Comment on: Athlete’s Heart: Is the Morganroth Hypothesis Obsolete?

[madman]

We would like to point out that we have questioned a disproportionate increase in wall thickness in strength athletes already in 1989 [5] and 1999 [6]. We could demonstrate that clean resistance-trained athletes (weightlifters and bodybuilders) and combined resistance- and endurance-trained athletes (rowers) do not develop a concentric hypertrophy of the left ventricle, given that there is no pathological pressure load or hypertrophic cardiomyopathy. On the other side, the left ventricular wall thickness correlates with the extent of misuse of anabolic steroids [7]. The generally accepted limit of relative wall thickness (cut-off 42%) is rarely exceeded in clean athletes. Only strength athletes misusing anabolic steroids exhibited distinctly a higher relative wall thickness, together with reduced diastolic and systolic left ventricular function, compared to all other athletes [6,8]. Consequently, anabolic-induced cardiac structural changes, in particular concentric left ventricular hypertrophy, should be paid more attention than in the past Wilfried Kindermann, MD