Distinguishing left ventricular hypertrophy from hypertrophic cardiomyopathy in adolescents: a longitudinal observation study.

It is important to distinguish exercise-induced cardiac left ventricular (LV) hypertrophy from hypertrophic cardiomyopathy (HCM), because athletes with HCM may have an increased risk of sudden cardiac death. Limited data are available on this distinction in adolescent athletes. Therefore, we performed a longitudinal observation study comparing the development of LV hypertrophy during adolescence in athletes and HCM genotype­positive patients. In early adolescence, LV hypertrophy was found in a similar proportion of athletes and HCM genotype­positive patients, with a potential grey zone ranging from a septum thickness Z-score of 2.0 to 3.3. After 3 years of follow-up, LV hypertrophy had progressed only in HCM genotype­positive patients, while athletes had larger LV volumes throughout the study period.Evaluation of LV volume and septum thickness progression may assist clinicians in distinguishing exercise-induced LV hypertrophy from early HCM disease in adolescents.