Left ventricular diastolic function in physiologic and pathologic hypertrophy.
BACKGROUND
Patients with hypertensive heart disease and left ventricular hypertrophy demonstrate an impaired left ventricular diastolic filling pattern. The aim of this study was to find out whether physiologic left ventricular hypertrophy induced by endurance training causes disturbances in left ventricular systolic and diastolic filling.


METHODS
We examined 49 athletes with left ventricular (LV) hypertrophy due to endurance training, 49 patients with LV hypertrophy due to arterial hypertension, and 26 untrained healthy control subjects by conventional echocardiography. Parameters of LV diastolic filling using pulse wave and color flow Doppler were also assessed.


RESULTS
All three study groups showed normal fractional shortening and mid-wall fractional shortening. Conventional echocardiography revealed a higher LV muscle mass index in the two study groups compared with the controls (athletes, 99 +/- 10 g; hypertensive patients, 95 +/- 11 g: controls: 52 +/- 7 g; P < .01 for athletes and hypertensive patients). In patients with arterial hypertension, a diastolic dysfunction consisting of a delayed relaxation pattern with a decrease in maximal early velocity of diastolic filling (0.44 +/- 0.1 m/sec) and a compensatory increase of the maximal late velocity of diastolic filling (0.53 +/- 0.1 m/sec) was demonstrated. In athletes with physiologic LV hypertrophy, a normal LV diastolic filling pattern was documented.


CONCLUSIONS
Doppler echocardiographic parameters of LV diastolic function can be of diagnostic importance for discrimination between pathologic and physiologic LV hypertrophy.
Schannwell
Christiana M
CM
Clinic of Cardiology, Pneumology and Angiology, University Hospital Duesseldorf, Germany. schannw@uni-duesseldorf.de
Schneppenheim
Markus
M
Plehn
Gunnar
G
Marx
Roger
R
Strauer
Bodo E
BE
D000328:Adult; D001830:Body Surface Area; D003937:Diagnosis, Differential; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D010807:Physical Endurance / Q000502:physiology*; D013177:Sports / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*