Cardiac Imaging in Athletes

Abstract

Athletic heart syndrome refers to the physiological and morphological changes that occur in a human heart after repetitive strenuous physical exercise. Examples of exercise-induced changes in the heart include increases in heart cavity dimensions, augmentation of cardiac output, and increases in heart muscle mass. These cardiac adaptations vary based on the type of exercise performed and are often referred to as sport-specific cardiac remodeling. The hemodynamic effects of endurance and strength training exercise lead to these adaptations. Any abnormalities in chamber dilatation and left ventricular function usually normalize with cessation of exercise. Athletic heart syndrome is rare and should be differentiated from pathologic conditions such as hypertrophic cardiomyopathy, left ventricular noncompaction, and arrhythmogenic right ventricular dysplasia when assessing a patient for athletic heart syndrome. This paper describes specific adaptations that occur in athletic heart syndrome and tools to distinguish between healthy alterations versus underlying pathology.

Monitoring Morphologic Changes in Male Rowers Using Limited Portable Echocardiography Performed by a Frontline Physician

“…Implementation of limited echocardiography would allow sports medicine providers to monitor individual athletes' responses to exercise. Sports medicine clinicians could use limited echocardiography to track cardiac morphologic and function changes in their athletes and adjust training loads accordingly . Tracking training load adjustments and their subsequent effects on cardiac morphologic characteristics and function could produce more effective exercise prescriptions while also serving to prevent maladaptive responses to exercise training in elite athletes .…”

“…This factor has the potential to dramatically improve training load monitoring and personalized exercise training. The use of limited echocardiography performed by frontline providers to monitor training loads could serve to prevent overtraining syndrome and improve performance …”

(Athlete's heart vs hypertrophic cardiomyopathy - differential diagnostics according to current guidelines)

“…Vytrvalostní sportovci mohou mít klidovou ejekční frakci levé komory při dolní hranici normy. 8 Při zátěži se jejich ejekční frakce zvyšuje. 9 Kromě morfologických změn myokardu se u trénovaných jedinců manifestuje také vagotonie, která se může projevit klidovou sinusovou nebo junkční bradykardií.…”

“…12,13 Mimo výše zmíněné morfologické varianty EKG je pro trénované jedince také typický sklon ke klidové bradykardii, jež bývá asymptomatická. 8 Povětšinou jde o sinusovou nebo junkční bradykardii, někdy můžeme dokumentovat atrioventrikulární (AV) blokádu II. stupně Wenckebachova typu.…”

Echocardiographic Assessment of Left Ventricular Remodeling in American Style Footballers

“…Echocardiography is simple, yet effective in characterizing left ventricular (LV) parameters such as LV end-diastolic diameter (LVEDD) and relative wall thickness in athletes [5][6][7]. Prior studies have observed that these LV remodeling parameters, along with sphericity index, ventricular mass, and wall thickness, are important features in differentiating athletic remodeling [8,9].…”