Tissue doppler imaging can be useful to distinguish pathological from physiological left ventricular hypertrophy: a study in master athletes and mild hypertensive subjects.
BACKGROUND
Transthoracic 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.


METHODS
we 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.


RESULTS
Pulsed 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).


CONCLUSIONS
Our 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.
Postgraduate School of Sports Medicine-Sports Medicine Laboratory, University of Florence, Florence, Italy. giorgio.galanti@unifi.it
Giorgio
G
Galanti
Loira
L
Toncelli
Francesca
F
Del Furia
Laura
L
Stefani
Brunello
B
Cappelli
Alessio
A
De Luca
Maria Concetta Roberta
MC
Vono
D000328:Adult; D056352:Athletes; D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged