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Gepubliceerd in: Netherlands Heart Journal 10/2012

01-10-2012 | Original article

Ethnic differences in ventricular hypertrabeculation on cardiac MRI in elite football players

Auteurs: T. Luijkx, M. J. Cramer, A. Zaidi, R. Rienks, P. J. Senden, S. Sharma, F. J. van Hellemondt, C. F. Buckens, W. P. Mali, B. K. Velthuis

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2012

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Abstract

Purpose

Left ventricular (LV) trabeculation may be more pronounced in ethnic African than in Caucasian (European) athletes, leading to possible incorrect diagnosis of left ventricular non-compaction cardiomyopathy (LVNC). This study investigates ethnic differences in LV hypertrabeculation amongst elite athletes with cardiac magnetic resonance (CMR) and electrocardiography (ECG).

Methods

38 elite male football (soccer) players (mean age 23.0, range 19–34 years, 28/38 European, 10/38 African) underwent CMR and ECG. Hypertrabeculation was assessed using the ratio of non-compacted to compacted myocardium (NC/C ratio) on long-axis and short-axis segments. ECGs were systematically rated.

Results

No significant differences were seen in ventricular volumes, wall mass or E/A ratio, whereas biventricular ejection fraction (EF) was significantly lower in African athletes (European/African athletes LVEF 55/50 %, p = 0.02; RVEF 51/48 %, p = 0.05). Average NC/C ratio was greater in African athletes but only significantly at mid-ventricular level (European/African athletes: apical 0.91/1.00, p = 0.65; mid-ventricular 0.89/1.45, p < 0.05; basal 0.40/0.46, p = 0.67). ECG readings demonstrated no significant group differences, and no correlation between ECG anomalies and hypertrabeculation.

