Athlete’s heart : an echocardiographic study

الملخص EN

Objrctives: To define the expression of athlete's heart in response to physical training and to identify the upper limits of left ventricular hypertrophy (LVH) associated with long-term intense conditioning in elite male athletes.

Methods: A comparative study was conducted from November 2001 to June 2002 to investigate the morphological adaptation of the heart.

Evaluations were performed using two-dimensional echocardiography studies.

The 90 participants in the study group (mean age 23.4 years, range 18-36 years) had participated in vigorous training and had competed in 3 types of sports.

These participants included 26 endurance, 30 strength, and 34 mixed training athletes.

In addition 54 sedentary medical students (mean age 23.2 years, range 19-35 years) were studied as a control group.

The main outcome measures were left ventricular diastolic dimension (LVDD), wall thickness (LVWT) and mass index (LVMI).

Results: Athletes demonstrated larger LVDD (51.6+/-4.5 mm), greater LVWT (11.3+/-0.9 mm), and greater LVMI (123.9+/-24.5 g/m2) than sedentary controls (45.3+/-3.6 mm, 8.7+/-0.8 mm and 66.1+/-10.8 g/m2); p<0.001.

Among athletes, LVDD was 40-59 mm and exceeded normal limits (>54 mm) in 25 athletes, 27.8%.

LVWT was above normal (>12 mm) in 15 athletes, 16.7%.

LVMI range was 75.1-214.5 g/m2 and exceeded normal limits (>130 g/m2) in 32 athletes, 35.6%.

Training for endurance sports had the greatest effect on LVDD, LVWT, and LVMI.

Conclusions: Highly trained athletes frequently demonstrate cardiac dimensional changes as an adaptation to physical training.

In some athletes, increases in LVWT and LVDD within the diagnostic "gray zone" have been identified, and they may be difficult to distinguish from pathological LVH.