Athlete's heart in women: Echocardiographic characterization of highly trained elite female athletes

JAMA

Volumn 276, Issue 3, 1996, Pages 211-215

  Pelliccia, Antonio ^a   Maron, Barry J ^c   Culasso, Franco ^b   Spataro, Antonio ^a   Caselli, Giovanni ^a  

^a Italian National Olympic Committee   (Italy)

^b SAPIENZA UNIVERSITY OF ROME   (Italy)

^c MINNEAPOLIS HEART INSTITUTE FOUNDATION   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; ATHLETE; CONTROLLED STUDY; ELECTROCARDIOGRAPHY; FEMALE; HEART LEFT VENTRICLE SIZE; HEART VENTRICLE HYPERTROPHY; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; MALE; NORMAL HUMAN; PRIORITY JOURNAL; SEX DIFFERENCE; SPORTS MEDICINE;

EID: 0030056084     PISSN: 00987484     EISSN: None     Source Type: Journal    
DOI: 10.1001/jama.276.3.211     Document Type: Article

References (46)

1. Rost R, Hollman W. Athlete's heart. Int J Sports Med. 1983;4:147-165.
2. Huston TP, Puffer JC, Rodney WM. The athletic heart syndrome. N Engl J Med. 1985;313:24-32.
3. Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the 'athlete's heart' assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol. 1994;74:802-806.
4. Maron BJ. Structural features of the athlete's heart as defined by echocardiography. J Am Coll Cardiol. 1986;7:190-203.
5. Keul J, Dickhuth H-H, Simon G, Lehman M. Effect of static and dynamic exercise on heart volume, contractility, and left ventricular dimensions. Circ Res. 1981;48(pt 1):162-170.
6. Longhurst JC, Kelly AR, Gonyea WJ, Mitchell JH. Chronic training with static and dynamic exercise. Circ Res. 1981;48(pt 1):171-178.
7. Fagard R, Aubert A, Lysens R, Staessen J, Vanhees L, Amery A. Noninvasive assessment of seasonal variations in cardiac structure and function in cyclists. Circulation. 1983;67:896-901.
8. Douglas PS, O'Toole ML, Hiller DB, Reichek N. Left ventricular structure and function by echocardiography in ultraendurance athletes. Am J Cardiol. 1986;58:805-809.
9. Pelliccia A, Spataro A, Caselli G, Maron BJ. Absence of left ventricular wall thickening in athletes engaged in intense power training. Am J Cardiol. 1993;72:1048-1054.
10. Orencia A, Bailey K, Yawn BP, Kottke TE. Effect of gender on long-term outcome of angina pectoris and myocardial infarction/sudden unexpected death. JAMA. 1993;269:2392-2397.
11. Kuhn FE, Rackley CE. Coronary artery disease in women. Arch Intern Med. 1993;153:2626-2636.
12. Gandhi MM, Wood DA, Lampe FC. Characteristics and clinical significance of ambulatory myocardial ischemia in men and women in the general population presenting with angina pectoris. J Am Coll Cardiol. 1994;23:74-81.
13. Pelliccia A, Maron BJ. Preparticipation cardiovascular evaluation of the competitive athlete. Am J Cardiol. 1995;75:827-828.
14. Maron BJ, Gottdiener JS, Epstein SE. Patterns and significance of the distribution of left ventricular hypertrophy in hypertrophic cardiomyopathy. Am J Cardiol. 1981;48:418-428.
15. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991;324:295-301.
16. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography. Circulation. 1978;58:1072-1083.
17. Devereux RB. Detection of left ventricular hypertrophy by M-mode echocardiography: anatomic validation, standardization, and comparison to other methods. Hypertension. 1987;9(suppl 2, pt 2):19-26.
18. de Simone G, Daniels SR, Devereux RB, et al. Left ventricular mass and body size in normotensive children and adults. J Am Coll Cardiol. 1992;20:1251-1260.
19. Ford LE. Heart size. Circ Res. 1976;39:297-303.
20. Maron BJ, Spirito P, Green KJ, Wesley YE, Bonow RO, Arce J. Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in patients with hypertrophic cardiomyopathy. J Am Coll Cardiol. 1987;10:733-742.
21. Spirito P, Maron BJ. Influence of aging on Doppler echocardiographic indices of left ventricular diastolic function. Br Heart J. 1988;59:672-679.
22. Dixon WJ. BMDP Statistical Software Manual. Berkeley: University of California Press; 1992:145-162, 489-527, 903-920.
23. Armitage P, Berry G. Statistical Methods in Medical Research. Oxford, England: McGraw-Hill Book Co; 1994:277.
24. Henry WL, Gardin JM, Ware JH. Echocardiographic measurements in normal subjects from infancy to old age. Circulation, 1980;62:1054-1061.
25. Devereux RB, Lutas EM, Casale PN, et al. Standardization of M-mode echocardiographic left ventricular anatomic measurements. J Am Coll Cardiol. 1984;4:1222-1230.
26. Michels VV, Moll PP, Miller FA, et al. The frequency of familial dilated cardiomyopathy in a series of patients with idiopathic dilated cardiomyopathy. N Engl J Med. 1992;326:77-82.
27. Gavazzi A, De Maria R, Renosto G, et al. The spectrum of left ventricular size in dilated cardiomyopathy. Am Heart J. 1993;125;410-422.
28. Redfield MM, Gersh BJ, Bailey KR, Rodeheffer RJ. Natural history of incidentally discovered, asymptomatic idiopathic dilated cardiomyopathy. Am J Cardiol. 1994;74:737-739.
29. Zeldis SM, Morganroth J, Rubler S. Cardiac hypertrophy in response to dynamic conditioning in female athletes. J Appl Physiol. 1978;44:849-852.
30. Mickelson JK, Byrd BF III, Bouchard A, Botvinick EH, Schiller NB. Left ventricular dimensions and mechanics in distance runners. Am Heart J. 1986; 112:1251-1256.
31. Pollak SJ, McMillan ST, Mumpower E, et al. Echocardiographic analysis of elite women distance runners. Int J Sports Med. 1987;8:81-83.
32. Fagard R, Van Den Broeke C, Vanhees L, Staessen J, Amery A. Noninvasive assessment of systolic and diastolic left ventricular function in female runners. Eur Heart J. 1987;8:1305-1311.
33. Riley-Hagan M, Peshock RM, Stray-Gundersen J, Katz J, Ryschon TW, Mitchell JH. Left ventricular dimensions and mass using magnetic resonance imaging in female endurance athletes. Am J Cardiol. 1992;69:1067-1074.
34. Crouse SF, Rohack JJ, Jacobsen DJ. Cardiac structure and function in women basketball athletes. Res Q Exerc Sport. 1992;63:393-401.
35. Morales MC, Gleim GW, Marino ND, Glace BT, Coplan NL. The role of gender in echocardiographically determined left ventricular mass in equally trained populations of runners. Am Heart J. 1992; 124:1104-1106.
36. George KP, Wolfe LA, Burggraf GW, Norman R. Electrocardiographic and echocardiographic characteristics of female athletes. Med Sci Sports Exerc. 1995;27:1362-1370.
37. Astrand PO, Rodahl K, eds. Textbook of Work Physiology: Physiological Bases of Exercise. New York, NY: McGraw Hill Book Co; 1986:414-415.
38. Knutsen KM, Stugaard M, Michelsen S, Otterstad JE. M-mode echocardiographic findings in apparently healthy, non-athletic Norwegians aged 20-70 years. J Intern Med. 1989;225:111-115.
39. Maron BJ, Pelliccia A, Spirito A. Cardiac disease in young trained athletes: insights into methods for distinguishing athlete's heart from structural heart disease with particular emphasis on hypertrophic cardiomyopathy. Circulation. 1995;91:1596-1601.
40. Maron BJ, Bonow RO, Cannon RO III, Leon BJ, Epstein SE. Hypertrophic cardiomyopathy. N Engl J Med. 1987;316:780-789,844-852.
41. Klues HG, Schiffers A, Maron BJ. Phenotypic spectrum and patterns of left ventricular hypertrophy in hypertrophic cardiomyopathy: morphologic observations and significance as assessed by two-dimensional echocardiography in 600 patients. J Am Coll Cardiol. 1995;26:1699-1708.
42. Petrofsky JS, Burse RL, Lind AR. Comparison of physiological responses of women and men to isometric exercise. J Appl Physiol. 1975;38:863-868.
43. Hanley PC, Zinsmeister AR, Clements JP, Bove AA, Brown ML, Gibbons RJ. Gender-related differences in cardiac response to supine exercise assessed by radionuclide angiography. J Am Coll Cardiol. 1989;13:624-629.
44. Gleim GW, Stachenfeld NS, Coplan NL, Nicholas JA. Gender differences in the systolic blood pressure response to exercise. Am Heart J. 1991;121:524-530.
45. McGill HC, Anselmo VC, Buchanan JM, Sheridan PJ. The heart is a target for androgen. Science. 1980;207:775-777.
46. Koenig H, Goldstone A, Lu CY. Testosterone-mediated sexual dimorphism of the rodent heart. Circ Res. 1982;50:782-787.