Herzhypertrophie und Kritisches Herzgewicht

Linzbach, A. J.

doi:10.1007/bf01480968

Cited by 73 publications

(6 citation statements)

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“…Therefore, the corresponding clinical limits can be exceeded. The heart weight was above the so-called absolute critical heart weight (20) in the majority of the male and still in 11 % of the female rowers. without indicating a pathological finding.…”

Section: Matched-pair Comparisonsmentioning

confidence: 77%

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Sports-Specific Adaptation of Left Ventricular Muscle Mass in Athlete's Heart

Urhausen¹,

Monz²,

Kindermann³

1996

Int J Sports Med

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The differentiation of the physiological left ventricular (LV) hypertrophy of the athlete's heart in opposition to a pathological finding may be problematic especially in both strength and endurance trained athletes with simultaneously large body dimensions: 64 male and 71 female rowers of regional up to national level were examined by (Doppler) echocardiography. In addition, the rowers were compared by matched-pair procedures both with 32 male and 30 female non-endurance trained (pairwise similar body surface area) and with 28 male endurance athletes (pairwise similar absolute heart volume). The so-called critical heart weight of 500 g was exceeded by 63% of the male and 11% of the female rowers. 9% of the male rowers showed even an LV muscle mass above the limit of 3.5 g.kg-1 body mass. The individual maximal body surface area-related values were 170 g.m-2 (men) and 133 g.m-2 (women). The LV enddiastolic internal diameter was measured to be above the upper clinical limit of 55 mm in 69% or 23% of the male and female rowers, although a maximal LV wall thickness of 14 or 13 mm, respectively, was never exceeded. The systolic LV function as well as ECG and blood pressure did not reveal any pathological findings, the diastolic LV function was measured within the (supra) normal range. The LV wall thicknesses, internal diameter and hypertrophic index (relation between wall thickness and internal diameter) were significantly higher in rowers than in non-endurance trained subjects, but similar if compared to the endurance athletes. The clinical limits, however, keep their validity until a body mass of about 70 kg. In conclusion, some upper absolute clinical limits, especially those referring to volume measurements, so far considered critical (LV internal diameter, heart weight and LV mass), may be clearly exceeded by healthy strength endurance trained athletes presenting high body dimensions. The LV wall thickness, however, rather exceptionally exceeded the clinical limits. If referring to body dimensions, the cardiac dimensions in rowers are still lower in comparison to highly-trained "pure" endurance athletes. A specific influence of the isometric exercise component on the LV hypertrophy cannot be observed.

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Section: Matched-pair Comparisonsmentioning

confidence: 77%

“…The LV muscle mass was derived according to the corrected ASE cube formula of Devereux et al (6), taking into account the overestimation of the LV muscle mass calculated by Devereux and Reichek (7). The heart weight was calculated based on the assumption that the L V constitutes 47% of the total heart weight (20).…”

Section: Methodsmentioning

confidence: 99%

Sports-Specific Adaptation of Left Ventricular Muscle Mass in Athlete's Heart

Urhausen¹,

Monz²,

Kindermann³

1996

Int J Sports Med

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“…Die seit Ende des letzten Jahrhunderts bekannte Anpas- sungsreaktion wurde bis in die 60er Jahre kontrovers diskutiert, da wie bei Herzerkrankungen eine Herzvergrößerung grundsätzlich als pathologisch angesehen wurde. Seit den pathologisch-anatomischen Untersuchungen von Kirch [19] und Linzbach [24] und den radiologisch-hämodynamischen Untersuchungen von Reindell et al [34] in den 60er und 70er Jahren gilt es als gesichert, dass das physiologisch hypertrophierte Herz ein gesundes, besonders leistungsfähiges Herz ist. Das Ausmaß einer physiologischen Hypertrophie wird von der individuellen genetischen Veranlagung mitbestimmt [28].…”

Section: Strukturelle Anpassungsmechanismen (Physiologische Hypertropunclassified

