scholarly journals Some topical aspects of the problem of "athlete’s heart" (review). Part II

2021 ◽  
pp. 127-140
Author(s):  
Yu. V. Vakhnenko ◽  
I. E. Dorovskikh ◽  
E. N. Gordienko ◽  
M. A. Chernykh
Keyword(s):  
Cardiovascular System ◽  
Sports Medicine ◽  
Holter Monitoring ◽  
Athlete’S Heart ◽  
Connective Tissue Dysplasia ◽  
The Right ◽  
Intensive Work ◽  
Electrocardiogram Ecg ◽  
Athlete's Heart ◽  
Wolff Parkinson White Syndrome

Electrocardiography occupies a special place among a significant list of other methods for diagnosing the pathology of the cardiovascular system of athletes. Often its results differ significantly from those in the general population, being a consequence of the adaptation of the heart to economical functioning at rest and super-intensive work in training and competitions. This review focuses on the features of the “athlete’s electrocardiogram (ECG)”. in particular, those changes that are not a reason for removing athletes from physical activity, but in combination with known factors can lead to more serious changes up to sudden cardiac death. Fatal rhythm disorders in athletes are described, possible in Wolff-Parkinson-White syndrome, syndrome of ion channel pathology, arrhythmogenic dysplasia of the right ventricle, etc. Particular attention is paid to arrhythmia due to connective tissue dysplasia syndrome. Knowledge of these issues is necessary to choose the right tactics for an athlete with changes to the electrocardiogram and in the protocol of daily Holter monitoring of the electrocardiogram, and a doctor related to sports medicine should be aware of the features of “electrophysiological remodeling” of the athlete’s heart, normal and pathological “sports electrocardiogram”, about conditions accompanied with the development of serious rhythm disorders and algorithms for examining the cardiovascular system of the athlete.

Ambulatory (24-hour Holter monitoring, event recorders) and signal-averaged ECG for arrhythmia registration in the athlete’s heart

2019 ◽  
pp. 107-114
Author(s):  
Mahdi Sareban ◽  
Josef Niebauer
Keyword(s):  
Clinical Importance ◽  
Holter Monitoring ◽  
Athlete’S Heart ◽  
Grey Zone ◽  
Diagnostic Uncertainty ◽  
Diagnostic Work ◽  
Work Up ◽  
Opening Up ◽  
Heart Arrhythmias ◽  
Athlete's Heart

Systematic physical exercise leads to structural, functional, and electrical cardiovascular changes summarized in the term ‘athlete’s heart’. Arrhythmias that are common features in the resting ECG of otherwise healthy athletes may be an expression of the athlete’s heart, but on the other hand may be caused by underlying cardiac pathology, opening up a grey zone of diagnostic uncertainty. Differentiating adaptive changes from pathological cardiac conditions is of great clinical importance because some cardiomyopathies are leading causes of sudden cardiac death in athletes. In addition, there is increasing evidence that excessive endurance training may induce intermittent atrial arrhythmias, which can be hard to detect by resting ECG. Therefore this chapter will highlight 24-hour Holter monitoring, event recorders, and signal-averaged ECGs in the emerging field of ambulatory arrhythmia registration as part of the diagnostic work-up of athlete’s heart.

scholarly journals Implantation of DDD Pacemaker in a Patient With Dextrocardia and Sick Sinus Syndrome: A Case Report

2021 ◽  
Author(s):  
Junqian Luo ◽  
Zihao Zhou ◽  
Kaicong Chen ◽  
Junyao Lin ◽  
Chaogeng Cai ◽  
...  
Keyword(s):  
Main Part ◽  
Sick Sinus Syndrome ◽  
Holter Monitoring ◽  
Mirror Image ◽  
Pacing Threshold ◽  
Case Presentation ◽  
X Ray ◽  
Active Fixation ◽  
The Right ◽  
Electrocardiogram Ecg

