Abstract 19125: Athletes With Repolarization Abnormalities During Exercise Stress Test Have a Lower Global Longitudinal Strain Compared to Hypertensive Patients With the Same Degree of Septal Thickness
Introduction: Athletes may have electrocardiographic (ECG) repolarization abnormalities during stress test suggestive for ischemia in the absence of ischemic coronary artery disease. These alterations can be related to a certain degree of septal hypertrophy often associated to intensive training. Global longitudinal strain (GLS) by speckle tracking is a novel technique able to detect segmental alterations in myocardial contractility even in presence of a preserved ventricular function.
Hypothesis: GLS might be altered in athletes with ECG repolarization abnormalities at the stress test compared to hypertensive patients with the same degree of septal hypertrophy.
Methods: 735 consecutive subjects (mean age 53±12.5 yrs) were enrolled. At the screening stress test, 23 (19 M, 4 F) were found to have ECG repolarization abnormalities suggestive for ischemia in the presence of normal coronary vessels at the multi-slice computed tomography. They were compared to a control group of 10 hypertensive patients (9 M, 1 F mean age 50 ±10 yrs) with no ECG abnormalities during stress test. An echocardiographic exam with strain evaluation of apical 4, 2 and 3 chamber views to obtain GLS was performed on both groups. Interventricular septum thickness (IST) and relative wall thickness (RWT) were also calculated.
Results: A preserved ventricular function was seen in both groups (64±8 % in athletes vs 60±6 % in controls, p=0.42). IST and RWT were not significantly different in both groups (respectively 1.3 ± 0.43 cm vs 1.2 ± 0.35 cm, p=0.9 and 0.48 ± 0.09 vs 0.46 ± 0.04, p=0.67). GLS was significantly lower in athletes versus hypertensive patients (-18.6 ± 3.05 vs -20.5 ± 0.24, p=0.001).
Conclusions: In athletes with septal hypertophy and a positive stress test not associated to coronary disease, GLS is lower with respect to a population of hypertensive patient with the same degree of septal hypertrophy. Further investigations in a larger population are required to better define the potentiality of GLS in differentiating physiological versus pathological septum hypertrophy.
Author Disclosures: E. D’Elia: None. P. Ferrero: None. A. Calabrese: None. C. Vittori: None. G. Cavallaro: None. R. Rossini: None. M. Senni: None.
- © 2014 by American Heart Association, Inc.