The Role of Presystolic A Wave in the Differentiation of Non-obstructive Hypertrophic Cardiomyopathy and Athlete's Heart

Background: Even though hypertrophic cardiomyopathy (HCM) can be distinguished from the athlete’s heart with a difference in echocardiographic measurements, difficulties may be encountered in clinical practice from time to time. The aim of this study was to evaluate the use of presystolic A wave (PSAW) assessed by the Doppler echocardiography for differentiating between HCM and athlete’s heart. Methods: A total of 52 subjects were included in the present study, of which, 27 had HCM and 25 were athletes. The pulsed Doppler assessment of the left ventricular outflow tract was performed on the ventricular face from the immediate proximal of the aortic valve on the apical five-chamber view. Allpatients were assessed for the presence of PSAW,and the velocity of this wave was recordedin PSAW positive subjects. Results: The frequency of PSAW was found to be higher in patients with HCM [n = 12 (44%)] than in athletes [n = 4 (16%)] (p = 0.026). PSAW velocity measurements were observed to be higher in the HCM group; however, there was no statistical significance [53 ms (36–84)], [68 ms (35–193)], (p = 0.362). Conclusion: While there is a need for scaling-up similar studies, the current findings suggest that PSAW can be used as a distinguishing parameter for differentiating HCM and athlete’s heart.