Exercise echocardiography showed that 96% of grey-zone athletes increased LVEF by >11% from baseline to peak exercise compared to only 23% of DCM patients (p<0.0001).
Cohort
No
Does a cascade of investigations, including exercise stress echocardiography, differentiate between physiological LV dilatation in athletes and early dilated cardiomyopathy?
84 asymptomatic active males, including 35 with non-ischaemic dilated cardiomyopathy (DCM), 25 athletes in the 'grey zone' (LV enlargement and LVEF <55% exercising ≥8 hours/week), and 24 healthy athlete controls with normal LV geometry and LVEF.
A cascade of investigations including NT-proBNP measurement, 12-lead ECG, Holter monitoring, cardiovascular magnetic resonance (CMR), and exercise stress echocardiography.
Comparison of diagnostic findings between grey-zone athletes and patients with DCM.
Differentiation between physiological left ventricular dilatation (grey-zone athletes) and early dilated cardiomyopathy (DCM).surrogate
Exercise stress echocardiography, specifically the inability to increase LVEF >11% or achieve a peak LVEF >63%, provides the greatest discriminatory value in differentiating physiological LV dilatation in athletes from early dilated cardiomyopathy.
Objective Distinguishing early dilated cardiomyopathy (DCM) from physiological left ventricular (LV) dilatation with LV ejection fraction 11% from baseline to peak exercise compared with 23% of patients with DCM (p63% in 92% grey-zone athletes compared with 17% patients with DCM (p11% from baseline to peak exercise or achieve a peak LV ejection fraction >63% had sensitivity of 77% and 83%, respectively, and specificity of 96% and 92%, respectively, for predicting DCM. Conclusion Comprehensive assessment using a cascade of routine investigations revealed that exercise stress echocardiography has the greatest discriminatory value in differentiating between grey-zone athletes and asymptomatic patients with DCM. Our findings require validation in larger studies.
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Lynne Millar
Zephryn Fanton
Gherardo Finocchiaro
Heart
University of Manchester
King's College London
St George's, University of London
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Millar et al. (Mon,) conducted a cohort in Dilated cardiomyopathy and athlete’s heart differentiation (n=84). Exercise echocardiography vs. Control athletes was evaluated on Change in left ventricular ejection fraction (LVEF) from baseline to peak exercise (null, 95% CI null, p=<0.0001). Exercise echocardiography showed that 96% of grey-zone athletes increased LVEF by >11% from baseline to peak exercise compared to only 23% of DCM patients (p<0.0001).
www.synapsesocial.com/papers/696fa7ccb84853cc293d8007 — DOI: https://doi.org/10.1136/heartjnl-2019-316147
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