Conclusions

A greater degree of LV hypertrabeculation is seen in healthy African athletes, combined with biventricular EF reduction at rest. Recognition of this phenomenon is necessary to avoid misdiagnosis of LVNC.
Literatuur
1.
go back to reference Rawlins J, Carre F, Kervio G, et al. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation. 2010;121(9):1078–85.PubMedCrossRef Rawlins J, Carre F, Kervio G, et al. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation. 2010;121(9):1078–85.PubMedCrossRef
2.
go back to reference Crouse SF, Meade T, Hansen BE, et al. Electrocardiograms of collegiate football athletes. Clin Cardiol. 2009;32(1):37–42.PubMedCrossRef Crouse SF, Meade T, Hansen BE, et al. Electrocardiograms of collegiate football athletes. Clin Cardiol. 2009;32(1):37–42.PubMedCrossRef
3.
go back to reference Magalski A, Maron BJ, Main ML, et al. Relation of race to electrocardiographic patterns in elite American football players. J Am Coll Cardiol. 2008;51(23):2250–5.PubMedCrossRef Magalski A, Maron BJ, Main ML, et al. Relation of race to electrocardiographic patterns in elite American football players. J Am Coll Cardiol. 2008;51(23):2250–5.PubMedCrossRef
4.
go back to reference Schmied C, Zerguini Y, Junge A, et al. Cardiac findings in the precompetition medical assessment of football players participating in the 2009 African Under-17 Championships in Algeria. Br J Sports Med. 2009;43(9):716–21.PubMedCrossRef Schmied C, Zerguini Y, Junge A, et al. Cardiac findings in the precompetition medical assessment of football players participating in the 2009 African Under-17 Championships in Algeria. Br J Sports Med. 2009;43(9):716–21.PubMedCrossRef
5.
go back to reference Lewis JF. Considerations for racial differences in the athlete’s heart. Cardiol Clin. 1992;10(2):329–33.PubMed Lewis JF. Considerations for racial differences in the athlete’s heart. Cardiol Clin. 1992;10(2):329–33.PubMed
6.
go back to reference Basavarajaiah S, Boraita A, Whyte G, et al. Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. J Am Coll Cardiol. 2008;51(23):2256–62.PubMedCrossRef Basavarajaiah S, Boraita A, Whyte G, et al. Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. J Am Coll Cardiol. 2008;51(23):2256–62.PubMedCrossRef
7.
go back to reference Stollberger C, Finsterer J. A diagnostic dilemma in non-compaction, resulting in near expulsion from the Football World Cup. Eur J Echocardiogr. 2011;12(2):E8.PubMedCrossRef Stollberger C, Finsterer J. A diagnostic dilemma in non-compaction, resulting in near expulsion from the Football World Cup. Eur J Echocardiogr. 2011;12(2):E8.PubMedCrossRef
8.
go back to reference Maron BJ, Carney KP, Lever HM, et al. Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy. J Am Coll Cardiol. 2003;41(6):974–80.PubMedCrossRef Maron BJ, Carney KP, Lever HM, et al. Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy. J Am Coll Cardiol. 2003;41(6):974–80.PubMedCrossRef
9.
go back to reference Kohli SK, Pantazis AA, Shah JS, et al. Diagnosis of left-ventricular non-compaction in patients with left-ventricular systolic dysfunction: time for a reappraisal of diagnostic criteria? Eur Heart J. 2008;29(1):89–95.PubMedCrossRef Kohli SK, Pantazis AA, Shah JS, et al. Diagnosis of left-ventricular non-compaction in patients with left-ventricular systolic dysfunction: time for a reappraisal of diagnostic criteria? Eur Heart J. 2008;29(1):89–95.PubMedCrossRef
10.
go back to reference Chandra N, Papadakis M, Duschl J, et al. Abstract 17865: hypertrabeculation of the left ventricular apex in elite athletes: pathology versus physiology? Circulation. 2010;122(21_MeetingAbstracts):A17865. Chandra N, Papadakis M, Duschl J, et al. Abstract 17865: hypertrabeculation of the left ventricular apex in elite athletes: pathology versus physiology? Circulation. 2010;122(21_MeetingAbstracts):A17865.
11.
go back to reference Sarma RJ, Chana A, Elkayam U. Left ventricular noncompaction. Prog Cardiovasc Dis. 2010;52(4):264–73.PubMedCrossRef Sarma RJ, Chana A, Elkayam U. Left ventricular noncompaction. Prog Cardiovasc Dis. 2010;52(4):264–73.PubMedCrossRef
12.
go back to reference Engberding R, Stollberger C, Ong P, et al. Isolated non-compaction cardiomyopathy. Dtsch Arztebl Int. 2010;107(12):206–13.PubMed Engberding R, Stollberger C, Ong P, et al. Isolated non-compaction cardiomyopathy. Dtsch Arztebl Int. 2010;107(12):206–13.PubMed
13.
go back to reference Jenni R, Oechslin EN, van der Loo B. Isolated ventricular non-compaction of the myocardium in adults. Heart. 2007;93(1):11–5.PubMedCrossRef Jenni R, Oechslin EN, van der Loo B. Isolated ventricular non-compaction of the myocardium in adults. Heart. 2007;93(1):11–5.PubMedCrossRef
14.
go back to reference Petersen SE, Selvanayagam JB, Wiesmann F, et al. Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. J Am Coll Cardiol. 2005;46(1):101–5.PubMedCrossRef Petersen SE, Selvanayagam JB, Wiesmann F, et al. Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. J Am Coll Cardiol. 2005;46(1):101–5.PubMedCrossRef
15.
