Exercise-induced cardiac remodeling in non-elite endurance athletes: Comparison of 2-tiered and 4-tiered classification of left ventricular hypertrophy

Figures

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  Fig 1. Schematic illustration of the four-tiered classification of left ventricular hypertrophy. LV EDV indicates left ventricular end-diastolic volume; BSA, body surface area; and LVH, left ventricular hypertrophy.

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  Fig 2. Impact of cumulative lifetime endurance training and 10 mile race time on LV mass illustrated for normal (<120/80 mmHg, filled circles) and non-optimal (120/80-139/89 mmHg, empty circles) blood pressure. Solid line indicates linear regression for athletes with normal blood pressure and dashed line linear regression for athletes with non-optimal blood pressure.

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  Fig 3. Number of athletes in each tier of the 2TC and 4TC, as well as number of athletes who were reclassified from 2TC to 4TC. LV end-diastolic volume and LV length are indicated inside or next to the schematic representations of the ventricles (mean ± SD). Training characteristics are indicated by the number of runner symbols (cumulative lifetime training (hours)/10 mile race time (min): 1 runner: <4000 and/or ≥70; 2 runners: 4000 to 5999 and/or 65 to 69; 3 runners: 6000–7999 and/or 60 to 64; 4 runners: ≥8000 and/or <60).

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  Fig 4. Echocardiography images of M-mode and apical two-chamber views. Athlete 1 was classified as eccentric LVH with 2TC due to a LVID of 57.1 mm and a PWT of 9.8 mm resulting in a relative wall thickness of 0.34. He was reclassified with 4TC to concentric non-dilated LVH due to a relative short LV length of 8.2 cm and an associated LV EDV/BSA of 60.1 ml/m2 resulting in a Concentricity of 10.4 ml/m2/3. Athlete 2 was also classified as eccentric LVH with 2TC due to a LVID of 53.6 mm and a PWT of 10.6 mm resulting in a relative wall thickness of 0.40. In contrast to Athlete 1, Athlete 2 was reclassified with 4TC to eccentric non-dilated LVH due to a longer LV length of 9.3 cm and an associated higher LV EDV/BSA of 71.5 ml/m2 resulting in a smaller Concentricity of 8.7 ml/m2/3.