The right heart in athletes

Herzschrittmachertherapie + Elektrophysiologie - Tập 23 - Trang 82-86 - 2012
H. Heidbüchel1, A. La Gerche1
1Department of Cardiovascular Medicine, Cardiology – Electrophysiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium

Tóm tắt

Although ‘athlete’s heart’ usually constitutes a balanced dilation and hypertrophy of all four chambers, there is increasing evidence that intense endurance activity may particularly tax the right ventricle (RV), both acutely and chronically. We review the evidence that the high wall stress of the RV during intense sports may explain observed B-type natriuretic peptide (BNP) elevations immediately after a race, may lead to cellular disruption and leaking of cardiac enzymes, and may even result in transient RV dilatation and dysfunction. Over time, this could lead to chronic remodelling and a pro-arrhythmic state resembling arrhythmogenic RV cardiomyopathy (ARVC) in some cases. ARVC in high-endurance athletes most often develops in the absence of underlying desmosomal abnormalities, probably only as a result of excessive RV wall stress during exercise. Therefore, we have labelled this syndrome ‘exercise-induced ARVC’. Sports cardiologists should be aware that excessive sports activity can lead to cardiac sports injuries in some individuals, just like orthopaedic specialists are familiar with musculoskeletal sports injuries. This does not negate the fact that moderate exercise has positive cardiovascular effects and should be encouraged.

Tài liệu tham khảo

Maron BJ, Doerer JJ, Haas TS et al (2009) Sudden deaths in young competitive athletes: analysis of 1866 deaths in the united states, 1980–2006. Circulation 119:1085–1092

Oxborough D, Shave R, Warburton D et al (2011) Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise: exploratory insights from conventional two-dimensional and speckle tracking echocardiography. Circ Cardiovasc Imaging 4:253–263

Shave R, Baggish A, George K et al (2010) Exercise-induced cardiac troponin elevation: Evidence, mechanisms, and implications. J Am Coll Cardiol 56:169–176