PT  - JOURNAL ARTICLE
AU  - Victor Utomi
AU  - David Oxborough
AU  - Euan Ashley
AU  - Rachel Lord
AU  - Sarah Fletcher
AU  - Mike Stembridge
AU  - Rob Shave
AU  - Martin D Hoffman
AU  - Greg Whyte
AU  - John Somauroo
AU  - Sanjay Sharma
AU  - Keith George
TI  - Predominance of normal left ventricular geometry in the male ‘athlete's heart’
AID  - 10.1136/heartjnl-2014-305904
DP  - 2014 Aug 15
TA  - Heart
PG  - 1264--1271
VI  - 100
IP  - 16
4099  - http://heart.bmj.com/content/100/16/1264.short
4100  - http://heart.bmj.com/content/100/16/1264.full
SO  - Heart2014 Aug 15; 100
AB  - Aims This study evaluated (a) global LV adaption to endurance versus resistance training in male athletes, (b) LV assessment using by modern imaging technologies and (c) the impact of scaling for body size on LV structural data. Methods A prospective cross-sectional design assessed the LV in 18 elite endurance-trained (ET), 19 elite resistance-trained (RT) and 17 sedentary control (CT) participants. Standard 2D, tissue Doppler and speckle tracking echocardiography assessed LV structure and function. Indexing of LV structures to body surface area (BSA) was undertaken using ratio and allometric scaling. Results Absolute and scaled LV end-diastolic volume (ET: 43.7±6.8; RT: 34.2±7.4; CT 32.5±8.9 mL/m1.5; p<0.05) and LV mass (ET: 29.8±6.6; RT: 25.4±8.7; CT 25.9±6.4 g/m2.7; p < 0.05) were significantly higher in ET compared with RT and CT. LV wall thickness were not different between ET and RT. 65% of ET and 95% of RT had normal geometry. Stroke volume was higher in ET compared with both RT and CT (p<0.05). Whilst regional tissue velocity data were not different between groups, longitudinal and basal circumferential strain (ε) was reduced in RT compared with ET. Conclusions In this comprehensive evaluation of the male athlete's heart (AH), normal LV geometry was predominant in both athlete groups. In the ET, 30% demonstrated an eccentric hypertrophy with no concentric hypertrophy in RT. Cardiac ε data in RT require further evaluation, and any interpretation of LV size should appropriately index for differences in body size.