Abstract Background: Dextrocardia is a congenital abnormal position of the heart in which the main part of the heart is in the right chest and the long axis of the heart points to the lower right, cases with combination of dextrocardia and sick sinus syndrome are rare.Case presentation: A 65-year-old female patient was admitted with palpitations and dizziness for 1 week. Mirror-image Dextrocardia and sick sinus syndrome was diagnosed by electrocardiogram (ECG), echocardiography, Holter monitoring, and X-ray. The rarity of the case and the specificity of anatomy brought great challenges to our interventional treatments. Finally, we successfully implanted a DDD pacemaker into the patient.Conclusion: For dextrocardia, using active fixation leads in both atrial and ventricular leads is easier to find the position with optimal sensing and pacing threshold, which also have a lower and more stable pacing threshold and can reduce the incidence of falling off at the same time. During operation, combine the multiple positions under fluoroscopy to confirm the leads position, which can improve the success rate of implantation.

scholarly journals Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes

2022 ◽  
Vol 8 ◽  
Author(s):  
Tee Joo Yeo ◽  
Mingchang Wang ◽  
Robert Grignani ◽  
James McKinney ◽  
Lay Pheng Koh ◽  
...  
Keyword(s):  
Female Athletes ◽  
Elite Athletes ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Left Ventricular Cavity ◽  
Male Athletes ◽  
Endurance Sport ◽  
Electrocardiogram Ecg ◽  
Athlete's Heart

Background: Asian representation in sport is increasing, yet there remains a lack of reference values for the Asian athlete's heart. Consequently, current guidelines for cardiovascular screening recommend using Caucasian athletes' norms to evaluate Asian athletes. This study aims to outline electrocardiographic and echocardiographic characteristics of the Asian athlete's heart using a Singaporean prospective registry of Southeast (SE) Asian athletes.Methods and Results: One hundred and fifty elite athletes, mean age of 26.1 ± 5.7 years (50% males, 88% Chinese), were evaluated using a questionnaire, 12-lead electrocardiogram (ECG) and transthoracic echocardiogram. All ECGs were analyzed using the 2017 International Recommendations. Echocardiographic data were presented by gender and sporting discipline. The prevalence of abnormal ECGs among SE Asian athletes was 6.7%—higher than reported figures for Caucasian athletes. The abnormal ECGs comprised mainly anterior T wave inversions (ATWI) beyond lead V2, predominantly in female athletes from mixed/endurance sport (9.3% prevalence amongst females). None had echocardiographic structural abnormalities. Male athletes had reduced global longitudinal strain compared to females (−18.7 ± 1.6 vs. −20.7 ± 2.1%, p < 0.001). Overall, SE Asian athletes had smaller left ventricular cavity sizes and wall thickness compared to non-Asian athletes.Conclusion: SE Asian athletes have higher abnormal ECG rates compared to Caucasian athletes, and also demonstrate structural differences that should be accounted for when interpreting their echocardiograms compared to athletes of other ethnicities.

Athlete's heart in the practice of a family doctor

2020 ◽  
pp. 43-50
Author(s):  
Margarita Ustinova ◽  
Vsevolod Skvortsov
Keyword(s):  
Sports Medicine ◽  
Family Doctor ◽  
Professional Sports ◽  
Cardiovascular Complications ◽  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Low Intensity ◽  
Adaptation Mechanisms ◽  
Common Causes ◽  
Athlete's Heart

The term “athlete's heart” was first described in 1899 by S. Henschen. This concept refers to the activation of physiological adaptation mechanisms and structural remodeling of the heart in sports medicine. The article presents the basic concepts used in sports medicine, signs of an "athlete's heart", physiological manifestations and pathological abnormalities that require attention from a doctor are highlighted. The most common causes of cardiovascular complications in professional sports are indicated. Today, the fact that physical activity of low intensity favorably affects the state of the cardiovascular system causes no doubt, while overloads or their absence of any loads are of no use.

