Athletes heart is a left ventricular adaptation to long-term, intensive training which includes changes as increased cavity diameter, wall thickness and mass. Even if the standard 2-dimensional echocardiography represents an irreplaceable method in the evaluation of cardiac adaptations to physical exercise, the data currently available suggests the usefulness of Doppler Myocardial Imaging (DMI) in the assessment of the myocardial systolic and diastolic function of the athletes heart. In particular, DMI analysis in the trained subject has demonstrated interesting prospective for : 1) the differential diagnosis from pathological left ventricular hypertrophy due to Hypertrophic Cardiomyopathy (HCM); 2) the prediction of cardiac performance during physical effort; 3) the evaluation of the bi-ventricular interaction; 4) the analysis of the myocardial adaptations to various training protocols; 5) the early identification of specific genotypes associated with cardiomyopathies. Such a combined use of standard 2-D echo and DMI may be taken into account for a valid noninvasive and easy-repeatable evaluation of both physiological and pathological ventricular hypertrophy.
Keywords: Athlete's heart, doppler myocardial imaging, strain rate imaging, ventricular hypertrophy, hypertrophic cardiomyopathy, training
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