Left ventricular mass in male adolescent athletes and non-athletes

  • Erling David Kaunang Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Jane G. C. Metusala Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Audrey M. I. Wahani Department of Child Health, Sam Ratulangi University Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
Keywords: adolescent, athlete, non-athlete, left ventricular mass, left ventricular hypertrophy


Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy). T he cause of left ventricular hypertrophy is an important risk factor in the morbidity and mortality of cardiovascular diseases.

Objective To compare left ventricular mass and left ventricular hypertrophy in male adolescent athletes and non-athletes.

Methods We conducted a cross-sectional, analytic study, from September to December 2012 in male adolescents aged 15-18 years. The case group included athletes from the Bina Taruna Football Club Manado, while the control group included non-athlete adolescents. All subjects underwent history-taking, physical examinations and further supporting examinations. Left ventricular mass was measured by cardiovascular echocardiography (Esaote Mylab 4.0) and calculated based on a formula. Left ventricular hypertrophy was defined as left ventricular mass of > 134 g/m2 body surface area.

Results Subjects' mean left ventricular masses were 359.69 (SD 188.4; 95%CI 283.58 to 435.81) grams in the athlete group and 173.04 (SD 50.69; 95%CI 152.56 to 103.51) grams in the non· athlete group, a statistically significant difference (P=0.0001). Ventricular hypertrophy was found 76.9% compared to 11.5% in  the non-athlete group (P= 0.0001).

Conclusion Left ventricular mass in athletes is bigger than in non-athletes. In addition, left ventricular hypertrophy is more cornmon in male adolescent athletes than in non-athletes.


Kreso A, Arslanagic A. Athlete's heart syndrome and echocardiographic changes. Bosn J Basic Med Sci. 2008; 8:116-20.

Donnelly DK, Howard TM. Electrocardiography and preparticipation physical examination: is it time for routine screening? Curr Sports Med Rep. 2006;5:67-73.

Thompson PD. D. Bruce Dill Historical lecture. Historical concepts of the athlete's heart. Med Sci Sports Exerc. 2004;36:363-70.

Fagard R. Athlete's heart. Heart. 2003;89:1445-61.

Sharma S, Maron BJ, Whyte G, Firoozi S, Elliott PM, McKenna WJ. Physiologic limits of left ventricular hypertrophy in elite junior athletes: relevance to differential diagnosis of athlete's heart and hypertrophic cardiomyopathy. J Am Coll of Cardiol. 2002;40:1431-6.

Atchley AE, Douglas PS. Left ventricular hypertrophy in athletes: morphologic features and clinical correlates. Cardiol Clin.2007;25:371-82.

Pelliccia A, Maron MS, Maron BJ. Assessment of left ventricular hypertrophy in a trained athlete: differential diagnosis of physiologic athlete's heart from pathologic hypertrophy. Prog Cardiovasc Dis. 2012;54:387-96.

Puffer JC. Overview of the athletic heart syndrome. In: Thomson PD, editor. Exercise and sports cardiology. New York, McGraw-Hill; 2001. p. 43-70.

Cheng TO. Hypertrophic cardiomyopathy vs. athlete's heart. Int J Cardial. 2009;131:151-5.

Maron BJ. Sudden death in young athletes. N Engl J Med. 2003;349:1064-75.

Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and yaung adults? J Am Coll Cardiol. 2003;42:1959-63.

Corrado D, Basso C, Schiavon M, Pelliccia A, Thiene G. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. J Am Coll Cardiol. 2008;52:1981-9.

Devereux RB. Detection of left ventricular hypertrophy by M-mode echocardiography Anatomic validation, standardization, and comparison to other methods. Hypertension. 1987;9:1119-26.

Florescu M, Vinereanu D. How to differentiate athlete's heart from pathological cardiac hypertrophy? Maedica. 2006;1:19- 26.

Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipant screening and criteria for disqualification. Cardiol Clin. 2007;25:399-414.

Astawa P. Kedokteran olah raga dan cedera olah raga pada remaja. In: Soetjiningsih, editor. Buku ajar tumbuh kembang remaja dan permasalahannya. 1st ed. Jakarta: Sagung Seto; 2004. p. 201-5.

Weiner RB, Baggish AL. Exercise-induced cardiac remodeling. Prog Cardiovasc Dis. 2012;54:380-6.

Ghorayeb N, Batlouni M, Pinto IM, Dioguardi GS. Left ventricular hypertrophy in athletes: adaptive physiologic response of the heart. Arq Bras Cardiol. 2005;85:191-7.

Whyte GP, George K, Sharma S, Firoozi S, Stephens N, Senior R, et al. The upper limit of physiological cardiac hypertrophy in elite male and female athletes: the British experience. Eur J Appl Physiol. 2004;92:592-7.

Douglas PS, O'Toole ML, Katz SE, Ginsburg GS, Hiller WD, Laird RH. Left ventricular hypertrophy in athletes. Am J Cardiol. 1997;80:1384-8.

Perrino C, Naga Prasad SV, Mao L, Noma T, Yan Z, Kim HS, et al. Intermittent pressure overload triggers hypertrophy-independent cardiac dysfunction and vascular rarefaction. J Clin Invest. 2006;116:1547-60.

Limongelli G, Verrengia M, Padeo G, Da Ponte A, Brancaccio P, Canonico R, et al. Left ventricular hypertrophy in Caucasian master athletes: differences with hypertension and hypertrophic cardiomyopathy. Int J Cardiol. 2006:111:113-9.

Butz T, van Buuren F, Mellwig KP, Langer C, Plehn G, Meissner A, et al. Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 2011:27:91-100.

Caso P, D'Andrea A, Galderisi M, Liccardo B, Severino S, De Simone L, et al. Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function. Am J Cardiol. 2000;85:1131-6.

How to Cite
Kaunang E, Metusala J, Wahani A. Left ventricular mass in male adolescent athletes and non-athletes. PI [Internet]. 30Oct.2014 [cited 27Jun.2022];54(5):305-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1014
Received 2016-11-10
Accepted 2016-11-10
Published 2014-10-30