods: Healthy controls (n=62, 58% men) and endurance athletes (n=120, 62% men) aged 18 to 40 years were prospectively enrolled and underwent both standard echocardiography as well as TDI. Longitudinal TDI derived strain and strain-rate (SR) were calculated in the septal and posterior wall in three segments. LVH was defined as an LVmass of >132 g/m2 in men and >109 g/m2 in women.
Results: Echocardiographic LVH was observed in 33 athletes (67% men). LVmass was significantly increased in both athlete groups (102.6±16.0 and 135.7±15.9 g/m2 vs. 88.0±16.5 in controls, p<0.001). Diastolic parameters were not significantly different between groups. Athletes with LVH showed no significant difference in strain and SR values in any segment of the septal or posterior wall compared to controls or those without LVH. A weak but significant correlation (also after multivariate analysis) was found for septal wall thickness and LVmass in peak systolic strain (r=0.26, p<0.01 and 0.23, p<0.01) and SR (r=0.27, p<0.01 and 0.29, p<0.01). Nevertheless, strain and SR values were still within normal limits in all athletes.
Conclusion: Athletes with LVH overall show normal deformation values in the LV. Our data suggest that a moderate reduction in regional septal deformation should not be considered as pathological when evaluating the endurance athlete with echocardiographic LVH of unknown origin.