title: Left ventricular dyssynchrony and 2D and 3D global longitudinal strain for differentiating physiological and pathological left ventricular hypertrophy.
abstract: BACKGROUND
  Diagnosis of hypertrophic cardiomyopathy (HCM) in athletes can be challenging.
  
  
  OBJECTIVE
  To ascertain parameters that differentiate patients with HCM from athletes with moderate left ventricular (LV) hypertrophy (LVH 13-15mm).
  
  
  METHODS
  We retrospectively included 100 men: 50 elite rugby players (25 with moderate LVH and 25 with no LVH), 25 patients with HCM and moderate LVH and 25 controls. LV dyssynchrony was defined as the standard deviation of time to peak 2D longitudinal strain (16-segment model) and global strain components were computed from two- (2D) and three-dimensional (3D) speckle tracking.
  
  
  RESULTS
  2D global longitudinal strain (GLS) (18±2% vs. 19±2%) and various 3D strain components were similar in athletes with moderate LVH and controls, while LV volumes and dyssynchrony (39±8 vs. 31±9ms; P<0.001) were greater in athletes with moderate LVH. The accuracy for differentiating patients with HCM from athletes ranged between 0.57 and 0.92 for various markers, with the best obtained for LV dyssynchrony (AUC=0.92;>48ms had sensitivity=83%, specificity=89%). Binary logistic regression showed that accuracy was improved when LV dyssynchrony was combined with 2D GLS. HCM was excluded when 2D GLS was preserved (>18%) and there was no LV dyssynchrony (>48ms) and only patients with HCM had reduced longitudinal strain and LV dyssynchrony.
  
  
  CONCLUSIONS
  LV dyssynchrony combined with GLS can be used to differentiate athletes with moderate LVH from patients with HCM.
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Ternacle
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Bremont
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: d'Humieres
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Laureline
authors.initials: L
authors.lastname: Faivre
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Huy Long
authors.initials: HL
authors.lastname: Doan
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Gallet
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Leopold
authors.initials: L
authors.lastname: Oliver
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dubois-Randé
authors.affiliation: AP-HP, Henri Mondor University Hospital, Cardiovascular department and Inserm U955, 51, avenue de Lattre-de-Tassigny, 94100 Créteil, France. Electronic address: lim.pascal.hmn@gmail.com.
authors.forename: Pascal
authors.initials: P
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001696:Biomechanical Phenomena; D059267:Cardiomegaly, Exercise-Induced; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005538:Football; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted; D016015:Logistic Models; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013314:Stress, Mechanical; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Asynchronisme ventriculaire gauche; Athlete's heart; Cœur d’athlète; Hypertrophie ventriculaire gauche; Left ventricular dyssynchrony; Left ventricular hypertrophy; Speckle tracking