“…die Gesamtmyokardmasse angegeben werden [7,41]. Nach Linzbach [24] wird zwar ein absolutes kritisches Herzgewicht von 500 g angenommen, welches jedoch auf pathologisch-anatomischen Untersuchungen ohne Berücksichtigung des Körpergewichts beruht. Besser ist die Angabe einer relativen kritischen Grenze, die bei 7 g/kg Körpergewicht (relatives kritisches Herzgewicht) anzusehen ist und physiologisch nicht überschritten wird [6,7].…”

Section: Figureunclassified

Ausdauersport und kardiale Adaptation (Sportherz)

Dickhuth

Röcker

Mayer

et al. 2004

Herz

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One essential function of the cardiovascular system is to provide an adequate blood supply to all organs, including the skeletal muscles at rest and during exercise. Adaptation to chronic exercise proceeds mainly via the autonomic nervous system. On the one hand, peripheral muscles influence the autonomic reactions through "feedback" control via ergoreceptors, in particular, mechano- and chemoreceptors. On the other hand, there is central control in the sense of a "feed forward" regulation, e. g., the reaction of an athlete before competition. Along with other influential factors, such as circulatory presso-, chemo-, and volume receptors, the incoming impulses are processed in vegetative centers.A cardiovascular reaction, then, is the result of nerval and humoral sympathetic and parasympathetic activity. At rest, the parasympathetic tone dominates. It reduces heart frequency and conduction velocity. The high vagal tone is initially reduced with increasing physical exertion and switches at higher intensity to increasingly sympathetic activation. This mechanism of reaction to exercise is supported by inverse central and peripheral transmissions.Chronic endurance training leads to an improved local aerobic capacity of the exercised musculature. At rest, it augments parasympathetic activity when the muscle mass is sufficiently large, i. e., 20-30% of the skeletal musculature. The extent of the adaptation depends on individual factors, such as scope, intensity of training, and type of muscle fiber. A higher vagal tone delays the increase in the sympathetic tone during physical exertion. The regulatory range of heart rate, contractility, diastolic function, and blood pressure is increased. In addition, adaptation results in functional and structural changes in the vascular system. Cardiocirculatory work is economized, and maximum performance and oxygen uptake are improved. Endurance training exceeding an individual limit causes harmonic enlargement and hypertrophy of the heart. The thickness of both, the septum and posterior wall increases to the same extent as the interior volume. The mass/volume ratio, and therefore the maximum systolic wall stress, remains constant in contrast to pathologic forms of hypertrophy. Adaptations, including function and size of the heart, show a regression in healthy inactive persons without any structural heart disease.

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“…The anthropometric data such as age, height, weight or body surface must be taken into account in the assessment of echocardiography dimensions (11,18,23,35). There is no uniform normal range for children and adults in calculating the ratio of one-dimensional measurements to body weight or body surface (23,55).…”

Section: Volumementioning

confidence: 99%

The Echocardiographic Determination of Volume and Muscle Mass of the Heart

Röecker²,

Nieß³

et al. 1996

Int J Sports Med

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One- and two-dimensional echocardiography permits assessment of left ventricular size and muscle mass, whereas the validity and reliability differ. It is comparable to other methods, such as angiography, scintigraphy and magnetic resonance imaging, but has the advantage of being noninvasive and of lower cost. It therefore appears particularly well-suited for applications in sports medicine. However, changes of 10%-20%, depending on the parameter, are necessary in individual cases to permit assumption of a proven change. A further methodical improvement, especially in respect to reliability but also to validity may be expected in the future from three-dimensional, computer-supported examination techniques. Enlargement of the heart due to endurance sports is harmonic and affects all four cardiac chambers. Limits to the increase in left ventricular volume and muscle mass can be recognized in relation to body weight. They usually do not exceed 70% of the baseline value or the value obtained for untrained persons. Power training, even in extreme forms, results in no or only minimal dimensional changes.

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Herzhypertrophie und Kritisches Herzgewicht

Cited by 73 publications

References 0 publications

Sports-Specific Adaptation of Left Ventricular Muscle Mass in Athlete's Heart

Sports-Specific Adaptation of Left Ventricular Muscle Mass in Athlete's Heart

Ausdauersport und kardiale Adaptation (Sportherz)

The Echocardiographic Determination of Volume and Muscle Mass of the Heart

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