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Dtsch Med Wochenschr 2015; 140(15): 1158-1164
DOI: 10.1055/s-0041-102559
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© Georg Thieme Verlag KG Stuttgart · New York

Sportlerherz oder hypertrophe Kardiomyopathie?

So gelingt die DifferenzierungAthlete’s heart and hypertrophic cardiomyopathy: contribution on clinical and morphologic differentiation
Edda Bahlmann
1   Abteilung für Kardiologie, Asklepios Klinik St. Georg Hamburg
,
Karl Heinz Kuck
1   Abteilung für Kardiologie, Asklepios Klinik St. Georg Hamburg
,
Christoph A. Nienaber
2   Herzzentrum der Universitätsmedizin Rostock
› Author Affiliations
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Publication History

Publication Date:
31 July 2015 (online)

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Zusammenfassung

Die hypertrophe Kardiomyopathie (HCM, engl.: Hypertrophic Cardiomyopathy) ist eine komplexe, genetisch bedingte kardiale Erkrankung. Die Diagnose basiert auf dem echokardiografischen Nachweis einer linksventrikulären Hypertrophie ohne kardiale Ursache oder systemische Erkrankung. Die Differenzierung zwischen Formen der HCM und physiologischer linksventrikulärer Hypertrophie (Sportlerherz bzw. „Athlete’s Heart“) ist wichtig: Die HCM ist die häufigste Ursache des belastungsinduzierten plötzlichen Herztodes bei jungen Menschen, insbesondere von jungen Athleten. Die charakteristische Unterscheidung zwischen beiden Hypertrophieformen ist nicht trivial. Eine detaillierte Beurteilung der Struktur und Funktion des linken Ventrikels kann wesentlich zur Lösung dieser diagnostischen Herausforderung beitragen. Des Weiteren können genetische Untersuchungen zur Identifikation des HCM-Phänotyps notwendig sein, um zwischen Sportlerherz und HCM zu differenzieren.

Abstract

Hypertrophic cardiomyopathy (HCM) is a complex genetic disorder usually diagnosed in a young adult population. The diagnosis is based on echocardiographic identification of left ventricular hypertrophy, associated with a non-dilated hyperdynamic chamber in the absence of another cardiac or systemic disorder. The differentiation between HCM and physiological left ventricular hypertrophy (athlete`s heart) is essential: HCM is the main cause of exercise-induced sudden cardiac death in the young and especially in young athletes with overlapping features in Athlete’s Heart or HCM. Differentiation between physiological left ventricular hypertrophy and HCM is challenging. Echocardiography allows detailed assessment of left ventricular structure and function which is fundamental. Additional genetic studies for identification of the broad HCM phenotype can be necessary to differentiate between Athlete’s Heart and HCM.

Schlüsselwörter

Hypertrophe Kardiomyopathie - Sportlerherz - Risikoevaluation

Keywords

hypertrophic cardiomyopathy - Athlete’s Heart - risk evaluation
 

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