TY - JOUR
T1 - Clinical profile of athletes with hypertrophic cardiomyopathy
AU - Sheikh, Nabeel
AU - Papadakis, Michael
AU - Schnell, Frédéric
AU - Panoulas, Vasileios F.
AU - Malhotra, Aneil
AU - Wilson, Mathew
AU - Carré, François
AU - Sharma, Sanjay
N1 - © 2015 American Heart Association, Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background: The phenotype of individuals with hypertrophic cardiomyopathy (HCM) who exercise regularly is unknown. This study characterized the clinical profile of young athletes with HCM. Methods and Results: The electrical, structural, and functional cardiac parameters from 106 young (14.35 years) athletes with HCM were compared with 101 sedentary HCM patients. A subset of athletes with HCM exhibiting morphologically mild (13.16 mm), concentric disease was compared with 55 healthy athletes with mild physiological left ventricular hypertrophy (LVH). Most athletes with HCM (96%) exhibited T-wave inversion and had milder LVH (15.8±3.4 mm versus 19.7±6.5 mm, P<0.001), larger left ventricular cavity dimensions (47.8±6.0 mm versus 44.3±7.7 mm, P<0.001), and superior indices of diastolic function (average E/E' 7.9±2.4 versus 10.7±3.9, P<0.001) compared with sedentary HCM patients. In athletes with HCM, LVH was frequently (36%) confined to the apex and only 15 individuals (14%) exhibited mild concentric LVH mimicking physiological LVH. In these 15 athletes, conventional structural and functional cardiac parameters showed modest sensitivity and specificity for differentiating HCM from physiological LVH: 13% had a left ventricular cavity >54 mm, 87% had a left atrium.40, and 100% had an E/E' <12. Conclusions: Athletes with HCM exhibit less LVH, larger left ventricular cavities, and normal indices of diastolic function compared with sedentary patients. Only a minority of athletes with HCM constitute the conventional gray zone of mild, concentric LVH. In this minority, conventional echocardiographic parameters alone are insufficient to differentiate HCM from physiological LVH and should be complemented by additional structural and functional assessments to minimize the risk of false reassurance.
AB - Background: The phenotype of individuals with hypertrophic cardiomyopathy (HCM) who exercise regularly is unknown. This study characterized the clinical profile of young athletes with HCM. Methods and Results: The electrical, structural, and functional cardiac parameters from 106 young (14.35 years) athletes with HCM were compared with 101 sedentary HCM patients. A subset of athletes with HCM exhibiting morphologically mild (13.16 mm), concentric disease was compared with 55 healthy athletes with mild physiological left ventricular hypertrophy (LVH). Most athletes with HCM (96%) exhibited T-wave inversion and had milder LVH (15.8±3.4 mm versus 19.7±6.5 mm, P<0.001), larger left ventricular cavity dimensions (47.8±6.0 mm versus 44.3±7.7 mm, P<0.001), and superior indices of diastolic function (average E/E' 7.9±2.4 versus 10.7±3.9, P<0.001) compared with sedentary HCM patients. In athletes with HCM, LVH was frequently (36%) confined to the apex and only 15 individuals (14%) exhibited mild concentric LVH mimicking physiological LVH. In these 15 athletes, conventional structural and functional cardiac parameters showed modest sensitivity and specificity for differentiating HCM from physiological LVH: 13% had a left ventricular cavity >54 mm, 87% had a left atrium.40, and 100% had an E/E' <12. Conclusions: Athletes with HCM exhibit less LVH, larger left ventricular cavities, and normal indices of diastolic function compared with sedentary patients. Only a minority of athletes with HCM constitute the conventional gray zone of mild, concentric LVH. In this minority, conventional echocardiographic parameters alone are insufficient to differentiate HCM from physiological LVH and should be complemented by additional structural and functional assessments to minimize the risk of false reassurance.
KW - Echocardiography
KW - Exercise physiology
KW - Hypertrophic cardiomyopathy
KW - Left ventricular hypertrophy
KW - Primary prevention
KW - Multivariate Analysis
KW - Predictive Value of Tests
KW - Ventricular Function, Left
KW - Humans
KW - Male
KW - Echocardiography, Doppler, Pulsed
KW - Case-Control Studies
KW - Young Adult
KW - Exercise Test
KW - Heart Conduction System/physiopathology
KW - Electrocardiography
KW - Adult
KW - Female
KW - France
KW - Severity of Illness Index
KW - Diagnosis, Differential
KW - Logistic Models
KW - Cardiomyopathy, Hypertrophic/diagnosis
KW - Athletes
KW - Chi-Square Distribution
KW - Hypertrophy, Left Ventricular/diagnosis
KW - Stroke Volume
KW - Cardiomegaly, Exercise-Induced
KW - Phenotype
KW - Adolescent
KW - London
KW - Sedentary Behavior
KW - exercise physiology
KW - echocardiography
KW - primary prevention
KW - left ventricular hypertrophy
KW - hypertrophic cardiomyopathy
UR - http://www.scopus.com/inward/record.url?scp=84942893115&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/clinical-profile-athletes-hypertrophic-cardiomyopathy
U2 - 10.1161/CIRCIMAGING.114.003454
DO - 10.1161/CIRCIMAGING.114.003454
M3 - Article
C2 - 26198026
AN - SCOPUS:84942893115
SN - 1941-9651
VL - 8
SP - 1
EP - 9
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
IS - 7
M1 - e003454
ER -