The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete’s heart
We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athlet...
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| Published in | PloS one Vol. 14; no. 2; p. e0211624 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
14.02.2019
Public Library of Science (PLoS) |
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| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0211624 |
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| Abstract | We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients.
Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method.
Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001).
Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. |
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| AbstractList | Background We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients. Methods Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method. Results Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUC.sub.CQ :0.998, AUC.sub.TQ :0.999). Cut-off value for LVM/LVEDV.sub.CQ <0.82 mmxm.sup.2 /ml and for EDWT/LVEDVi.sub.TQ <1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001). Conclusions Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients. Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method. Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUC.sub.CQ :0.998, AUC.sub.TQ :0.999). Cut-off value for LVM/LVEDV.sub.CQ <0.82 mmxm.sup.2 /ml and for EDWT/LVEDVi.sub.TQ <1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001). Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. Background We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients. Methods Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method. Results Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001). Conclusions Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete’s heart, especially in highly trained athletes in the grey zone of hypertrophy. BackgroundWe aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients.MethodsElite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method.ResultsWhereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001).ConclusionsAlmost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients. Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method. Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001). Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients.BACKGROUNDWe aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients.Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method.METHODSElite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method.Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001).RESULTSWhereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001).Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy.CONCLUSIONSAlmost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete's heart, especially in highly trained athletes in the grey zone of hypertrophy. Background We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR) quantification method to differentiate physiological hypertrophy and hypertrophic cardiomyopathy based on a large population of highly trained athletes and hypertrophic cardiomyopathy patients. Methods Elite athletes (n = 150,>18 training hours/week), HCM patients (n = 194) and athletes with hypertrophic cardiomyopathy (n = 10) were examined by CMR. CMR based sport indices such as maximal end-diastolic wall thickness to left ventricular end-diastolic volume index ratio (EDWT/LVEDVi) and left ventricular mass to left ventricular end-diastolic volume ratio (LVM/LVEDV) were calculated, established using both conventional and threshold-based quantification method. Results Whereas 47.5% of male athletes, only 4.1% of female athletes were in the grey zone of hypertrophy (EDWT 13-16mm). EDWT/LVEDVi discriminated between physiological and pathological left ventricular hypertrophy with excellent diagnostic accuracy (AUCCQ:0.998, AUCTQ:0.999). Cut-off value for LVM/LVEDVCQ<0.82 mm×m2/ml and for EDWT/LVEDViTQ<1.27 discriminated between physiological and pathological left ventricular hypertrophy with a sensitivity of 77.8% and 89.2%, a specificity of 86.7% and 91.3%, respectively. LVM/LVEDV evaluated using threshold-based quantification performed significantly better than conventional quantification even in the male subgroup with EDWT between 13-16mm (p<0.001). Conclusions Almost 50% of male highly trained athletes can reach EDWT of 13 mm. CMR based sport indices provide an important tool to distinguish hypertrophic cardiomyopathy from athlete’s heart, especially in highly trained athletes in the grey zone of hypertrophy. |
