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European Journal of Echocardiography Advance Access originally published online on February 26, 2009
European Journal of Echocardiography 2009 10(3):350-356; doi:10.1093/ejechocard/jep017
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Left ventricular hypertrophy in athletes

John Rawlins, Amit Bhan and Sanjay Sharma*

King's College Hospital, Denmark Hill, London SE5 9RS, UK

Received 8 January 2009; accepted after revision 7 February 2009; online publish-ahead-of-print 26 February 2009.

* Corresponding author. Tel: +44 203 233 4925.E-mail address: sanjay.sharma{at}kch.nhs.uk


  Abstract

Participation in regular intensive exercise is associated with a modest increase in left ventricular wall thickness (LVWT) and cavity size. The magnitude of these physiological changes is predominantly determined by a variety of demographic factors which include age, gender, size, ethnicity, and sporting discipline. A small minority of male athletes participating in sporting disciplines involving intensive isotonic and isometric exercise may exhibit substantial increases in cardiac size that overlap with the phenotypic manifestation of the cardiomyopathies. The most challenging clinical dilemma incorporates the differentiation between physiological left ventricular hypertrophy (LVH) (athlete's heart) and hypertrophic cardiomyopathy (HCM), which is recognized as the commonest cause of non-traumatic exercise related sudden cardiac death in young (<35 years old) athletes. This review aims to highlight the distribution and physiological upper limits of LVWT in athletes, determinants of LVH in athletes, and echocardiographic methods of differentiating athlete's heart from HCM.

Keywords: Athlete's heart; Left ventricular hypertrophy; Hypertrophic cardiomyopathy


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