ECHOCARDIOGRAPHIC CRITERIA OF PHYSIOLOGICAL LEFT-VENTRICULAR HYPERTROPHY IN COMBINED STRENGTH-TRAINED AND ENDURANCE-TRAINED ATHLETES

In combined strength- and endurance-trained athletes who are showing b oth unusual large body dimensions as well as a high physical fitness, the dimensions of the 'athlete's heart' are expected to reach physiolo gical limits. Therefore we investigated 75 male and 77 female competit ive rowers by means of doppler-echocardiography. The absolute ''critic al'' heart weight of 500 g was exceeded by 61% of the male and 10% of the female rowers. Maximal values of the left ventricular (LV) muscle mass were measured at 170 (men) and 133 (women) g . m(-2) body surface area, respectively. The LV end-diastolic internal diameter was measur ed to be above the upper clinical limit of 55 mm in 55% of the male an d 17% of the female rowers. A LV wall thickness of 13 and 12 mm was on ly exceeded by 3 male and 1 female athlete, respectively (maximal valu es: 14 and 12.5 mm). The LV wall/internal diameter ratio did not excee d 48-50%. The systolic LV function as well as ECG and blood pressure d id not reveal any pathological finding, the diastolic LV function was always measured within the normal range. The LV wall thicknesses, inte rnal diameter and hypertrophic index (relation between wall thickness and internal diameter) of the rowers were significantly higher than th ose of 62 non-endurance trained athletes (pairwise matched according t o the body dimensions) and similar to 28 male 'pure' endurance athlete s (pairwise matched according to the absolute heart volume). In conclu sion, upper limits of echocardiographic volume measurements that are c onsidered critical may be clearly exceeded by healthy strength-enduran ce trained athletes with simultaneously high body dimensions. The clin ical limits, however, are still valid in subjects with a body mass up to approximately 70 kg. The LV wall thickness only exceptionally excee d the clinical limits. A specific influence of the strength elements i n training on the LV hypertrophy had not be found.