| Audience | Academic |
| Author | Vago, Hajnalka Suhai, Ferenc Imre Czimbalmos, Csilla Toth, Attila Dohy, Zsofia Csecs, Ibolya Apor, Astrid Sydo, Nora Kiss, Orsolya Merkely, Bela |
| AuthorAffiliation | Heart and Vascular Center, Semmelweis University, Budapest, Hungary University of California, Davis, UNITED STATES |
| AuthorAffiliation_xml | – name: University of California, Davis, UNITED STATES – name: Heart and Vascular Center, Semmelweis University, Budapest, Hungary |
| Author_xml | – sequence: 1 givenname: Csilla surname: Czimbalmos fullname: Czimbalmos, Csilla – sequence: 2 givenname: Ibolya surname: Csecs fullname: Csecs, Ibolya – sequence: 3 givenname: Attila surname: Toth fullname: Toth, Attila – sequence: 4 givenname: Orsolya surname: Kiss fullname: Kiss, Orsolya – sequence: 5 givenname: Ferenc Imre surname: Suhai fullname: Suhai, Ferenc Imre – sequence: 6 givenname: Nora surname: Sydo fullname: Sydo, Nora – sequence: 7 givenname: Zsofia surname: Dohy fullname: Dohy, Zsofia – sequence: 8 givenname: Astrid surname: Apor fullname: Apor, Astrid – sequence: 9 givenname: Bela surname: Merkely fullname: Merkely, Bela – sequence: 10 givenname: Hajnalka orcidid: 0000-0002-3568-3572 surname: Vago fullname: Vago, Hajnalka |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30763323$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2019 Public Library of Science 2019 Czimbalmos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Czimbalmos et al 2019 Czimbalmos et al |
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| References_xml | – volume: 129 start-page: 1170 issue: 11 year: 2016 ident: ref5 article-title: Demographics and Epidemiology of Sudden Deaths in Young Competitive Athletes: From the United States National Registry publication-title: Am J Med doi: 10.1016/j.amjmed.2016.02.031 – year: 2017 ident: ref11 article-title: European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart publication-title: Eur Heart J – volume: 8 start-page: e003454 issue: 7 year: 2015 ident: ref26 article-title: Clinical Profile of Athletes With Hypertrophic Cardiomyopathy publication-title: Circ Cardiovasc Imaging doi: 10.1161/CIRCIMAGING.114.003454 – volume: 35 start-page: 259 issue: 3 year: 2014 ident: ref9 article-title: Left ventricular untwisting in athlete's heart: key role in early diastolic filling? publication-title: Int J Sports Med – volume: 24 start-page: 326 issue: 5 year: 2016 ident: ref16 article-title: Impact of the papillary muscles on cardiac magnetic resonance image analysis of important left ventricular parameters in hypertrophic cardiomyopathy publication-title: Neth Heart J doi: 10.1007/s12471-016-0805-y – volume: 112 start-page: 855 issue: 6 year: 2005 ident: ref24 article-title: Utility of cardiac magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.104.507723 – volume: 91 start-page: 1596 issue: 5 year: 1995 ident: ref6 article-title: Cardiac disease in young trained athletes. Insights into methods for distinguishing athlete's heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy publication-title: Circulation doi: 10.1161/01.CIR.91.5.1596 – volume: 17 start-page: 198 issue: 2 year: 2010 ident: ref14 article-title: Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex publication-title: Eur J Cardiovasc Prev Rehabil doi: 10.1097/HJR.0b013e3283347fdb – volume: 30 start-page: 1197 issue: 5 year: 2009 ident: ref17 article-title: Impact of papillary and trabecular muscles on quantitative analyses of cardiac function in hypertrophic cardiomyopathy publication-title: J Magn Reson Imaging doi: 10.1002/jmri.21958 – volume: 54 start-page: 220 issue: 3 year: 2009 ident: ref25 article-title: Hypertrophic cardiomyopathy phenotype revisited after 50 years with cardiovascular magnetic resonance publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2009.05.006 – volume: 5 start-page: 1115 issue: 11 year: 2012 ident: ref15 article-title: Correlation of trabeculae and papillary muscles with clinical and cardiac characteristics and impact on CMR measures of LV anatomy and function publication-title: JACC Cardiovasc Imaging doi: 10.1016/j.jcmg.2012.05.015 – volume: 7 start-page: 551 issue: 3 year: 2005 ident: ref12 article-title: Differentiation of athlete's heart from pathological forms of cardiac hypertrophy by means of geometric indices derived from cardiovascular magnetic resonance publication-title: J Cardiovasc Magn Reson doi: 10.1081/JCMR-200060631 – volume: 7 start-page: 190 issue: 1 year: 1986 ident: ref8 article-title: Structural features of the athlete