Abstract
BackgroundPrevious studies revealed a high rate of abnormal exercise test (ET) results in the absence of obstructive coronary artery disease (CAD) in asymptomatic athletes. The physiological background of this phenomenon is not well established. In particular, it is unclear whether sports-induced morphological cardiac adaptations are determinants of abnormal ET results. The main objective of this study was to investigate if healthy asymptomatic recreational and competitive athletes with abnormal ET results without obstructive CAD have a higher LV mass when compared with athletes with normal ET results.MethodsSeventy-three athletes with abnormal ET results without presence of obstructive CAD underwent echocardiographic assessment of LV mass, systolic and diastolic measurements. These data were compared with data from 73 athletes with normal ET results, matched for gender, age, body composition, sports characteristics and exercise capacity.ResultsNo significant increase in LV mass (161.9 ± 39 g vs. 166.9 ± 42.1 g, p = 0.461) was found between groups. Athletes with abnormal ET results had a significant thicker IVSd (9.7 ± 1.8 mm vs. 9.0 ± 1.7 mm, p = 0.014), higher IVSd/PWTd ratio (1.08 ± 0.20 vs. 1.00 ± 0.12, p = 0.011) and deceleration time (DT) was prolonged ((225.14 ± 55.08 vs. 199.96 ± 34.65, p = 0.003).ConclusionAthletes with abnormal ET result did not show a higher in LV mass when compared to athletes with a normal ET result. However, a pattern of asymmetric cardiac remodeling, together with altered diastolic function is present. Due to small differences, cardiac remodeling only plays a limited role in the occurrence of positive ET results in athletes.
Highlights
Previous studies revealed a high rate of abnormal exercise test (ET) results in the absence of obstructive coronary artery disease (CAD) in asymptomatic athletes
In all 73 athletes, no obstructive CAD was found. These 73 athletes were matched with athletes with normal ET results according to gender, age, body mass index (BMI), body surface area (BSA), hours of sports per week, sports category and maximal workload per kilogram as described above
This study showed that athletes with a positive ET result in the absence of obstructive CAD do not have a higher LV mass than athletes with normal ET results
Summary
Previous studies revealed a high rate of abnormal exercise test (ET) results in the absence of obstructive coronary artery disease (CAD) in asymptomatic athletes. The physiological background of this phenomenon is not well established It is unclear whether sports-induced morphological cardiac adaptations are determinants of abnormal ET results. Different types of exercise training (endurance and strength) affect the cardiovascular system in different manners This leads to various cardiac adaptations, including structural, functional and electrical changes, often referred to as “the athlete’s heart” [12]. LV hypertrophy and hypertrophic cardiomyopathy were shown to be related to ST-segment depression independent from macrovascular CAD [10] It remains unclear whether a sports-induced increase in LV mass, which is the most common morphological cardiac adaptation [12, 14], is a determinant of abnormal ET results
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