scholarly journals Electrophysiological characteristics of the athlete's heart

2007 ◽  
Vol 60 (3-4) ◽  
pp. 156-159
Author(s):  
Dejana Popovic ◽  
Predrag Brkic ◽  
Dejan Nesic ◽  
Stanimir Stojiljkovic ◽  
Ljiljana Scepanovic ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular System ◽  
Vigorous Physical Activity ◽  
Critical Role ◽  
The Body ◽  
Athlete’S Heart ◽  
Intensive Training ◽  
Neurohumoral Regulation ◽  
Organ Systems ◽  
Athlete's Heart

Introduction. The athletic heart syndrome is characterized by morphological, functional and electrophysiological alterations as an adaptive response to vigorous physical activity. Athletes heart is predominantly associated with a programmed, intensive training. But as there are different kinds of physical activities, the degree of these changes is highly variable. Electrophysiological characteristics of the athlete's heart. The response of the body to vigorous physical activity is a multiorgan system phenomenon. The integrated functioning of each of these organ systems is very important, but the cardiovascular system plays a critical role in mediating the activity. Because of that, most changes in the neurohumoral regulation pre- dominantly affect the cardiovascular system. These changes include: depression of sympathetic activity and stimulation of parasympathetic activity, so electrophysiological characteristics of the athlete's heart must differ from the sedentary. Although these facts, are well known, the athlete's heart is not a precisely defined concept. It is a gray zone between physiology and pathology. Conclusion. Considering the number of sudden cardiac deaths in athletes, it is needless to say how important it is to distinguish physiological changes of the heart due to physical activity, and pathological changes due to some cardiac diseases.

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.

Clinical assessment of the athlete’s heart: normal and abnormal ECGs in athletes

ESC CardioMed ◽  
2018 ◽  
pp. 2916-2920
Author(s):  
Alessandro Zorzi ◽  
Domenico Corrado
Keyword(s):  
Cardiovascular Disease ◽  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Ecg Changes ◽  
Increased Risk ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities ◽  
Work Up ◽  
And Training ◽  
Athlete's Heart

The electrocardiogram (ECG) of trained athletes may show changes that represent the consequence of the heart’s adaptation to physical exercise (‘athlete’s heart’) such as enlarged cardiac chamber size and increased vagal tone. Physiological ECG changes must be differentiated from the ECG abnormalities secondary to an underlying cardiovascular disease that may be responsible for sudden cardiac death during exercise. The ECG changes of athletes are classified according to their prevalence, relation to exercise training, association with an increased risk of cardiovascular disease, and the need for further investigations: common ECG changes should be considered as a benign sign of physiological adaptation to exercise and do not require additional evaluation; on the other hand, in case of uncommon and training-unrelated abnormalities, which may be associated with an underlying cardiovascular disease, further work-up should be performed. This chapter reviews the abnormalities that may be found in an athlete’s ECG and proposes criteria for interpretation of such changes as normal or abnormal findings.

Common ECG patterns in the athlete’s heart

2019 ◽  
pp. 68-77
Author(s):  
Ricardo Stein ◽  
Victor Froelicher
Keyword(s):  
Athlete’S Heart ◽  
Chronic Exercise ◽  
Metabolic Factors ◽  
Clinical Expression ◽  
Phenotypic Changes ◽  
Sport Training ◽  
Electrocardiogram Ecg ◽  
Athlete's Heart

Chronic exercise can lead to phenotypic changes in athletes that are directly related to the type, duration, intensity, and years of sport training. The clinical expression can be influenced by the individual’s genetic, gender, humoral, and metabolic factors. Alterations founded in the athlete’s electrocardiogram (ECG) have been considered to be an electrical expression of these adaptations and usually reflect benign remodelling of the heart (athlete’s heart) and autonomic adaptations. In this chapter, we discuss the most prevalent normal features found on the 12-lead ECG of athletes.

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