CORRESPONDENCE: LETTER TO THE EDITOR
Reply
Gillian A. Whalley, MHSc, DMU*,
Robert N. Doughty, MD, FRACP and
James C. Baldi, PhD
* Department of Medicine University of Auckland Private Bag 92 019 Auckland New Zealand (Email: g.whalley{at}auckland.ac.nz).
We thank Drs. Abergel and Hagege for their interest in our research (1). They point to their own work (2) that indicates that professional cyclists may have more left ventricular (LV) hypertrophy and dilation (2) than the weight-bearing endurance athletes (runners) that we investigated. We chose not to include cyclists in our study because of the altered loading conditions they endure while training and the potential for the use of performance-enhancing drugs, as mentioned by Abergel et al. (2).
We do not advocate height or height2.7 to be the perfect indexation measure to assess ventricular size, but in the absence of fat-free mass it does appear to be a reasonable surrogate in our small group of athletes (1). However, as mentioned in our report, indexing measurements to height will not take into account longitudinal changes that occur with training, especially when training is associated with altered fat-free mass.
With reference to the data presented by Abergel et al. (2), in the absence of fat-free mass measurements, it would be difficult to ascertain whether the increased LV size is physiologic or pathologic; moreover, it may be the case that the relationship between fat-free mass and LV size observed in runners does not extend to other trained athletes, nor in fact all runners. We believe our study (1) was the first to demonstrate this relationship in athletes and, as we concluded in our report, this requires further confirmation in other groups of athletes.
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References
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1. Whalley GA, Doughty RN, Gamble GD, et al. Association of fat-free mass and training status with left ventricular size and mass in endurance-trained athletes J Am Coll Cardiol 2004;44:892-896.[Abstract/Free Full Text]
2. Abergel E, Chatellier G, Hagege AA, et al. Serial left ventricular adaptations in world-class professional cyclistsimplications for disease screening and follow-up. J Am Coll Cardiol 2004;44:144-149.[Abstract/Free Full Text]
Related Article
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Detection of Pathologic or Physiologic Left Ventricular Remodeling in Athletes
- Eric Abergel and Albert A. Hagege
J. Am. Coll. Cardiol. 2005 45: 1731.
[Full Text]
[PDF]
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