ECHOCARDIOGRAPHIC FINDINGS IN ENDURANCE ATHLETES WITH HYPERTROPHIC NONOBSTRUCTIVE CARDIOMYOPATHY (HNCM) COMPARED TO NONATHLETES WITH HNCM AND TO PHYSIOLOGICAL HYPERTROPHY (ATHLETES HEART)

Hypertrophic non-obstructive cardiomyopathy (HNCM) is one of the most frequent causes of sudden cardiac death in young athletes. Since the c linical findings in HNCM patients may be inconspicuous and the ECG cha nges found in endurance athletes may be similar to those of HNCM patie nts, echocardiography, as a non-invasive procedure, seems to take on a n important role in differential diagnostics. To prove this hypothesis , conventional echocardiographic parameters were compared in three gro ups with confirmed diagnosis: Group I: HNCM (n = 9) without sports act ivity; Group II: HNCM (n = 9) with regular, intensive endurance traini ng (3-5 hours/week). The diagnosis was invasively confirmed in both gr oups. Group III: healthy subjects (n = 9) with physiological hypertrop hy and regular endurance training (3-6 hours/week). In the presence of HNCM, endurance sports activity appears to offset the reduction in th e left ventricle and enlargement of the left atrium. The wall thicknes s of the septum and posterior wall do not differ in the two HNCM group s, but show a significant difference to the healthy athletes. The endd iastolic diameter, the absolute septum and posterior wall thickness an d the ratio of septum+posterior wall/enddiastolic diameter can be take n as the most important differential diagnostic criterium in physiolog ical hypertrophy, but not the ratio between septum/posterior wall. It is concluded that conventional echocardiographic examination can be co nsidered a valuable non-invasive method for differentiating HNCM from athlete's heart, even in patients with HNCM who participate in enduran ce sports. However, a reliable diagnosis may not be possible in indivi dual cases.