Differentiating between young, athletic patients with hypertrophic cardiomyopathy (HCM) and elite athletes sometimes can be problematic.^1–4 Left ventricular hypertrophy is seen mainly in athletes participating in endurance sports.¹ A conflict exists with regard to strength athletes.² Recent investigations suggest that strength athletes who use anabolic steroids have increased left ventricular hypertrophic response to exercise² compared with drug-free, sport matched athletes. Therefore, in some cases athletic, young patients with HCM and strength athletes must also be differentiated.

Cardiopulmonary exercise testing (CET) metabolic parameters have been considered to contribute to differentiating patients with HCM from athletes participating in endurance sports.¹ However, the metabolic profiles of patients with HCM⁵ and of strength athletes have not yet been compared.

The objective of the present study was to identify the relation between the CET profiles of young, male athletic patients with HCM and the profiles of elite, male strength athletes, and to question the value of CET in differentiating patients with HCM from strength athletes.

METHODS

For this study, 19 strength athletes from the Greek Olympic weight lifting team, 20 endurance athletes (middle and long distance runners) from the national team, and 27 patients with HCM with recent physical activity (mainly aerobic type) were compared. All patients had diagnosed non-obstructive HCM. They were subjectively asymptomatic and …