Objective Distinguishing early dilated cardiomyopathy (DCM) from physiological left
ventricular (LV) dilatation with LV ejection fraction< 55% in athletes (grey zone) is
challenging. We evaluated the role of a cascade of investigations to differentiate these two
entities. Methods Thirty-five asymptomatic active males with DCM, 25 male athletes in the
'grey zone'and 24 male athletes with normal LV ejection fraction underwent N-terminal pro-
brain natriuretic peptide (NT-proBNP) measurement, ECG and exercise echocardiography …

Background: Distinguishing early dilated cardiomyopathy (DCM) from physiological left
ventricular (LV) dilatation with mildly reduced LV ejection fraction ('grey-zone') is
challenging. We evaluated the role of a cascade of investigations to differentiate these two
entities. Methods and Results: Thirty-five asymptomatic active males with DCM, 25 male
athletes in the 'grey-zone'and 24 male athlete controls with normal LV ejection fraction were
investigated with NT-proBNP, electrocardiography (ECG) and exercise echocardiography.' …