Cardiac Phenotypes and Markers of Adverse Outcome in Elite Athletes With Ventricular Arrhythmias

Lie, Øyvind; Klaboe, L G; Dejgaard, Lars A.; Skjølsvik, Eystein Theodor Ek; Grimsmo, Jostein; Bosse, Gerhard; Hopp, Einar; Edvardsen, Thor; Haugaa, Kristina H

doi:10.1016/j.jcmg.2020.07.039

Cited by 31 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An additional technique of novel interest is "mechanical desynchrony," referring to increased temporal spread of peak deformation. In athletic studies, this has been applied not only to the LV, but also more recently to the RV (53).…”

Section: Recommendations For Echocardiographicmentioning

confidence: 99%

Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID-19

Phelan¹,

Kim

Elliott³

et al. 2020

JACC: Cardiovascular Imaging

114

111

View full text Add to dashboard Cite

As our understanding of the complications of coronavirus disease–2019 (COVID-19) evolve, sub-clinical cardiac pathology such as myocarditis, pericarditis and right ventricular dysfunction in the absence of significant clinical symptoms represents a concern. The potential implications of these findings in athletes are significant given the concern that exercise, during the acute phase of viral myocarditis, may exacerbate myocardial injury and precipitate malignant ventricular arrhythmias. Such concerns have led to the development and publication of expert consensus documents aimed at providing guidance for the evaluation of athletes after contracting COVID-19 in order to permit safe return-to-play. Cardiac imaging is at the center of these evaluations. This review seeks to evaluate the current evidence regarding COVID-19associated cardiovascular disease and how multi-modality imaging may be useful in the screening and clinical evaluation of athletes with suspected cardiovascular complications of infection. Guidance is provided with diagnostic “red flags” that raise the suspicion of pathology. Specific emphasis is placed on the unique challenges posed in distinguishing athletic cardiac remodeling from sub-clinical cardiac disease. The strengths and limitations of different imaging modalities are discussed and an approach to return-to-play decision making for athletes’ post COVID-19, as informed by multi-modality imaging, is provided.

show abstract

Section: Recommendations For Echocardiographicmentioning

confidence: 99%

Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID-19

Phelan¹,

Kim

Elliott³

et al. 2020

JACC: Cardiovascular Imaging

114

111

View full text Add to dashboard Cite

show abstract

“…Unlike in the LV, fibrosis in the RV or atria is clearly associated with potential adverse events. Ventricular arrhythmias, mainly originating from the RV outflow tract in endurance athletes [ 69 ], are often associated with an impaired RV function and RV fibrosis [ 70 , 71 ].…”

Section: Long-term Health Implications: Key Aspects By Organ Systemmentioning

confidence: 99%

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Scheer¹,

Tiller

Doutreleau

et al. 2021

Sports Med

View full text Add to dashboard Cite

It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.

show abstract

“…Recent evidence confirmed the association between NLVSs and VAs in athletes. A recent study by Lie et al compared 43 high-performance competitive athletes with VAs to healthy athletes using clinical data and cardiac imaging and found a higher prevalence of non-ischemic LGE on CMR in athletes with VAs compared to healthy controls [75].…”

Section: Relationship Between Pvb Features and Nlvs Revealed By Cmrmentioning

confidence: 99%

Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Athletes with Premature Ventricular Beats

Brunetti

Cipriani

Marra

et al. 2022

JCM

View full text Add to dashboard Cite

Premature ventricular beats (PVBs) in athletes are not rare. The risk of PVBs depends on the presence of an underlying pathological myocardial substrate predisposing the subject to sudden cardiac death. The standard diagnostic work-up of athletes with PVBs includes an examination of family and personal history, resting electrocardiogram (ECG), 24 h ambulatory ECG (possibly with a 12-lead configuration and including a training session), maximal exercise testing and echocardiography. Despite its fundamental role in the diagnostic assessment of athletes with PVBs, echocardiography has very limited sensitivity in detecting the presence of non-ischemic left ventricular scars, which can be revealed only through more in-depth studies, particularly with the use of contrast-enhanced cardiac magnetic resonance (CMR) imaging. The morphology, complexity and exercise inducibility of PVBs can help estimate the probability of an underlying heart disease. Based on these features, CMR imaging may be indicated even when echocardiography is normal. This review focuses on interpreting PVBs, and on the indication and role of CMR imaging in the diagnostic evaluation of athletes, with a special focus on non-ischemic left ventricular scars that are an emerging substrate of cardiac arrest during sport.

show abstract

Cardiac Phenotypes and Markers of Adverse Outcome in Elite Athletes With Ventricular Arrhythmias

Cited by 31 publications

References 29 publications

Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID-19

Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID-19

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Athletes with Premature Ventricular Beats

Contact Info

Product

Resources

About