Differences in cardiac mechanics assessed by left ventricular hemodynamic forces in athletes and patients with hypertension

Abstract

Abstract We sought to assess cardiac magnetic resonance derived left ventricular hemodynamic forces (HDF) in athletes compared to patients with hypertension. Sixty athletes and 48 hypertensive patients were studied. HDF were measured during the entire cardiac cycle, the systolic phase, suction, early LV filling, and atrial thrust. Statistical comparisons were made between athletes and hypertensive patients, and between endurance and strength athletes. The slope of the systolic ejection was higher in athletes compared to hypertensive patients (541.5 vs. 435 1/sec; p = 0.033). Athletes showed higher HDF during the first phase of systole (4.53 vs. 3.86; p = 0.047) and the systolic impulse (11.26 vs. 8.76; p = 0.045). Compared to hypertensive patients, the AUC of the elastic rebound in athletes was lower (-0.31 vs. -0.44; p = 0.011). Moreover, hypertensive patients had an abnormal suction as revealed by a divergent direction (apex-to-base) of the HDF. The atrial thrust was higher in hypertensive patients than in athletes (-0.31 vs. -0.05; p < 0.001). Compared to endurance athletes, strength athletes had a shorter duration of the systolic impulse (250 vs. 280 ms; p = 0.019) and higher AUC during the early LV filling (1.65 vs. 0.97; p = 0.016). We conclude that HDF allows distinction between the hemodynamic patterns of athletes and patients with hypertension.

Keywords

• Hemodynamic forces
• Intraventricular pressure gradients
• Cardiovascular magnetic resonance
• Athletes
• Hypertension