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Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling
AIMS: Differentiation of left ventricular (LV) hypertrophy in healthy athletes from pathological LV hypertrophy in heart disease is often difficult. We explored whether extended echocardiographic measurements such as E/e’ and global longitudinal strain (GLS) distinguish physiologic from maladaptive...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096142/ https://www.ncbi.nlm.nih.gov/pubmed/35573652 http://dx.doi.org/10.1016/j.ijcha.2022.101044 |
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author | Bewarder, Yvonne Lauder, Lucas Kulenthiran, Saarraaken Schäfer, Ortwin Ukena, Christian Percy Marshall, Robert Hepp, Pierre Laufs, Ulrich Stöbe, Stephan Hagendorff, Andreas Böhm, Michael Mahfoud, Felix Ewen, Sebastian |
author_facet | Bewarder, Yvonne Lauder, Lucas Kulenthiran, Saarraaken Schäfer, Ortwin Ukena, Christian Percy Marshall, Robert Hepp, Pierre Laufs, Ulrich Stöbe, Stephan Hagendorff, Andreas Böhm, Michael Mahfoud, Felix Ewen, Sebastian |
author_sort | Bewarder, Yvonne |
collection | PubMed |
description | AIMS: Differentiation of left ventricular (LV) hypertrophy in healthy athletes from pathological LV hypertrophy in heart disease is often difficult. We explored whether extended echocardiographic measurements such as E/e’ and global longitudinal strain (GLS) distinguish physiologic from maladaptive hypertrophy in hypertrophic cardiomyopathy, excessively trained athletes’ hearts and normal hearts. METHODS: Seventy-eight professional athletes (cyclists n = 37, soccer players n = 29, handball players n = 21) were compared with patients (n = 88) with pathological LV hypertrophy (hypertrophic obstructive cardiomyopathy (HOCM, n = 17), hypertensive heart disease (HHD, n = 36), severe aortic valve stenosis (AVS, n = 35) and with sedentary healthy individuals as controls (n = 37). RESULTS: LV ejection fraction (LVEF) was ≥50% in all patients, athletes (median age 26 years, all male) and the controls (97% male, median age 32 years). LV mass index (LVMI) and septal wall thickness was in normal range in controls, but elevated in cyclists and patients with pathological hypertrophy (p < 0.001 for both). E/e’ was elevated in all patients with maladaptive hypertrophy but normal in controls and athletes (p < 0.001 vs. pathological hypertrophy). Furthermore GLS was reduced in patients with pathological hypertrophy compared with athletes and controls (for both p < 0.001). In subjects with septal wall thickness >11 mm, GLS (≥−18%) has a specificity of 79% to distinguish between physiological and pathological hypertrophy. CONCLUSION: GLS and E/e’ are reliable parameters unlike left ventricular mass or LV ejection fraction to distinguish pathological and physiological hypertrophy. |
format | Online Article Text |
id | pubmed-9096142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-90961422022-05-13 Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling Bewarder, Yvonne Lauder, Lucas Kulenthiran, Saarraaken Schäfer, Ortwin Ukena, Christian Percy Marshall, Robert Hepp, Pierre Laufs, Ulrich Stöbe, Stephan Hagendorff, Andreas Böhm, Michael Mahfoud, Felix Ewen, Sebastian Int J Cardiol Heart Vasc Original Paper AIMS: Differentiation of left ventricular (LV) hypertrophy in healthy athletes from pathological LV hypertrophy in heart disease is often difficult. We explored whether extended echocardiographic measurements such as E/e’ and global longitudinal strain (GLS) distinguish physiologic from maladaptive hypertrophy in hypertrophic cardiomyopathy, excessively trained athletes’ hearts and normal hearts. METHODS: Seventy-eight professional athletes (cyclists n = 37, soccer players n = 29, handball players n = 21) were compared with patients (n = 88) with pathological LV hypertrophy (hypertrophic obstructive cardiomyopathy (HOCM, n = 17), hypertensive heart disease (HHD, n = 36), severe aortic valve stenosis (AVS, n = 35) and with sedentary healthy individuals as controls (n = 37). RESULTS: LV ejection fraction (LVEF) was ≥50% in all patients, athletes (median age 26 years, all male) and the controls (97% male, median age 32 years). LV mass index (LVMI) and septal wall thickness was in normal range in controls, but elevated in cyclists and patients with pathological hypertrophy (p < 0.001 for both). E/e’ was elevated in all patients with maladaptive hypertrophy but normal in controls and athletes (p < 0.001 vs. pathological hypertrophy). Furthermore GLS was reduced in patients with pathological hypertrophy compared with athletes and controls (for both p < 0.001). In subjects with septal wall thickness >11 mm, GLS (≥−18%) has a specificity of 79% to distinguish between physiological and pathological hypertrophy. CONCLUSION: GLS and E/e’ are reliable parameters unlike left ventricular mass or LV ejection fraction to distinguish pathological and physiological hypertrophy. Elsevier 2022-05-06 /pmc/articles/PMC9096142/ /pubmed/35573652 http://dx.doi.org/10.1016/j.ijcha.2022.101044 Text en © 2022 Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Paper Bewarder, Yvonne Lauder, Lucas Kulenthiran, Saarraaken Schäfer, Ortwin Ukena, Christian Percy Marshall, Robert Hepp, Pierre Laufs, Ulrich Stöbe, Stephan Hagendorff, Andreas Böhm, Michael Mahfoud, Felix Ewen, Sebastian Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title | Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title_full | Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title_fullStr | Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title_full_unstemmed | Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title_short | Global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
title_sort | global longitudinal strain differentiates physiological hypertrophy from maladaptive remodeling |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096142/ https://www.ncbi.nlm.nih.gov/pubmed/35573652 http://dx.doi.org/10.1016/j.ijcha.2022.101044 |
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