Abstract 2154: Myocardial Deformation by Bidimensional Strain in Professional Football Players: Comparison with Controls and Hypertrophic Cardiomyopathy
In athletes, the extent of physiologic cardiac remodeling may occasionally be substantial and may raise a potential diagnosis of structural cardiac disease such as hypertrophic cardiomyopathy (HCM). Deformation analysis using 2D strain is a promising technique to detect early systolic function abnormalities, especially in cases of borderline left ventricular hypertrophy.
Methods: 99 subjects (29 professional football players (PFP), 25 patients with hypertrophic cardiomyopathy (HCM) and 45 controls (CTL)) were investigated at rest by transthoracic echocardiography. 2D strain analysis was performed to measure deformation in 17 myocardial segments in the longitudinal, transverse, radial and circumferential axis.
Results: Ejection fraction was 61.1±7%, 67±7 %, 69±6 % respectively for PFP, CTL and HCM. Compared to HCM (237±78g/m2), left ventricular mass was lower for PFP (119±22g/m2) and CTL (91±22 g/m2), p<0.05. Average radial and transverse myocardial deformation were significantly higher in PFP compared to CTL whereas longitudinal strain was lower (table⇓) (p<0.01). No significant difference was observed in terms of circumferential strain between the 2 groups (p ns). Compared to HCM, athletes had higher values of transverse, radial and circumferential strain (p<0.01). Interestingly, no significant difference was observed between PFP and HCM for longitudinal strain except when comparing pathological septal hypertrophic segments to corresponding areas in PFP (−11.3±4.8 % vs −15.8±2.4%, p<0.01). Finally, no strain apex-base gradient was observed in HCM whereas it was found in PFP and CTL. Inter and intra-observer variabilities ranged between 9 and 13%.
Conclusion: 2D strain can identify specific patterns of myocardial deformation in PFP, CTL and HCM, particularly for pathological segments. The feasibility and reproducibility of this technique make it an easily clinically applicable method to distinguish between athlete’s heart and HCM.