Abstract
BackgroundTransthoracic echocardiography left ventricular wall thickness is often increased in master athletes and it results by intense physical training. Left Ventricular Hypertrophy can also be due to a constant pressure overload. Conventional Pulsed Wave (PW) Doppler analysis of diastolic function sometimes fails to distinguish physiological from pathological LVH.The aim of this study is to evaluate the role of Pulsed Wave Tissue Doppler Imaging in differentiating pathological from physiological LVH in the middle-aged population.Methodswe selected a group of 80 master athletes, a group of 80 sedentary subjects with essential hypertension and an apparent normal diastolic function at standard PW Doppler analysis. The two groups were comparable for increased left ventricular wall thickness and mass index (134.4 ± 19.7 vs 134.5 ± 22.1 gr/m2; p > .05). Diastolic function indexes using the PW technique were in the normal range for both.ResultsPulsed Wave TDI study of diastolic function immediately distinguished the two groups. While in master athletes the diastolic TDI-derived parameters remained within normal range (E' 9.4 ± 3.1 cm/sec; E/E' 7.8 ± 2.1), in the hypertensive group these parameters were found to be constantly altered, with mean values and variation ranges always outside normal validated limits (E' 7.2 ± 2.4 cm/sec; E/E' 10.6 ± 3.2), and with E' and E/E' statistically different in the two groups (p < .001).ConclusionOur study showed that the TDI technique can be an easy and validated method to assess diastolic function in differentiating normal from pseudonormal diastolic patterns and it can distinguish physiological from pathological LVH emphasizing the eligibility certification required by legal medical legislation as in Italy.
Highlights
Transthoracic echocardiography left ventricular wall thickness is often increased in master athletes and it results by intense physical training
Left ventricular wall thickness and mass at transthoracic echocardiography are often increased in master athletes, a growing population of trained subjects observed in Sports Medicine
Aim of this study is to evaluate the role of Pulsed Wave Tissue Doppler Imaging (PW-TDI) in differentiating normal from pathological diastolic patterns in the middleaged population with a mildmoderate LVM increase [13]
Summary
Transthoracic echocardiography left ventricular wall thickness is often increased in master athletes and it results by intense physical training. Left ventricular wall thickness and mass at transthoracic echocardiography are often increased in master athletes, a growing population of trained subjects observed in Sports Medicine. These modifications induced by intense physical training (athlete's heart) result from cardiac remodelling which is characterized by normal left ventricular performance and normal or increased capillary density with little or no fibrosis [1,2]. Increase in left ventricular mass may be the consequence of a constant pressure overload, typical of the hypertensive state that is often present in this middle-aged population [3,4]. We adopted the Roldan 's classification [14,15] that defines the diastolic values matched for age with a 50 years cut-off (Tables 1 and 2)
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