Method
An Ultrasound Speckle Tracking (Two-Dimensional Strain) Analysis of Myocardial Deformation in Professional Soccer Players Compared With Healthy Subjects and Hypertrophic Cardiomyopathy

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Deformation analysis using 2-dimensional strain echocardiography can detect early systolic function abnormalities in patients with left ventricular hypertrophy. This study was designed to characterize global and regional myocardial deformation using 2-dimensional strain in professional soccer players (PSPs) compared with control subjects and patients with hypertrophic cardiomyopathy (HC). Twenty nine PSPs, 26 patients with HC, and 17 controls were investigated at rest using transthoracic echocardiography with 2-dimensional strain analysis. Radial and transverse strains were significantly higher in PSPs compared with controls, whereas longitudinal strain was lower. Compared with patients with HC, athletes had higher values for transverse, radial, and circumferential strains. In pathologic hypertrophic segments, longitudinal strain was lower in patients with HC than in PSPs. In conclusion, 2-dimensional strain can identify specific patterns of myocardial deformation in PSPs, controls, and patients with HC. It has the potential to become a routinely used method for the differentiation of athlete’s heart and HC.

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Methods and Results

Seventeen healthy control subjects, 29 PSPs, and 26 patients with familial nonobstructive HC were included in the study. PSPs were in a top-level team of the French first-division soccer championship, who train an average of 15 hours/week. None of the screened athletes was excluded. All patients with HC were required to have a positive family history for the disease. Criteria for asymmetric HC were septal wall thickness >15 mm, septal–posterior wall thickness ratio >1.3, and, for patients with

Discussion

This study assessed the role of 2-dimensional strain in evaluating global and regional function in highly trained football players and its ability to differentiate athlete’s heart from HC. Our results showed that (1) PSPs had a different strain profile at rest than control subjects and patients with HC, (2) myocardial deformation significantly decreased in patients with HC compared with PSPs and controls, (3) 2-dimensional strain can be used to differentiate athletes with LV hypertrophy from

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