go back to reference Prakken NH, Velthuis BK, Teske AJ, et al. Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex. Eur J Cardiovasc Prev Rehabil. 2010;17(2):198–203.PubMedCrossRef Prakken NH, Velthuis BK, Teske AJ, et al. Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex. Eur J Cardiovasc Prev Rehabil. 2010;17(2):198–203.PubMedCrossRef
16.
go back to reference Pluim BM, Zwinderman AH, van der Laarse A, et al. The athlete’s heart. A meta-analysis of cardiac structure and function. Circulation. 2000;101(3):336–44.PubMedCrossRef Pluim BM, Zwinderman AH, van der Laarse A, et al. The athlete’s heart. A meta-analysis of cardiac structure and function. Circulation. 2000;101(3):336–44.PubMedCrossRef
17.
go back to reference Prakken NH, Velthuis BK, Cramer MJ, et al. Advances in cardiac imaging: the role of magnetic resonance imaging and computed tomography in identifying athletes at risk. Br J Sports Med. 2009;43(9):677–84.PubMedCrossRef Prakken NH, Velthuis BK, Cramer MJ, et al. Advances in cardiac imaging: the role of magnetic resonance imaging and computed tomography in identifying athletes at risk. Br J Sports Med. 2009;43(9):677–84.PubMedCrossRef
18.
go back to reference Prakken NH, Velthuis BK, Vonken EJ, et al. Cardiac MRI: standardized right and left ventricular quantification by briefly coaching inexperienced personnel. Open Magn Reson J. 2008;1:104–11.CrossRef Prakken NH, Velthuis BK, Vonken EJ, et al. Cardiac MRI: standardized right and left ventricular quantification by briefly coaching inexperienced personnel. Open Magn Reson J. 2008;1:104–11.CrossRef
19.
go back to reference Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10(2):165–93.PubMedCrossRef Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10(2):165–93.PubMedCrossRef
20.
go back to reference Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J. 2010;31(2):243–59.PubMedCrossRef Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J. 2010;31(2):243–59.PubMedCrossRef
21.
go back to reference Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989;5(5):303–11. discussion 12-3.PubMed Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989;5(5):303–11. discussion 12-3.PubMed
22.
go back to reference Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.PubMedCrossRef Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.PubMedCrossRef
23.
go back to reference Maron BJ, Gardin JM, Flack JM, et al. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary Artery Risk Development in (Young) adults. Circulation. 1995;92(4):785–9.PubMedCrossRef Maron BJ, Gardin JM, Flack JM, et al. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary Artery Risk Development in (Young) adults. Circulation. 1995;92(4):785–9.PubMedCrossRef
24.
go back to reference Oechslin E, Jenni R. Left ventricular non-compaction revisited: a distinct phenotype with genetic heterogeneity? Eur Heart J. 2011;32(12):1446–56.PubMedCrossRef Oechslin E, Jenni R. Left ventricular non-compaction revisited: a distinct phenotype with genetic heterogeneity? Eur Heart J. 2011;32(12):1446–56.PubMedCrossRef
25.
go back to reference Alhabshan F, Smallhorn JF, Golding F, et al. Extent of myocardial non-compaction: comparison between MRI and echocardiographic evaluation. Pediatr Radiol. 2005;35(11):1147–51.PubMedCrossRef Alhabshan F, Smallhorn JF, Golding F, et al. Extent of myocardial non-compaction: comparison between MRI and echocardiographic evaluation. Pediatr Radiol. 2005;35(11):1147–51.PubMedCrossRef
26.
go back to reference Fazio G, Novo G, D'Angelo L, et al. Magnetic resonance in isolated noncompaction of the ventricular myocardium. Int J Cardiol. 2010;140(3):367–9.PubMedCrossRef Fazio G, Novo G, D'Angelo L, et al. Magnetic resonance in isolated noncompaction of the ventricular myocardium. Int J Cardiol. 2010;140(3):367–9.PubMedCrossRef
27.
go back to reference Jenni R, Oechslin E, Schneider J, et al. Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart. 2001;86(6):666–71.PubMedCrossRef Jenni R, Oechslin E, Schneider J, et al. Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart. 2001;86(6):666–71.PubMedCrossRef
28.
go back to reference Sedmera D, Pexieder T, Vuillemin M, et al. Developmental patterning of the myocardium. Anat Rec. 2000;258(4):319–37.PubMedCrossRef Sedmera D, Pexieder T, Vuillemin M, et al. Developmental patterning of the myocardium. Anat Rec. 2000;258(4):319–37.PubMedCrossRef
29.
go back to reference Papadakis M, Carre F, Kervio G, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J. 2011 May 25. Papadakis M, Carre F, Kervio G, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J. 2011 May 25.
30.
go back to reference Zaidi A, Sharma S. The athlete’s heart. Br J Hosp Med (Lond). 2011;72(5):275–81. Zaidi A, Sharma S. The athlete’s heart. Br J Hosp Med (Lond). 2011;72(5):275–81.
Metagegevens
Titel
Ethnic differences in ventricular hypertrabeculation on cardiac MRI in elite football players
Auteurs
T. Luijkx
M. J. Cramer
A. Zaidi
R. Rienks
P. J. Senden
S. Sharma
F. J. van Hellemondt
C. F. Buckens
W. P. Mali
B. K. Velthuis
Publicatiedatum
01-10-2012
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2012
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-012-0305-7

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