title: Systolic and early diastolic left ventricular velocities assessed by tissue Doppler imaging in 100 top-level handball players.
abstract: OBJECTIVE
  Echocardiographic tissue Doppler imaging (TDI) has been proposed for the differentiation of physiologic left ventricular hypertrophy and pathologic left ventricular hypertrophy in athletes. In addition, cutoff values for systolic (S'<9 cm/s) and early diastolic (E'<9 cm/s) myocardial velocities had been defined. The aim of our study was the analysis of the morphologic cardiac changes by standard echocardiography, and the myocardial velocities S' and E' by TDI in top-level handball players with respect to the predefined cutoff values.
  
  
  METHODS
  Pulsed-wave TDI of the systolic and early diastolic velocities was performed at the lateral and septal mitral annulus (MA) in the four-chamber view in 100 athletes (100 Caucasian men; professional handball players of the first German handball league and the German national team; mean age 25.8+/-4.8 years).
  
  
  RESULTS
  Global and regional left ventricular systolic function was normal in all athletes. They showed an eccentric hypertrophy of the left ventricle (LV), which was characterized by an increased mass of the LV (287.3+/-58.4 g), and an increased end diastolic diameter of the LV (LVEDD: 58+/-5.9 mm), but no echomorphologic signs of pathologic hypertrophy or hypertrophic cardiomyopathy. TDI showed a systolic velocity S' of the MA of 9.3+/-1.5 cm/s at the septal and 10.5+/-2.1 at the lateral MA. Ten of the 100 athletes showed a S'<9 cm/s at both sides of the MA. TDI showed an early diastolic velocity E' of the MA of 13.2+/-2.8 cm/s at the septal and of 16.6+/-3.4 cm/s at the lateral MA. None of the 100 athletes showed reduced systolic or early diastolic velocities below the proposed cutoff values (S' and E'<9 cm/s) at any sides of the MA.
  
  
  CONCLUSIONS
  Our study provides further insights into systolic and diastolic function as assessed by TDI in top-level handball players. Owing to the large cohort of individuals, our findings might be helpful as reference values for the echocardiographic assessment of handball players, who are performing a moderate static and high dynamic sport.
authors.affiliation: Department of Cardiology, Heart Center Northern-Westphalia, Bad Oeynhausen, Germany. Thomas.Butz@Marienhospital-Herne.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Butz
authors.forename: Frank
authors.initials: F
authors.lastname: van Buuren
authors.forename: Klaus Peter
authors.initials: KP
authors.lastname: Mellwig
authors.forename: Christoph
authors.initials: C
authors.lastname: Langer
authors.forename: Olaf
authors.initials: O
authors.lastname: Oldenburg
authors.forename: Kuno Alexander
authors.initials: KA
authors.lastname: Treusch
authors.forename: Axel
authors.initials: A
authors.lastname: Meissner
authors.forename: Gunnar
authors.initials: G
authors.lastname: Plehn
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Trappe
authors.forename: Dieter
authors.initials: D
authors.lastname: Horstkotte
authors.forename: Lothar
authors.initials: L
authors.lastname: Faber
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005858:Germany; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D009200:Myocardial Contraction; D010101:Oxygen Consumption; D012189:Retrospective Studies; D013147:Spirometry; D013177:Sports; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult