Vergleich echokardiographischer methoden zur linksventrikulären muskelmassenbestimmung mit der MRT bei ausdauerathleten mit sportherz und untrainierten

The echocardiographic determination of left ventricular mass (LVM) and volume is of importance for the interpretation of cardiac adaptions and risk-stratification. In pathologically hypertrophied hearts, conventional one- and two-dimensional echocardiographic methods tend to overestimate LVM. For the athlete's heart, a comparison between different echocardiographic methods and magnetic resonance imaging (MRI) has not been performed so far. 23 healthy male endurance-athletes (28 ± 4 yr) with athlete's heart (A) and 26 healthy untrained males (U; 26 ± 4 yr) were examined by MRI and the following echocardiographic methods: ASE-Cube (ASE), Devereux (DEV), Troy (TRO), Teichholz (TEI), Reichek (REI) and Dickhuth (DIC). Indexed LVM were: MRI: 107 ± 6 g/m² (A) 79 ± 7 g/m² (U); ASE: 170 ± 20g/m² (A), 119 ± 14 g/m² (U); DEV: 134 ± 16 g/m² (A), 95 ± 11 g/m² (U); TRO: 134 ± 16 g/m² (A), 92 ± 12 g/m² (U); TEI: 115 ± 10 g/m² (A), 91 ± 8 g/m² (U); REI: 114 ± 14 g/m² (A), 89 ± 11 g/m² (U); DIC: 110 ± 14 g/m² (A); 80 ± 9 g/m² (U). In A and U, LVM is significantly overestimated by ASE, DEV, TRO, TEI, and REI compared to MRI (p < 0.05), but not by DIC. Although coefficients of correlation were similar, only DIC revealed acceptable limits of agreement (ASE: +20 to +172 g; DEV: -13 to +93 g; TRO: -18 to +92 g; TEI: -17 to +53 g; REI: -25 to +57 g; DIC: -37 to +45 g). Depending on the used method, LVM upper limits range between 93 (MRT) and 146 g/m² (ASE) in U, and 119 (MRT) and 209 g/m² (ASE) in A. Conclusion: Compared to MRI, DIC is the most accurate conventional echocardiographic method to determine LVM in U and A. For a correct interpretation of LVM, differences of the echocardiographic methods have to be considered.