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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| Veröffentlicht in: | PloS one 2019-02, Vol.14 (2), p.e0211624-e0211624 |
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| creator | Czimbalmos, Csilla Csecs, Ibolya Toth, Attila Kiss, Orsolya Suhai, Ferenc Imre Sydo, Nora Dohy, Zsofia Apor, Astrid Merkely, Bela Vago, Hajnalka |
| description | 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 |
| doi_str_mv | 10.1371/journal.pone.0211624 |
| format | Article |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0211624</identifier><identifier>PMID: 30763323</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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 ; 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</subject><ispartof>PloS one, 2019-02, Vol.14 (2), p.e0211624-e0211624</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>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.</rights><rights>2019 Czimbalmos et al 2019 Czimbalmos et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-fb3adba5f3349b54a5c13415192e0bb05f2c4009709aad2249824b2d6d9683473</citedby><cites>FETCH-LOGICAL-c692t-fb3adba5f3349b54a5c13415192e0bb05f2c4009709aad2249824b2d6d9683473</cites><orcidid>0000-0002-3568-3572</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375568/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375568/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30763323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gomes, Aldrin V.</contributor><creatorcontrib>Czimbalmos, Csilla</creatorcontrib><creatorcontrib>Csecs, Ibolya</creatorcontrib><creatorcontrib>Toth, Attila</creatorcontrib><creatorcontrib>Kiss, Orsolya</creatorcontrib><creatorcontrib>Suhai, Ferenc Imre</creatorcontrib><creatorcontrib>Sydo, Nora</creatorcontrib><creatorcontrib>Dohy, Zsofia</creatorcontrib><creatorcontrib>Apor, Astrid</creatorcontrib><creatorcontrib>Merkely, Bela</creatorcontrib><creatorcontrib>Vago, Hajnalka</creatorcontrib><title>The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.</description><subject>Athletes</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Cardiomegaly - physiopathology</subject><subject>Cardiomegaly, Exercise-Induced - physiology</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - physiopathology</subject><subject>Care and treatment</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Gender</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Heart hypertrophy</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Hypertrophic cardiomyopathy</subject><subject>Hypertrophy</subject><subject>Hypertrophy, Left Ventricular - physiopathology</subject><subject>Magnetic resonance</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Measurement</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Myocardial diseases</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Physiology</subject><subject>Prospective Studies</subject><subject>Research and Analysis Methods</subject><subject>Resonance</subject><subject>Social Sciences</subject><subject>Sports - physiology</subject><subject>Sports injuries</subject><subject>Subgroups</subject><subject>Task forces</subject><subject>Ventricle</subject><subject>Wall thickness</subject><subject>Women athletes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEoqXwBggsIXG42MWHxIm5QKoqDitVqkQLt5bjjBNX2Ti1vYjlFXhpnN1ttYt6gXIRa_L9v2cmM1n2nOA5YSV5f-1WflD9fHQDzDElhNP8QXZMBKMzTjF7uHc-yp6EcI1xwSrOH2dHDJecMcqOsz9XHaAGlmpo7NCi1sMa_U6OH9Dl6HxENsU1BFSvkVa-sUqjpWoHiFYjD8ENatCAbIpN8sYaAx6GaFUE1K1H8NG7sUvwRu2Wazeq2K2R8W6J0qmHCG8C6kD5-DR7ZFQf4NnufZJ9__zp6uzr7Pziy-Ls9HymuaBxZmqmmloVhrFc1EWuCk1YTgoiKOC6xoWhOsdYlFgo1VCai4rmNW14I3jF8pKdZC-3vmPvgtz1MUhKKiyqimCSiMWWaJy6lqNP9fm1dMrKTcD5VqZ8re5BEiywZpSkREguVF1VhvPSEMGZgZJVyevj7rZVvYRGp-541R-YHn4ZbCdb91NyVhYFnwze7gy8u1lBiHJpg4a-VwO41SbvsiAlyyf01T_o_dXtqFalAuxgXLpXT6bytChzwoiopi7N76HSk6bF6jQixqb4geDdgSAxEX7FVq1CkIvLb__PXvw4ZF_vsWlS-tgF16-idUM4BPMtqL0LwYO5azLBctqZ227IaWfkbmeS7MX-D7oT3S4J-wtWohKH</recordid><startdate>20190214</startdate><enddate>20190214</enddate><creator>Czimbalmos, Csilla</creator><creator>Csecs, Ibolya</creator><creator>Toth, Attila</creator><creator>Kiss, Orsolya</creator><creator>Suhai, Ferenc Imre</creator><creator>Sydo, Nora</creator><creator>Dohy, Zsofia</creator><creator>Apor, Astrid</creator><creator>Merkely, Bela</creator><creator>Vago, Hajnalka</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3568-3572</orcidid></search><sort><creationdate>20190214</creationdate><title>The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart</title><author>Czimbalmos, Csilla ; Csecs, Ibolya ; Toth, Attila ; Kiss, Orsolya ; Suhai, Ferenc Imre ; Sydo, Nora ; Dohy, Zsofia ; Apor, Astrid ; Merkely, Bela ; Vago, Hajnalka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fb3adba5f3349b54a5c13415192e0bb05f2c4009709aad2249824b2d6d9683473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Athletes</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Cardiomegaly - physiopathology</topic><topic>Cardiomegaly, Exercise-Induced - physiology</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Care and treatment</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Gender</topic><topic>Health aspects</topic><topic>Heart</topic><topic>Heart hypertrophy</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Hypertrophic cardiomyopathy</topic><topic>Hypertrophy</topic><topic>Hypertrophy, Left Ventricular - physiopathology</topic><topic>Magnetic resonance</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Measurement</topic><topic>Medical diagnosis</topic><topic>Medicine and Health Sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Myocardial diseases</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Physiology</topic><topic>Prospective Studies</topic><topic>Research and Analysis Methods</topic><topic>Resonance</topic><topic>Social Sciences</topic><topic>Sports - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Czimbalmos, Csilla</au><au>Csecs, Ibolya</au><au>Toth, Attila</au><au>Kiss, Orsolya</au><au>Suhai, Ferenc Imre</au><au>Sydo, Nora</au><au>Dohy, Zsofia</au><au>Apor, Astrid</au><au>Merkely, Bela</au><au>Vago, Hajnalka</au><au>Gomes, Aldrin V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-02-14</date><risdate>2019</risdate><volume>14</volume><issue>2</issue><spage>e0211624</spage><epage>e0211624</epage><pages>e0211624-e0211624</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30763323</pmid><doi>10.1371/journal.pone.0211624</doi><tpages>e0211624</tpages><orcidid>https://orcid.org/0000-0002-3568-3572</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2180988101 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | 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 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 |
| title | The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T22%3A26%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20demanding%20grey%20zone:%20Sport%20indices%20by%20cardiac%20magnetic%20resonance%20imaging%20differentiate%20hypertrophic%20cardiomyopathy%20from%20athlete's%20heart&rft.jtitle=PloS%20one&rft.au=Czimbalmos,%20Csilla&rft.date=2019-02-14&rft.volume=14&rft.issue=2&rft.spage=e0211624&rft.epage=e0211624&rft.pages=e0211624-e0211624&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0211624&rft_dat=%3Cgale_plos_%3EA574131987%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2180988101&rft_id=info:pmid/30763323&rft_galeid=A574131987&rft_doaj_id=oai_doaj_org_article_1090c321b54149ab88f667f1963fe738&rfr_iscdi=true |