Key result
In 100 top-level male handball players, tissue Doppler imaging revealed eccentric left ventricular hypertrophy, but 0% had systolic or early diastolic velocities below the 9 cm/s cutoff.
Cross-Sectional (n=100)
Top-level handball players exhibit eccentric left ventricular hypertrophy with normal systolic and diastolic function as assessed by tissue Doppler imaging, providing reference values for this athletic population.
Answers are grounded in this paper and cite their sources.
Supports preserved TDI function despite eccentric LVH in elite handball players; leaves open generalizability to other sports or sexes.
BACKGROUND AND OBJECTIVE: Echocardiographic tissue Doppler imaging (TDI) has been proposed for the differentiation of physiologic left ventricular hypertrophy and pathologic left ventricular hypertrophy in athletes. In addition, cutoff values for systolic (S'<9 cm/s) and early diastolic (E'<9 cm/s) myocardial velocities had been defined. The aim of our study was the analysis of the morphologic cardiac changes by standard echocardiography, and the myocardial velocities S' and E' by TDI in top-level handball players with respect to the predefined cutoff values. PATIENTS AND METHODS: Pulsed-wave TDI of the systolic and early diastolic velocities was performed at the lateral and septal mitral annulus (MA) in the four-chamber view in 100 athletes (100 Caucasian men; professional handball players of the first German handball league and the German national team; mean age 25.8+/-4.8 years). RESULTS: Global and regional left ventricular systolic function was normal in all athletes. They showed an eccentric hypertrophy of the left ventricle (LV), which was characterized by an increased mass of the LV (287.3+/-58.4 g), and an increased end diastolic diameter of the LV (LVEDD: 58+/-5.9 mm), but no echomorphologic signs of pathologic hypertrophy or hypertrophic cardiomyopathy. TDI showed a systolic velocity S' of the MA of 9.3+/-1.5 cm/s at the septal and 10.5+/-2.1 at the lateral MA. Ten of the 100 athletes showed a S'<9 cm/s at both sides of the MA. TDI showed an early diastolic velocity E' of the MA of 13.2+/-2.8 cm/s at the septal and of 16.6+/-3.4 cm/s at the lateral MA. None of the 100 athletes showed reduced systolic or early diastolic velocities below the proposed cutoff values (S' and E'<9 cm/s) at any sides of the MA. CONCLUSION: Our study provides further insights into systolic and diastolic function as assessed by TDI in top-level handball players. Owing to the large cohort of individuals, our findings might be helpful as reference values for the echocardiographic assessment of handball players, who are performing a moderate static and high dynamic sport.
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Butz et al. (2009) conducted a cross-sectional in Physiologic left ventricular hypertrophy in athletes (n=100). Top-level handball playing was evaluated on Systolic (S') and early diastolic (E') myocardial velocities below proposed cutoff values (<9 cm/s). In 100 top-level male handball players, tissue Doppler imaging revealed eccentric left ventricular hypertrophy, but 0% had systolic or early diastolic velocities below the 9 cm/s cutoff.
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