From the Interuniversity Cardiology Institute of the Netherlands, Utrecht
(B.M.P., H.W.M.K., A. vd L., A. d R., E.E. vd W.), and the Departments of
Cardiology (B.M.P., F.L., H.P.B., A. vd L., H.W.V., E.E. vd W.), Radiology
(H.J.L., H.W.M.K., A. d R.), and Medical Statistics (A.H.Z.), Leiden
University Medical Center, The Netherlands.
Correspondence to Ernst E. van der Wall, MD, PhD, Department of Cardiology, Building 1, C5-P25, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. E-mail vanderwall{at}cardio.azl.nl
Background—The question of whether
training-induced left ventricular hypertrophy
in athletes is a physiological rather than a
pathophysiological phenomenon remains unresolved.
The purpose of the present study was to detect any abnormalities in
cardiac function in hypertrophic hearts of elite cyclists and to
examine the response of myocardial high-energy phosphate
metabolism to high workloads induced by
atropine-dobutamine stress.
Methods and Results—We studied 21 elite cyclists and 12 healthy
control subjects. Left ventricular mass, volume, and
function were determined by cine MRI. Myocardial high-energy phosphates
were examined by 31P magnetic resonance spectroscopy. There
were no significant differences between cyclists and control subjects
for left ventricular ejection fraction (59±5% versus
61±4%), left ventricular cardiac index (3.4±0.4 versus
3.4±0.4 L · min-1 · m-2), peak
early filling rate (562±93 versus 535±81 mL/s), peak atrial filling
rate (315±93 versus 333±65 mL/s), ratio of early and atrial filling
volumes (3.0±1.0 versus 2.6±0.6), mean acceleration gradient of early
filling (5.2±1.4 versus 5.8±1.9 L/s2), mean deceleration
gradient of early filling(-3.1±0.9 versus -3.2±0.7
L/s2), mean acceleration gradient of atrial filling
(3.6±1.8 versus 4.5±1.7 L/s2), and atrial filling
fraction (0.23±0.06 versus 0.26±0.04, respectively). Cyclists and
control subjects showed similar decreases in the ratio of myocardial
phosphocreatine to ATP measured with 31P magnetic resonance
spectroscopy during atropine-dobutamine stress (1.41±0.20
versus 1.41±0.18 at rest to 1.21±0.20 versus 1.16±0.13 during
stress, both P=NS).
Conclusions—Left ventricular hypertrophy
in cyclists is not associated with significant abnormalities of cardiac
function or metabolism as assessed by MRI and spectroscopy.
These observations suggest that training-induced left
ventricular hypertrophy in cyclists is
predominantly a physiological phenomenon.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Functional and Metabolic Evaluation of the Athlete's Heart By Magnetic Resonance Imaging and Dobutamine Stress Magnetic Resonance Spectroscopy
Key Words: hypertrophy • magnetic resonance imaging • metabolism • spectroscopy • stress
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