Abstract 17865: Hypertrabeculation of the Left Ventricular Apex in Elite Athletes: Pathology versus Physiology?
Objectives: Regular intensive physical training is associated with physiological cardiac remodelling including increased left ventricular (LV) wall thickness and cavity size. Hypertrabeculation (HTC) of the LV has not been documented in athletes but is a recognised feature of hypertrophic cardiomyopathy (HCM) and isolated LV non-compaction (ILVNC). The aim of this study was to evaluate the prevalence and significance of HTC in highly trained athletes.
Methods: Between 2008-2010, 478 athletes (mean age 21.4 years ± 4.5 years, 72% male, 85% Caucasian) were evaluated with a health questionnaire, physical examination, ECG and echocardiography. Standard echocardiographic views were obtained and measurements made in accordance with ESC guidelines. HTC was defined as the presence of 3 or more trabeculations in the apex and LV free wall.
Results: Of the 478 athletes, HTC of the LV was identified in 27 (5.6%) individuals. There was a higher prevalence of HTC in males compared to females (7.0% vs 0.93% respectively; p = 0.015) and in Afro-Caribbeans compared to Caucasians (14.0% vs 4.6% respectively; p = 0.011). There was no significant difference in the prevalence of HTC in endurance trained athletes compared to other sports (5.8% vs 5.6%). Athletes with HTC had a higher prevalence of LVH and T-wave inversion compared to athletes without HTC (Table 1). None of the athletes with HTC fulfilled diagnostic criteria for ILVNC or echocardiographic features of HCM and all exhibited normal cardiac function.
Conclusions: Hypertrabeculation of the LV in athletes is present in a proportion of male and Afro-Caribbean athletes. These athletes also exhibit a significantly higher prevalence of LV hypertrophy and T-wave inversions on ECG raising suspicion of cardiac pathology.The precise significance of this morphological anomaly requires familial evaluation, more detailed imaging and longitudinal follow up.
- © 2010 by American Heart Association, Inc.