scholarly journals 3081Exercise-induced shift in right ventricular contraction pattern: novel marker of athlete's heart?

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
B K Lakatos ◽  
O Kiss ◽  
M Tokodi ◽  
Z Toser ◽  
N Sydo ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Athlete’S Heart ◽  
Ventricular Contraction ◽  
Contraction Pattern ◽  
Athlete's Heart

scholarly journals Exercise-induced shift in right ventricular contraction pattern: novel marker of athlete’s heart?

2018 ◽  
Vol 315 (6) ◽  
pp. H1640-H1648 ◽  
Author(s):  
Bálint Károly Lakatos ◽  
Orsolya Kiss ◽  
Márton Tokodi ◽  
Zoltán Tősér ◽  
Nóra Sydó ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Athlete’S Heart ◽  
Longitudinal Motion ◽  
Contraction Pattern ◽  
Control Subjects ◽  
Relative Contribution ◽  
Functional Shift ◽  
The Right ◽  
Athlete's Heart

Data about the functional adaptation of the right ventricle (RV) to intense exercise are limited. Our aim was to characterize the RV mechanical pattern in top-level athletes using three-dimensional echocardiography. A total of 60 elite water polo athletes (19 ± 4 yr, 17 ± 6 h of training/wk, 50% women and 50% men) and 40 healthy sedentary control subjects were enrolled. We measured the RV end-diastolic volume index (RVEDVi) and ejection fraction (RVEF) using dedicated software. Furthermore, we determined RV global longitudinal (RV GLS) and circumferential strain (RV GCS) and the relative contribution of longitudinal ejection fraction (LEF) and radial ejection fraction (REF) to RVEF using the ReVISION method. Athletes also underwent cardiopulmonary exercise testing [O2 consumption (V̇o2)/kg]. Athletes had significantly higher RVEDVi compared with control subjects (athletes vs. control subjects, 88 ± 11 vs. 65 ± 10 ml/m2, P < 0.001); however, they also demonstrated lower RVEF (56 ± 4% vs. 61 ± 5%, P < 0.001). RV GLS was comparable between the two groups (−22 ± 5% vs. −23 ± 5%, P = 0.24), whereas RV GCS was significantly lower in athletes (−21 ± 4% vs. −26 ± 7%, P < 0.001). Athletes had higher LEF and lower REF contribution to RVEF (LEF/RVEF: 0.50 ± 0.07 vs. 0.42 ± 0.07, P < 0.001; REF/RVEF: 0.33 ± 0.08 vs. 0.45 ± 0.08, P < 0.001). Moreover, the pattern of RV functional shift correlated with V̇o2/kg (LEF/RVEF: r = 0.30, P < 0.05; REF/RVEF: r = −0.27, P < 0.05). RV mechanical adaptation to long-term intense exercise implies a functional shift; the relative contribution of longitudinal motion to global function was increased, whereas the radial shortening was significantly decreased, in athletes. Moreover, this functional pattern correlates with aerobic exercise performance, representing a potential new resting marker of an athlete’s heart. NEW & NOTEWORTHY Intensive regular physical exercise results in significant changes of right ventricular morphology and function. By separate quantification of the right ventricular longitudinal and radial function, a relative dominance of longitudinal motion and a decrease in radial motion can be observed compared with sedentary controls. Moreover, this contraction pattern correlates with cardiopulmonary fitness. According to these results, this functional shift of the right ventricle may represent a novel marker of an athlete’s heart.

Athletic Training and Arrhythmogenic Right Ventricular Cardiomyopathy

2019 ◽  
Vol 40 (05) ◽  
pp. 295-304 ◽  
Author(s):  
Sara Coelho ◽  
Filipe Silva ◽  
Joana Silva ◽  
Natália António
Keyword(s):  
Right Ventricular ◽  
Athletic Training ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Right Ventricular Dysfunction ◽  
Athlete’S Heart ◽  
Ventricular Cardiomyopathy ◽  
Inherited Cardiomyopathy ◽  
Arrhythmogenic Substrate ◽  
History Of ◽  
Athlete's Heart

AbstractArrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by ventricular arrhythmias and sudden death in the young and in competitive athletes. The deleterious role of exercise in the natural history of ARVC is clear. Even in the absence of a demonstrated arrhythmogenic substrate, family history or mutations of ARVC, intense physical exercise may in some individuals lead to the development of right ventricular dysfunction and arrhythmogenicity. This led to question the benignity of some adaptive features of the athlete's heart. In fact, there is an overlap between typical aspects of the athlete's heart and pathological changes described in ARVC, being challenging to distinguish the two conditions. The aim of this review is to highlight the aspects that help to distinguish between athlete's heart and ARVC, to review the major findings on exams helping in the differential diagnosis and to determine the implications on eligibility for leisure and competitive sports.