heart as defined by echocardiography publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(86)80282-0 – volume: 16 start-page: 353 issue: 4 year: 2015 ident: ref10 article-title: The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging publication-title: Eur Heart J Cardiovasc Imaging doi: 10.1093/ehjci/jeu323 – volume: 49 start-page: 1404 issue: 21 year: 2015 ident: ref21 article-title: Unravelling the grey zone: cardiac MRI volume to wall mass ratio to differentiate hypertrophic cardiomyopathy and the athlete's heart publication-title: Br J Sports Med doi: 10.1136/bjsports-2013-092360 – volume: 349 start-page: 1064 issue: 11 year: 2003 ident: ref4 article-title: Sudden death in young athletes publication-title: N Engl J Med doi: 10.1056/NEJMra022783 – volume: 324 start-page: 295 issue: 5 year: 1991 ident: ref3 article-title: The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes publication-title: N Engl J Med doi: 10.1056/NEJM199101313240504 – volume: 24 start-page: 297 issue: 2 year: 2006 ident: ref13 article-title: Sex-specific characteristics of cardiac function, geometry, and mass in young adult elite athletes publication-title: J Magn Reson Imaging doi: 10.1002/jmri.20633 – volume: 6 start-page: 262 issue: 2 year: 2013 ident: ref7 article-title: Left ventricular wall thickness and the presence of asymmetric hypertrophy in healthy young army recruits: data from the LARGE heart study publication-title: Circ Cardiovasc Imaging doi: 10.1161/CIRCIMAGING.112.979294 – volume: 24 start-page: 41 issue: 1 year: 2017 ident: ref2 article-title: Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE publication-title: Eur J Prev Cardiol doi: 10.1177/2047487316676042 – volume: 99 start-page: 401 issue: 6 year: 2013 ident: ref22 article-title: Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes? publication-title: Heart doi: 10.1136/heartjnl-2012-303418 – volume: 91 start-page: 1380 issue: 11 year: 2005 ident: ref1 article-title: Distinguishing hypertrophic cardiomyopathy from athlete's heart: a clinical problem of increasing magnitude and significance publication-title: Heart doi: 10.1136/hrt.2005.060962 – year: 2018 ident: ref18 article-title: Left and right ventricular parameters corrected with threshold-based quantification method in a normal cohort analyzed by three independent observers with various training-degree publication-title: Int J Cardiovasc Imaging – volume: 35 start-page: 2733 issue: 39 year: 2014 ident: ref20 article-title: 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC) publication-title: Eur Heart J doi: 10.1093/eurheartj/ehu284 – volume: 26 start-page: 1503 issue: 5 year: 2016 ident: ref19 article-title: Clinical feasibility of a myocardial signal intensity threshold-based semi-automated cardiac magnetic resonance segmentation method publication-title: Eur Radiol doi: 10.1007/s00330-015-3952-4 – volume: 74 start-page: 802 issue: 8 year: 1994 ident: ref23 article-title: Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports publication-title: Am J Cardiol doi: 10.1016/0002-9149(94)90439-1 |
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| Snippet | We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance (CMR)... Background We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance... BackgroundWe aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance... Background We aimed to characterize gender specific left ventricular hypertrophy using a novel, accurate and less time demanding cardiac magnetic resonance... |
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| SubjectTerms | Athletes Biology and Life Sciences Blood pressure Cardiomegaly - physiopathology Cardiomegaly, Exercise-Induced - physiology Cardiomyopathy Cardiomyopathy, Hypertrophic - physiopathology Care and treatment Diagnosis Diagnostic systems Electrocardiography Female Female athletes Gender Health aspects Heart Heart hypertrophy Heart Ventricles - physiopathology Humans Hypertrophic cardiomyopathy Hypertrophy Hypertrophy, Left Ventricular - physiopathology Magnetic resonance Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Measurement Medical diagnosis Medicine and Health Sciences Methods Middle Aged Myocardial diseases NMR Nuclear magnetic resonance Patients Physiology Prospective Studies Research and Analysis Methods Resonance Social Sciences Sports - physiology Sports injuries Subgroups Task forces Ventricle Wall thickness Women athletes |
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| Title | The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete’s heart |
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