Non-invasive assessment of left ventricular performance at rest and during exercise by T-M mode echocardiography.

The evaluation methodology of the cardiac performance has had during the last period of time the important contribution of the echocardiography. Sports cardiology is an ideal field for the use of the T-M echocardiography, for the assessment of the left ventricular performance, because of its various possibilities and non-invasive character. The review based on the data of the literature and on the author's experiences in T-M echocardiography, practised on the teenagers at rest and exercise, presents the advantages, the technical difficulties, the work methodology and the limits of the method. The use of this technique allows the measurement of the dimensions of the interventricular septum, of the posterior wall of the left ventricle and its cavity, and the dimension of the aorta; the monitoring of the valvular dynamics of the mitral and aortic valve, of the interventricular septum and posterior wall of the left ventricle at rest and during exercise; the functional evaluation of the left ventricular inotropic status by means of the determination of the cardiac index, stroke volume, ejection fraction and myocardial contractility; the possibility of a systematical control of the training effects on the development of heart in the case of children practising performance sports; the detection of some cardiac diseases (e.g. cardiomyopathy, septal hypertrophy, "silent" mitral valve prolapse), which limit the adaptation of the heart to effort. Though there are a lot of studies, the author considers that the limits of the application of echocardiography in sports medicine cannot yet be seen. The development of the ultrasound machines will allow the extension of the investigation field.