Data from: The demanding grey zone: sport indices by cardiac magnetic resonance imaging differentiate hypertrophic cardiomyopathy from athlete's heart

Background: We 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. Methods and Results: Elite 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. Whereas 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). Conclusions: Almost 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.