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Serial left ventricular adaptations in world-class professional cyclists

Implications for disease screening and follow-up

Eric Abergel, MD^*,*, Gilles Chatellier, MD, Albert A. Hagege, MD, PhD^*, Agnes Oblak, MD^*, Ales Linhart, MD^*, Alain Ducardonnet, MD and Joël Menard, MD, PhD

^* Service de Cardiologie, Paris, France
Unité d'Épidémiologie et de Recherche Clinique, Paris, France
Centre d'Investigations Cliniques, Hôpital Européen Georges Pompidou, Paris, France
Institut Cur Effort Santé, Paris, France

View larger version (24K): [in a new window]   Figure 1 Plot of left ventricular ejection fraction (LVEF) against left ventricular internal diameter at end diastole (LVIDd) in all cyclists (solid circles = 1995; open circles = 1998). The solid vertical bar represents the normality threshold (60 mm) for LVIDd, and the solid horizontal bar represents the normality threshold (52%) for LVEF. Numbers in italics in front of each axis value are cumulative numbers of cyclists with a value below the corresponding axis value.

View larger version (21K): [in a new window]   Figure 2 Plot of left ventricular internal diameter at end diastole (LVIDd) against maximal wall thickness (WT) in all cyclists. The solid horizontal bar represents the LVIDd threshold for dilated left ventricle (LV) (55 mm), and the solid vertical bar represents the normality threshold for maximal WT (13 mm). Numbers in italics in front of the X axis values are cumulative numbers of cyclists with a value below the corresponding axis value.

View larger version (17K): [in a new window]   Figure 3 Plot between the measured left ventricular ejection fraction (LVEF) (X axis) and the difference between measured LVEF and the lower limit of the 95% confidence interval of the predicted LVEF for a given end systolic stress (ESS) (Y axis). (Left) Predicted LVEF was defined by the model obtained in controls (LVEF = 87.55 – 0.38 · ESS, r = 0.75, p < 0.0001). (Right) Predicted LVEF was defined by the model obtained in cyclists (LVEF = 80.34 – 0.29 · ESS, r = 0.71, p < 0.0001). Results are shown for the 17 cyclists with both left ventricular internal diameter at end diastole >60 mm and LVEF <52% (solid circles), the remaining cyclists (n = 269) (+), and the control group (n = 52) (open squares).