title: Athlete's heart in Israel: fact or fiction.
abstract: BACKGROUND
  The effects of exercise training on cardiac structure and function have been thoroughly investigated in athletes from sport-developed nations; few data are available on sportsmen from sport-developing countries.
  
  
  OBJECTIVE
  To assess the incidence and magnitude of the "athlete heart" phenomenon in an elite group of Israeli cyclists.
  
  
  METHODS
  An echocardiography study was performed in 56 cyclists (49 males, mean age 38 +/- 10 years, weekly average training 13.1 +/- 5.9 hours); 96 sedentary subjects served as a control group.
  
  
  RESULTS
  There were significant differences in left ventricular end-diastolic diameter (LVEDD) between cyclists and the control group (48 +/- 4.7 mm versus 45 +/- 4.1 mm respectively, P < 0.001), as well as in inter-ventricular septum (IVS) thickness (9.9 +/- 1.2 versus 8.9 +/- 1.2 mm, P < 0.001) and LV mass index (LVMI) (79 +/- 16 versus 68 +/- 13 g/m(2), P < 0.001). In 5% of the cyclists LVEDD exceeded the upper normal limit of 56 mm. In 7% of the cyclists IVS thickness exceeded the upper normal limit of 11 mm. LV hypertrophy defined as LVMI > or = 134 g/m(2) was absent in the entire cyclist group.
  
  
  CONCLUSIONS
  Endurance sport activity in well-trained Israeli sportsmen results in a modest increment in LV dimensions and LV mass. LV dilatation and wall thickness above values compatible with primary cardiac disease are rare. These results highlight that in Israeli athletes any abnormal echocardiographic value must be thoroughly investigated and not simply assumed to be a consequence of sport activities.
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Horowitz
authors.affiliation: Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cafri
authors.affiliation: Department of lnternal Medicine, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Zeller
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Alina
authors.initials: A
authors.lastname: Vodonos
authors.affiliation: Department of Epidemiology and Health Services Evaluations, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Zvi H
authors.initials: ZH
authors.lastname: Perry
authors.affiliation: Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Sergio L
authors.initials: SL
authors.lastname: Kobal
mesh_terms: D000328:Adult; D056352:Athletes; D001642:Bicycling / Q000502:physiology*; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000502:physiology*; D006352:Heart Ventricles / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D057185:Sedentary Behavior; D055815:Young Adult