Observational studyPloS one2019
The demanding grey zone: Sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Efficacy and Safety of Mavacamten and Aficamten in Obstructive and Nonobstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis.Critical pathways in cardiology · 2026Pooled it
- Society for Cardiovascular Magnetic Resonance reference values ("normal values") in cardiovascular magnetic resonance: 2025 update.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Guideline
- Metalloproteinases and Hypertrophic Cardiomyopathy: A Systematic Review.Biomolecules · 2023Pooled it
- Best practices in specialized hypertrophic cardiomyopathy centers in the United States: a survey of cardiologists, nurses, pharmacists, patients, and patient advocates.Future cardiology · 2026Article
- Beyond volumes and ejection fraction: practical insights into cine-CMR interpretation and applications.The international journal of cardiovascular imaging · 2025Review
- Cardiac myosin inhibitors: Efficacy, safety and future directions of aficamten in hypertrophic obstructive cardiomyopathy.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Review
- Regulatory mechanisms of exercise-induced physiological cardiac hypertrophy: progress and prospects.Frontiers in cardiovascular medicine · 2025Review
- Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach.Reviews in cardiovascular medicine · 2023Review
- New Era: Mavacamten for Obstructive Hypertrophic Cardiomyopathy.Cardiovascular & hematological agents in medicinal chemistry · 2023Review
- Certainties and Uncertainties of Cardiac Magnetic Resonance Imaging in Athletes.Journal of cardiovascular development and disease · 2022Review
- Age- and Sex-Specific Characteristics of Right Ventricular Compacted and Non-compacted Myocardium by Cardiac Magnetic Resonance.Frontiers in cardiovascular medicine · 2021Article
- Article
- Cardiac magnetic resonance in hypertrophic and dilated cardiomyopathies.La Radiologia medica · 2020Review
- Genetic and Gender Influences on Hypertrophic Cardiomyopathy: A Comprehensive Population-based Study of Clinical Outcomes and Implications.International journal of applied & basic medical researchArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe 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.
methodsElite 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.
resultsWhereas 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).
conclusionsAlmost 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.
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