A novel diagnostic score to differentiate between athlete"s heart and ARVC

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
VA Rossi ◽  
D Niederseer ◽  
JM Sokolska ◽  
B Kovacs ◽  
S Costa ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Right Ventricular ◽  
Task Force ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Clinical Score ◽  
Athlete’S Heart ◽  
Clinical Parameters ◽  
Diagnostic Score ◽  
Funding Sources ◽  
Athlete's Heart

Abstract Funding Acknowledgements Type of funding sources: None. Background The 2010 Task Force Criteria (TFC), although representing the current gold standard to diagnose arrhythmogenic right ventricular cardiomyopathy (ARVC), have not been tested to differentiate ARVC from the athlete’s heart. Furthermore, not all 6 diagnostic categories are easy to obtain. Purpose We hypothesized that atrial dimensions are useful to differentiate between both entities. Therefore, we developed a new diagnostic score based upon readily available clinical parameters including atrial dimensions on TTE to help distinguishing the athlete’s heart from ARVC in daily clinical practice. Methods In this observational study, 37 patients with definite ARVC (from the Zurich ARVC Program) were compared to 68 athletes. Base on ROC analysis, the following echocardiographic, laboratory and electrocardiographic parameters were included in the final score: indexed right/left atrial volumes (RAVI/LAVI ratio), NT-proBNP, RVOT measurements (PLAX and PSAX adjusted for BSA) on TTE, tricuspid annular motion velocity (TAM) on TTE, precordial electrocardiographic T-wave inversions and depolarization abnormalities according to the TFC. Results ARVC patients had a higher RAVI/LAVI ratio (1.78 ± 1.6vs0.95 ± 0.3,p &lt; 0.001), lower right-ventricular function (fac:28 ± 9.7vs42.1 ± 4.8%,p &lt; 0.001; TAM:17.9 ± 5.6vs23.3 ± 3.7mm,p &lt; 0.001) and higher serum NT-proBNP levels (491 ± 771vs44.8 ± 50.6ng/l,p &lt; 0.001). Our novel score outperformed the performance of the 2010 TFC using those parameters, which are available in routine clinical practice (AUC95%,p &lt; 0.001(95%CI.91-.99)vs.AUC90%,p &lt; 0.001(95%CI.84-.97). A score value of 7/12 points yielded a specificity of 98% and a sensitivity of 61% for a diagnosis of ARVC. Conclusions ARVC patients present with significantly larger RA as compared to athletes, resulting in a greater RAVI/LAVI ratio. Our novel diagnostic score includes readily available clinical parameters and has a high diagnostic accuracy to differentiate between ARVC and the athlete´s heart. Abstract Figure. Novel clinical score

scholarly journals Electrocardiographic Features Differentiating Arrhythmogenic Right Ventricular Cardiomyopathy From an Athlete’s Heart

2018 ◽  
Vol 4 (12) ◽  
pp. 1613-1625 ◽  
Author(s):  
Maria J. Brosnan ◽  
Anneline S.J.M. te Riele ◽  
Laurens P. Bosman ◽  
Edgar T. Hoorntje ◽  
Maarten P. van den Berg ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Athlete’S Heart ◽  
Ventricular Cardiomyopathy ◽  
Athlete's Heart

Training-induced right ventricular remodelling in pre-adolescent endurance athletes: The athlete's heart in children

2017 ◽  
Vol 236 ◽  
pp. 270-275 ◽  
Author(s):  
Flavio D'Ascenzi ◽  
Antonio Pelliccia ◽  
Francesca Valentini ◽  
Angela Malandrino ◽  
Benedetta Maria Natali ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Athlete’S Heart ◽  
Endurance Athletes ◽  
Ventricular Remodelling ◽  
Athlete's Heart

scholarly journals Cardiac MRI findings to differentiate athlete's heart from hypertrophic (HCM), arrhythmogenic right ventricular (ARVC) and dilated (DCM) cardiomyopathy

2021 ◽  
Author(s):  
J. Kübler ◽  
C. Burgstahler ◽  
J. M. Brendel ◽  
S. Gassenmaier ◽  
F. Hagen ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Volume Index ◽  
Study Cohort ◽  
Mri Findings ◽  
Septal Thickness ◽  
Low Prevalence ◽  
Athlete's Heart

AbstractTo provide clinically relevant criteria for differentiation between the athlete’s heart and similar appearing hypertrophic (HCM), dilated (DCM), and arrhythmogenic right-ventricular cardiomyopathy (ARVC) in MRI. 40 top-level athletes were prospectively examined with cardiac MR (CMR) in two university centres and compared to retrospectively recruited patients diagnosed with HCM (n = 14), ARVC (n = 18), and DCM (n = 48). Analysed MR imaging parameters in the whole study cohort included morphology, functional parameters and late gadolinium enhancement (LGE). Mean left-ventricular enddiastolic volume index (LVEDVI) was high in athletes (105 ml/m2) but significantly lower compared to DCM (132 ml/m2; p = 0.001). Mean LV ejection fraction (EF) was 61% in athletes, below normal in 7 (18%) athletes vs. EF 29% in DCM, below normal in 46 (96%) patients (p < 0.0001). Mean RV-EF was 54% in athletes vs. 60% in HCM, 46% in ARVC, and 41% in DCM (p < 0.0001). Mean interventricular myocardial thickness was 10 mm in athletes vs. 12 mm in HCM (p = 0.0005), 9 mm in ARVC, and 9 mm in DCM. LGE was present in 1 (5%) athlete, 8 (57%) HCM, 10 (56%) ARVC, and 21 (44%) DCM patients (p < 0.0001). Healthy athletes’ hearts are characterized by both hypertrophy and dilation, low EF of both ventricles at rest, and increased interventricular septal thickness with a low prevalence of LGE. Differentiation of athlete’s heart from other non-ischemic cardiomyopathies in MRI can be challenging due to a significant overlap of characteristics also seen in HCM, ARVC, and DCM.

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