Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete's heart)

Background. This study sought to determine whether strain rate imaging could distinguish between individuals with hypertensive left ventricular hypertrophy (LVH) and those with strength-training athletic LVH. Methods: In all, 108 participants (30 hypertensive LVH, 30 strength-training LVH, 48 control) were enrolled. In addition to a baseline echocardiogram, strain, peak systolic strain rate (SRs), peak early diastolic strain rate (SRE), and peak late diastolic strain rate values were compared in the apical 4-chamber view. Results: Athletes had no significant differences in strain, SRs, SRE, or peak late diastolic strain rate compared with control subjects (P =.11,.99, .85, and .09, respectively). Individuals with hypertensive LVH had significantly decreased strain, SRs and sR(E) (-16.8 +/- 3.2%, -0.99 +/- 0.15 s(-1), and 1.54 +/- 0.40 s(-1), respectively) compared with control subjects (-21.7 +/- 3.5%, - 1.31 +/- 0.27 s(-1), and 2.35 +/- 0.57 s(-1), respectively; all P <.0001). Conclusion: Hypertensive LVH has significant longitudinal strain, SRs, and SRE reductions versus control. The lack of these reductions in athletes suggests that strain rate imaging may have clinical use in discerning the physiologic LVH state.