Abstract
Objectives: The upper limits of physiologic increase in the left ventricular (LV) dimensions for the purposes of differentiation from cardiomyopathies are well established in Caucasian athletes. However, there are few data regarding the physiologic LV remodelling in black athletes (BA) in whom deaths from cardiomyopathies are more prevalent. Methods: Between 2005 and 2006, 200 asymptomatic and normotensive black (African/AfroCaribbean) male athletes (mean age: 20.5 ± 5.80; range 14 –35 years and a mean BSA: 1.94 ± 0.16 m 2 ; range1.36 –2.29) underwent 12-lead EKG and 2-D echocardiography. The results were compared to those of 100 black controls (BC) and 200 highly trained white male athletes matched for age, size, sport and training programs. None of them had a family history of cardiomyopathy. Cardiac dimensions and function were measured in accordance using conventional methods. Results: The LV dimensions of black athletes (BA) compared with black controls (BC) and WA are shown below Data expressed as mean ± standard deviation (range) LVWTd- left ventricular wall thickness in end diastole LVIDd- left ventricular internal dimensions in end diastole Both BA and WA had a greater LV dimensions than BC. Black athletes had greater LVWT than WA amounting to a difference of 11%. In absolute terms, 40 (20%) BA had a LVWT > 12 mm compared with 12 (6%) WA. There were no significant differences in the LV cavity size or indices of diastolic function between BA and WA. All BA with a LVWT > 12 mm had an enlarged LV cavity size and normal indices of diastolic function indicating physiologic left ventricular hypertrophy (LVH) rather than hypertrophic cardiomyopathy (HCM). Conclusion: •Black athletes develop modest increase in the LV dimensions as compared to BC. •The magnitude of LVH in BA is significantly greater than in WA. •More BA have absolute LVWT values in the region compatible with morphologically mild HCM. •Our study calls for a separate physiologic upper limits for LV dimensions in BA.
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