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The role of echocardiography in the evaluation of cardiac re-modelling and differentiation between physiological and pathological hypertrophy in teenagers engaged in competitive amateur sports
Published online by Cambridge University Press: 18 October 2016
Abstract
“Athlete’s heart” is a cardiac adaptation to long-term intensive training. The aims of this study were to show the prevalence of left ventricular hypertrophy in teenagers who participate in sports, to define the different types of cardiac re-modelling, and to differentiate between physiological and pathological hypertrophy.
Echocardiographic measurements were obtained by M-mode, two dimensional, and Doppler techniques of participants from sports and control groups.
The echocardiographic examinations included 100 healthy teenagers taking part in dynamic sports such as football and basketball and 100 healthy teenagers taking part in static sports such as karate and judo. The control group (n=100) included healthy, sedentary teenagers. Sports participants had significantly higher left ventricular mass when compared with the control group, (p<0.001). In the dynamic sports group, 29% of the respondents had left ventricular mass above the 95th percentile, whereas 71% had left ventricular mass below the 95th percentile (p<0.001). The cardiac re-modelling was eccentric (79.4 versus 20.6%, p<0.001). In the group of static sports participants, 37% had left ventricular mass above the 95th percentile, whereas 63% had left ventricular mass below the 95th percentile (z score 0.74±0.82, p<0.001). The prevalence of concentric and eccentric types of re-modelling was equally manifested (54.05 versus 45.95%, p>0.05). Respondents from both groups had E/A ratios (transmitral flow velocity ratio)>1, preserved diastolic function, and statistically they did not differ from the control group.
Echocardiographic parameters show that physiological hypertrophy and cardiac re-modelling are present in teenagers who play sports. Unexpectedly, the prevalence of concentric and eccentric types of re-modelling is equally possible in the group of static sports participants.
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