Athlete's heart or hypertrophic cardiomyopathy: usefulness of N-terminal pro-brain natriuretic peptide.
BACKGROUND
Distinguishing physiological hypertrophy from hypertrophic cardiomyopathy in athletes remains difficult, but vital in view of the risk of sudden death under effort. NT-proBNP was previously reported to be usually normal in healthy athletes, but often elevated in case of hypertrophic cardiomyopathy.


OBJECTIVE
To assess the interest of NT-proBNP in differential diagnosis of left ventricular hypertrophy in athletes.


METHODS
NT-proBNP levels were measured at rest and after effort in trained athletes referred for suspectedly abnormal (>or=13 mm) left ventricular hypertrophy.


RESULTS
17 patients were included, 10 of whom were diagnosed with hypertrophic cardiomyopathy (group I) while the other 7 presented typical signs of athlete's heart (group II). NT-proBNP levels did not significantly differ between groups, whether at rest or after effort. NT-proBNP levels were, however, significantly elevated in 3 subjects in group I, while being consistently normal in group II.


CONCLUSIONS
In active athletes presenting with ambiguous left ventricular hypertrophy, abnormal NT-proBNP levels indicate hypertrophic cardiomyopathy, whereas normal values are inconclusive.
Godon
Patrick
P
Griffet
Vincent
V
Vinsonneau
Ulric
U
Caignault
Jean Raymond
JR
Prevosto
Jean Marc
JM
Quiniou
Gilles
G
Guerard
Sylvain
S
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D013177:Sports / Q000502:physiology*; D055815:Young Adult
D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain