Athlete's Heart: Diagnostic Challenges and Future Perspectives

Overview

Journal Sports Med

Specialty Orthopedics

Date 2018 Sep 26

PMID 30251086

Citations 19

Authors

Carlo De Innocentiis

Fabrizio Ricci

Mohammed Y Khanji

Nay Aung

Claudio Tana

Elvira Verrengia

Steffen E Petersen

Sabina Gallina

Affiliations

Soon will be listed here.

Abstract

Distinguishing between adaptive and maladaptive cardiovascular response to exercise is crucial to prevent the unnecessary termination of an athlete's career and to minimize the risk of sudden death. This is a challenging task essentially due to the substantial phenotypic overlap between electrical and structural changes seen in the physiological athletic heart remodeling and pathological changes seen in inherited or acquired cardiomyopathies. Stress testing is an ideal tool to discriminate normal from abnormal cardiovascular response by unmasking subtle pathologic responses otherwise undetectable at rest. Treadmill or bicycle electrocardiography, transthoracic echocardiography, and cardiopulmonary exercise testing are common clinical investigations used in sports cardiology, specifically among participants presenting with resting electrocardiographic abnormalities, frequent premature ventricular beats, or non-sustained ventricular arrhythmias. In this setting, as well as in cases of left ventricular hypertrophy or asymptomatic left ventricular dysfunction, stress imaging and myocardial tissue characterization by cardiovascular magnetic resonance show promise. In this review, we aimed to reappraise current diagnostic schemes, screening strategies and novel approaches that may be used to distinguish adaptive remodeling patterns to physical exercise from early phenotypes of inherited or acquired pathological conditions commanding prompt intervention.

Citing Articles

Exercise and the Heart: Benefits, Risks and Adverse Effects of Exercise Training.

Mannakkara N, Finocchiaro G Rev Cardiovasc Med. 2024; 24(3):94.

PMID: 39077491 PMC: 11264002. DOI: 10.31083/j.rcm2403094.

Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach.

Palermi S, Cavarretta E, DAscenzi F, Castelletti S, Ricci F, Vecchiato M Rev Cardiovasc Med. 2024; 24(5):151.

PMID: 39076743 PMC: 11273059. DOI: 10.31083/j.rcm2405151.

Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges.

Palermi S, Sperlongano S, Mandoli G, Pastore M, Lisi M, Benfari G J Clin Med. 2023; 12(24).

PMID: 38137747 PMC: 10743501. DOI: 10.3390/jcm12247678.

Cardiological Functional Assessment of National Olympic Team of Kazakhstan.

Yerezhepov D, Gabdulkayum A, Bilyalova G, Amangeldikyzy S, Kozhamkulov U, Rakhimova S J Clin Med. 2023; 12(24).

PMID: 38137580 PMC: 10743488. DOI: 10.3390/jcm12247511.

Selectively breeding for high voluntary physical activity in female mice does not bestow inherent characteristics that resemble eccentric remodeling of the heart, but the mini-muscle phenotype does.

Leszczynski E, Schwartz N, McPeek A, Currie K, Ferguson D, Garland Jr T Sports Med Health Sci. 2023; 5(3):205-212.

PMID: 37753423 PMC: 10518799. DOI: 10.1016/j.smhs.2023.07.003.

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