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.

中文翻译：

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多普勒舒张参数在生理性左心室肥厚与肥厚型心肌病鉴别中的作用

背景

运动参与和舒张功能改变之间的关联尚不明确。这项研究的目的是确定大量健康运动员队列中左心室（LV）舒张功能的多普勒参数频谱，并量化生理性LV肥大与肥厚型心肌病（HCM）之间的重叠。

方法

对1,510名健康运动员（平均年龄22±5岁；范围13-33岁； 72％的男性）进行了LV舒张功能指标的回顾性分析。将结果与58例HCM青年患者的结果进行了比较。

结果

分别在五名（0.3％）和八名（0.5％）运动员中发现中隔E'<7 cm / sec和横向E'<10 cm / sec。在170名（11％）的运动员中，间隔E'> 14.6 cm / sec，在430名（28％）的运动员中，外侧E'> 19.9 cm / sec。与年轻运动员相比，年龄大于25岁的运动员的E'速度较低（中隔E'分别为11.8±6.1 vs 12.9±5.9 cm / sec [ P  <.001]；平均侧向E'分别为17.1±3.6 vs 19.3±4.1 cm /秒[ P  <.001]）。左室舒张末期直径较高的运动员（> 32 mm / m ²）与左室舒张末期直径正常的运动员相比，其间隔E'低（平均间隔E'为11.9±6 vs 12.7±6 cm / sec；平均室间隔E'为11.9±6 vs. 12.7±6 cm / sec；P = .002）。间隔E'<10 cm / sec和侧面E'<12 cm / sec显示出区分HCM和运动员心脏的最佳准确性。

结论

在年轻的精英运动员中，间隔和外侧E'的减少很少见。组织多普勒速度倾向于随着年龄和左室尺寸的增加而降低，并且在不到三分之一的年轻运动员中发现了代表超正常舒张功能的值。对于多个人口统计学和临床​​变量，应校正舒张功能的多普勒参数的临界阈值，以区分年轻人的运动适应性与HCM的适应性。