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Objectives The purpose of this research was to study long term left ventricul ar(LV) adaptations in very high level endurance athletes. Background Knowledge of cardiac changes in athletes, who are at particularly high risk of sudden car diac death, is mandatory to detect hypertrophic cardiomyopathy (HCM) or dilated (DCM) cardiomyopathy. Methods We carried out echocardiographic examinations on 2 86 cyclists(group A) and 52 matched sedentary volunteers (group C); 148 cyclists participated in the 1995 “Tour de France”race (group A1), 138 in the 1998 rac e (group A2), and 37 in both (group B). Results In groups A, A1, A2, and C, resp ectively, diastolic left ventricular diameter (LVID)was 60.1±3.9 mm, 59.2±3.8 mm, 61.0±3.9 mm, and 49.0 ±4.3 mm (A vs. C and A1 vs. A2, p< 0.0001), and maxi mal wall thickness (WT) was 11.1 ±1.3 mm, 11.6 ±1.3 mm, 10.6 ±1.1 mm, and 8.6 ±1.0 mm (A vs. C and A1 vs. A2, p< 0.0001). Among group A, 147 (51.4%) had LV ID >60 mm; 17 of them had also a below normal (< 52%) left ventricular ejection fraction (LVEF). Wall thickness exceeded 13 mm in 25 athletes (8.7%) (always< 15 mm), 23 with LVID >55 mm. In group B, LVID increased (58.3 ±4.8 mm to 60.3 ±4.2 mm, p< 0.001) and WT decreased (11.8 ±1.2 mm to 10.8 ±1.2 mm, p< 0.001) with time. Conclusions Over one half of these athletes exhibited unusual LV dil ation, along with a reduced LVEF in 11.6%(17 of 147), compatible with the diagn osis of DCM. Increased WT was less common (always <15 mm) and scarce without LV dilation (< 1%), eliminating the diagnosis of HCM. Serial examinations showed evidence of furth er LV dilation along with wall thinning. These results might have important impl ications for screening in athletes.
Objectives The purpose of this research was to studying long term left ventricul ar (LV) adaptations in very high level endurance athletes. Background Knowledge of cardiac changes in athletes, who are at particularly particularly high risk of sudden car diac death, is mandatory to detect hypertrophic Methods We carried out echocardiographic examinations on 2 86 cyclists (group A) and 52 matched sedentary volunteers (group C); 148 cyclists participated in the 1995 “Tour de France” race (group A1 Results In groups A, A1, A2, and C, respctively, diastolic left ventricular diameter (LVID) was 60.1 ± 3.9 mm, respctively at 1998 rac e (group A2), and 37 in both 59.2 ± 3.8 mm, 61.0 ± 3.9 mm, and 49.0 ± 4.3 mm (A versus C and A1 vs. A2, p <0.0001), and maxi mal wall thickness (WT) was 11.1 ± 1.3 mm, 11.6 ± 1.3 mm, 10.6 ± 1.1 mm, and 8.6 ± 1.0 mm (A vs. C and A1 vs. A2, p <0.0001). Among group A, 147 (51.4%) had LV ID> 60 mm; 17 of them had also a belo Wall thickness exceeded 13 mm in 25 athletes (8.7%) (always <15 mm), 23 with LVID> 55 mm In group B, LVID increased (58.3 ± 4.8 mm to 60.3 ± 4.2 mm, p <0.001) and WT decreased (11.8 ± 1.2 mm to 10.8 ± 1.2 mm, p <0.001) with time. Conclusions Over one half of these athletes exhibited unusual LV diltion, along with a reduced LVEF in 11.6% (17 of 147), compatible with the diagnosis of DCM. Increased WT was less common (always <15 mm) and scarce without LV dilation (<1%), eliminating the diagnosis of HCM. Serial examinations showed evidence evidence of furth er LV dilation along with wall thinning. These results might have important impl ications for screening in athletes.