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Influence of Physiologic Cardiac Hypertrophy on the Prevalence of Heart Valve Regurgitation
Author(s) -
Sandrock Markus,
Schmidt-Trucksäß Arno,
Schmitz Daniel,
Niess Andreas,
Dickhuth Hans-Hermann
Publication year - 2008
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2008.27.1.85
Subject(s) - medicine , regurgitation (circulation) , cardiology , aortic valve regurgitation , muscle hypertrophy , mitral regurgitation , population , cardiac hypertrophy , doppler echocardiography , blood pressure , diastole , environmental health
Objective Chronic dynamic exercise leads to regulative and structural adaptations of the heart (athlete's heart). To what extent the enlargement and physiologic hypertrophy of the heart lead to changes in the function of the valves, particularly regurgitation, is not yet clear. The aim of this study was to examine the regurgitation levels of different states of “athlete's heart.” Methods Our study population consisted of 5124 healthy subjects (4046 male and 1078 female, 18–60 years), regularly exercising 1 to 20 h/wk. Subjects were divided into 3 groups depending on their relative heart volumes (RHVs): (1) very enlarged heart group (VEHG; male, n = 1251; female, n = 201), with RHVs of greater than 14 (male) and 13 (female) mL/kg; (2) mildly enlarged heart group (MEHG; male, n = 702; female, n = 224), with RHVs of 12 to 14 (male) and 11 to 13 (female) mL/kg; and (3) control subjects (CS; male, n = 2093; female, n = 653), with RHVs of less than 12 (male) and 11 (female) mL/kg. Results According to US Food and Drug Administration criteria for valve regurgitation, it could be shown by Doppler sonography that as physiologic enlargement and hypertrophy increased significantly, the frequency and severity of aortic valve regurgitation (mean ± SD: VEHG, 0.04 ± 0.09; MEHG, 0.09 ± 0.10; CS, 0.10 ± 0.11; P < .05) and high mitral regurgitation (VEHG, 0.10 ± 0.17; MEHG, 0.20 ± 0.29; CS, 0.26 ± 0.32; P < .01) decreased. On the contrary, pulmonary regurgitation (VEHG, 0.79 ± 0.45; MEHG, 0.47 ± 0.33; CS, 0.35 ± 0.38; P < .01) and tricuspid valve regurgitation (VEHG, 0.42 ± 0.29; MEHG, 0.47 ± 0.33; CS, 0.35 ± 0.38; P < .01) increased highly significantly with heart size. Conclusions These findings strongly support the view of athlete's heart as a physiologic adaptation of the heart, at least on the left side, not causing increased valvular regurgitation.