4.6 Review

Left ventricular hypertrophy in athletes: How to differentiate between hypertensive heart disease and athlete's heart

Journal

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
Volume 28, Issue 10, Pages 1125-1133

Publisher

OXFORD UNIV PRESS
DOI: 10.1177/2047487320911850

Keywords

Left ventricular hypertrophy; hypertension; heart disease; athlete's heart

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Athletes' hearts undergo remodeling due to exercise, but this can sometimes be mistaken for pathological hypertrophy seen in cardiac disorders like hypertension. Differentiating between athlete's heart and hypertensive heart disease can be challenging due to similar changes in left ventricular mass and wall thickness caused by training.
Athlete's heart is typically accompanied by a remodelling of the cardiac chambers induced by exercise. However, although competitive athletes are commonly considered healthy, they can be affected by cardiac disorders characterised by an increase in left ventricular mass and wall thickness, such as hypertension. Unfortunately, training-induced increase in left ventricular mass, wall thickness, and atrial and ventricular dilatation observed in competitive athletes may mimic the pathological remodelling of pathological hypertrophy. As a consequence, distinguishing between athlete's heart and hypertension can sometimes be challenging. The present review aimed to focus on the differential diagnosis between hypertensive heart disease and athlete's heart, providing clinical information useful to distinguish between physiological and pathological remodelling.

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