Table 5.
Main echo findings of cardiovascular pathologies in athletes
|
Pathology
|
What to assess? (echo view)
|
Cut-off mm (mean mm)
|
If pathological, what to assess? (echo view)
|
Cut-off mm (mean mm)
|
| HCM | LV Max end-diastolic wall thickness | M white 15 (10); M Afro-American 16 (11.5); F white 11; F Afro-American 13 (9.5); M/F adolescent 16 (12) | LV wall thickness distribution | Asymmetric (HCM) |
| LV end diastolic diameter (A4C) | M 70 (55); F 66 (49); Adolescent 60 (51) | |||
| LV mass/BSA | M 117 mm/m2 (83 mm/m2); F 143 mm/m2 (101 mm/m2) | |||
| LVOT obstruction | ||||
| E/A (A4C) | 1.3 (1.93) | |||
| DCM | LV end diastolic diameter (PLAX) | M 70 (50); F 66 (49); Adolescent 60 (51) | EF (A4C) | 55% (64%) |
| LVNC | LV trabeculation | NC/C layer ratio > 2.0 in systole | EF (A4C) | 55% (64%) |
| Thickness of compact layer in systole | 8 | |||
| E/A (A4C) | 1.3 (1.93) | |||
| ARVC | RVOT/BSA (PSAX) | > 21 mm/m2 | RV inflow (A4C)/ LV end diastolic diameter (PLAX) | > 0.9 |
| RVOVT/BSA (PLAX) | > 19 mm/m2 | RV wall motion abnormalities | ||
| RV FAC | 33% | |||
| Aortic dilatation | Aortic valve max dimension (PLAX) | M 40 (32); F 34 (28) | Other congenital defects (BAV) | |
| Ascending aorta dimension (PLAX) | Aortic regurgitation | |||
| Mitral prolapse | Mitral prolapse (PLAX) | Abnormal systolic bulging of leaflets > 2 mm toward LA | Mitral regurgitation | |
| PAPS (A4C) | 40 mmHg (24 mmHg) | |||
| Pulmonary veins flow | Reverse | |||
| EF (A4C) | 55% (64%) | |||
| LV mass/BSA | M 117 mm/m2 (83 mm/m2); F 143 mm/m2 (101 mm/m2) | |||
| LAVI | M 36 mm/m2 (28 mm/m2); F 33 mm/m2 (26.5 mm/m2) | |||
| AOCA | Coronary arteries origin (PSAX) | |||
| BAV | Aortic morphology (PSAX) | Aortic stenosis | ||
| Aortic regurgitation | ||||
| Aortic root max dimension (PLAX) | M 40 (32); F 34 (28) | |||
| Other congenital defects (coarctation of the aorta, interrupted aortic arch, patent ductus arteriosus, coronary anomaly or hypoplastic left heart, as well as Williams or Turner syndrome) | ||||
| ASD | ASD | RV dimension (A4C) | Basal RV: M 55 (43.5), F 49 (39); Medial RV: M 47 (34), F 43 (32); Longitudinal RV: M 109 (89), F 100 (82) | |
| RA area/BSA (A4C) | M 28 mm/m2 (19.5 mm/m2); F 24 mm/m2 (15.5 mm/m2) | |||
| PAPS (A4C) | 40 mmHg (24 mmHg) | |||
| VSD | VSD | LV mass/BSA (PLAX) | M 117 mm/m2 (83 mm/m2); F 143 mm/m2 (101 mm/m2) | |
| PAPS (A4C) | 40 mmHg (24 mmHg) | |||
| Aortic regurgitation | ||||
| Other congenital defects (aneurysm of Valsalva sinus, ToF, TGA, DCRV) | ||||
| PDA | PDA (PSAX) | LA/Aortic root ratio | ≥ 1.4 | |
| LV mass/BSA (PLAX) | M 117 mm/m2 (83 mm/m2); F 143 mm/m2 (101 mm/m2) | |||
| PAPS (A4C) | 40 mmHg (24 mmHg) | |||
| Pulmonary artery size (PSAX) | ||||
| RV dimension (A4C) | Basal RV: M 55 (43.5), F 49 (39); Medial RV: M 47 (34), F 43 (32); Longitudinal RV: M 109 (89), F 100 (82) | |||
| RA area/BSA (A4C) | M 28 mm/m2 (19.5 mm/m2); F 24 mm/m2 (15.5 mm/m2) | |||
| Other congenital defects (COA, pulmonary atresia) | ||||
| COA | COA (PSAX) | Aortic stenosis | ||
| Mitral stenosis | ||||
| LV mass/BSA (PSAX) | M 117 mm/m2 (83 mm/m2); F 143 mm/m2 (101 mm/m2) | |||
| EF (A4C) | 55% (64%) | |||
| Other congenital defects (BAV, ascending aortic aneurysm) | ||||
| Myocarditis | EF (A4C) | 55% (64%) | ||
| LV wall motion abnormalities | ||||
| Pericardial effusion | ||||
| Increased LV wall thickness | ||||
| Pericarditis | Pericardial effusion | |||
| Kawasaki disease | Coronary artery abnormalities | |||
| EF (A4C) | 55% (64%) | |||
| LV wall motion abnormalities | ||||
| Mitral regurgitation | ||||
| Aortic regurgitation | ||||
| Pericardial effusion | ||||
PLAX: Parasternal long axis view; PSAX: Parasternal short axis view; A4C: Apical 4 chambers view; HCM: Hypertrophic cardiomyopathy; DCM: Dilated cardiomyopathy; LVNC: Left ventricle non compaction; ARVC: Arrhythmogenic right ventricular cardiomyopathy; BAV: Bicuspid aortic valve; AOCA: Anomalous origin of coronary arteries; ASD: Atrial septum defects; VSD: Ventricular septal defects; PDA: Patent ductus arteriosus; CoA: Aortic coarctation; M: Male; F: Female; LV: Left ventricle; BSA: Body surface area; EF: Ejection fraction; LVOT: Left ventricle outflow tract; NC/C: Non-compact/compact; RVOT: Right ventricle outflow tract; RV: Right ventricle; FAC: Fractional area charge; PAPS: Pulmonary artery systolic pressure; LAVI: Left atrium ventricle index; RA: Right atrium; ToF: Tetralogy of fallot; TgA: Transposition of great arteries; DCRV: Double-chambered right ventricle.