Echocardiography Differences Between Athlete's Heart Hearth and Hypertrophic Cardiomyopathy

Abstract

Introduction:Among long term athletes there is always present hypertrophy of the left ventricle walls as well as increased cardiac mass. These changes are the result of the heart muscle adaptation to load during the years of training, which should not be considered as pathology. In people suffering from hypertrophic cardiomyopathy (HCM), there is also present hypertrophy of the left ventricle walls and increased mass of the heart, but these changes are the result of pathological changes in the heart caused by a genetic predisposition for the development HCM of. Differences between myocardial hypertrophy in athletes and HCM are not clearly differentiated and there are always dilemmas between pathological and physiological hypertrophy. The goal of the study is to determine and compare the echocardiographic cardiac parameters of longtime athletes to patients with hypertrophic cardiomyopathy.Material and methods:The study included 60 subjects divided into two groups: active athletes and people with hypertrophic cardiomyopathy.Results:Mean values of IVSd recorded in GB is IVSd=17.5 mm (n=20, 95% CI, 16.00–19.00 mm), while a significantly smaller mean value is recorded in GA, IVSd=10.0 mm (n=40, 95% CI, 9.00-11.00 mm). The mean value of the left ventricle in diastole (LVDd) recorded in the GA is LVDd=51 mm (n=40; 95% CI, 48.00 to 52.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVDd value is 42 mm (n=20; 95% CI, 40.00 to 48.00 mm). The mean value of the rear wall of the left ventricle (LVPWd) recorded in the GA is LVDd=10 mm (n=40; 95% CI, 9.00-10.00 mm) while in the group with hypertrophic cardiomyopathy (GB) mean LVDd is 14 mm (n=20; 95% CI, 12.00 to 16.00 mm). The mean of the left ventricle during systole (LVSD) observed in GA is LVSD=34 mm (n=40; 95% CI, 32.00 to 36.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVSD is 28 mm (n=20; 95% CI, 24.00 to 28.83 mm). The mean ejection fraction (EF%) observed in GA is EF=60% (n=40; 95% CI, 56.41 to 63.00%), while in the group with hypertrophic cardiomyopathy (GB) mean EF value is 69% (n=20; 95% CI, 62.00 to 70.83 mm). Somewhat higher mean diastolic left ventricular function (E/A) was observed in GA, E/A=1.76±0.15, and lower average values in the group with hypertrophic cardiomyopathy: (GB) E/A=0.78±0.02.Conclusion:Mean values of parameters intraventricular septum thickness in diastole (IVSd), the thickness of the rear wall of the left ventricle (LVPWd), the diameter of the left ventricle during systole (LVSD) were statistically different between groups of athletes (GA) compared to the group of patients with hypertrophic cardiomyopathy (GB).

Cardiac magnetic resonance T2 mapping and feature tracking in athlete’s heart and HCM

“…For feature tracking using CMR, there is no existing literature about the comparison of different LVH entities. As has been shown by TTE, diastolic parameters (E/A ratio, LV dyssynchrony) are good discriminators of HNCM and AH with the diastolic function being significantly more affected in HNCM [8,22]. This finding could not be reproduced in our LVH, left ventricular hypertrophy; LVMi, left ventricular mass per body surface area; SR cc , peak early circumferential strain rate study, since diastolic function in AH and HOCM/HNCM (as measured by SR cc ) was not significantly different.…”

Rhythm and conduction complications after COVID-19 infection in physiological hypertrophy of myocardium (athlete’s heart)

“…The myocardial hypertrophy observed involved equally all segments of the LV, in contrast to hypertrophic cardiomyopathy, in which the basal segments are predominantly involved. [16] The Global Longitudinal Strain-mean before the COVID-19 infection demonstrated normal values (21.3%), which indicates preserved ventricular deformity. [14] The compliance of the ventricle is determined by the structural properties of the cardiac muscle (e.g., muscle fibers and their orientation, and connective tissue), as well as by the state of ventricular contraction and relaxation.…”

Cardiac imaging in athlete’s heart: current status and future prospects

“…A study by Kreso et al provided useful information on the different echocardiographic characteristics between an athlete’s heart and HCM [ 12 ]. Reference values for the echocardiography parameters for athlete’s heart were as follows: IVSd ≤ 11 mm, LVDd ≤ 52 mm, PWd ≤ 10 mm, and LVDs ≤ 36 mm.…”