Ethnic differences between HCM and athlete’s heart (v1)

• Research type

  Research Study

• Full title

  Do ethnic differences in clinical parameters need to be considered when differentiating hypertrophic cardiomyopathy from athlete’s heart?

• IRAS ID

  164881

• Contact name

  Sanjay Sharma

• Sponsor organisation

  Joint Research and Enterprise Office

• Duration of Study in the UK

  2 years, 0 months, 1 days

• Research summary

  Do ethnic differences in clinical parameters need to be considered when differentiating athlete’s heart from hypertrophic cardiomyopathy?
  
  Prolonged exercising can cause changes to the heart’s structure and function including thickening of the heart muscle wall, enlargement of heart chambers and changes to the heart’s electrical pattern. These adaptive changes known as “athlete’s heart” allow the heart to cope with the body’s increased demand of oxygenated blood supply to the muscles. Athletes of African/Afro-Caribbean origin (black) can have slightly exaggerated characteristics of their heart compared to Caucasian (white) athletes. These changes may mimic those seen in inherited heart muscle diseases (cardiomyopathies) which are frequently implicated in an increased risk of exercise related sudden cardiac death. Hypertrophic cardiomyopathy (HCM) is characterised by thickened heart muscle wall, (usually 1.6-2.5cm). Occasionally the wall thickness is mild (1.3-1.5cm), overlapping with “athlete’s heart.”

  Differentiation between athlete’s heart and mild HCM is important, to provide appropriate treatment and follow-up care to those who need it, and to prevent us making an erroneous diagnosis that can result in the premature ending of a promising athlete’s career or their untimely death.

  Our group has previously demonstrated black athletes, compared with white athletes, develop more profound repolarization changes on electrocardiograms (ECG) and a greater magnitude of physiological left ventricular hypertrophy (LVH) on ultrasound scans of the heart (echocardiogram), which can mimic HCM. Cardiopulmonary exercise testing (CPET) and magnetic resonance imaging of the heart (CMR) can help differentiate between athlete’s heart and HCM, however, the majority of these studies have a predominantly Caucasian population.

  This study aims to identify if there are differences in parameters between black and white populations in:

  1. CPET in patients with HCM, athletes (with HCM, with LVH and without LVH) and healthy controls.
  2. Cardiac MRI and impedence cardiography in HCM patients.

• REC name

  London - Harrow Research Ethics Committee

• REC reference

  16/LO/0229

• Date of REC Opinion

  4 Apr 2016

• REC opinion

  Further Information Favourable Opinion