2014, Number 2
<< Back Next >>
Rev Mex Cardiol 2014; 25 (2)
Athlete’s cardiomyopathy
Asensio E, Álvarez M, Lara S, Álvarez CJ, Rodríguez H, Castro H, Fraga JM, Álvarez JB
Language: Spanish
References: 77
Page: 109-117
PDF size: 242.11 Kb.
ABSTRACT
High performance sports practice is more common every day. In the present work we evaluate several concepts regarding sudden death among athletes and the recently described «Athlete’s cardiomyopathy». The prevalence of sudden death among athletes is higher than among the general population (1.5:100,000 versus 0.2:100,000 respectively). This difference can be related to myocardial changes derived from endurance exercise. There are consistent descriptions of anatomical and functional changes, more specific to the right ventricle that simulate an arrhythmogenic right ventricular dysplasia/cardiomyopathy. This can originate the hypothesis that such a cardiomyopathy can explain a certain number of sudden deaths among athletes. As healthcare professionals we have to be aware of this possibility among trained athletes, although we must continue to encourage moderate physical activity as a healthy behaviour among the general population.
REFERENCES
Vanhees L, De Sutter J, Geladas N et al. Importance of characteristics and modalities of physical activity and exercise in defining the benefits to cardiovascular health within the general population: Recommendations from the EACPR (part I). Eur J Prev Cardiol. 2012; 19: 670-686.
Landaeta L, Fernández J, DaSilva M et al. Mediterranean diet, moderate to high intensity training and health related quality of life in adults with metabolic syndrome. Eur J Prev Cardiol. 2013; 20(4): 555-564.
Rook A. An investigation into the longevity of Cambridge sportsmen. Br Med J. 1954; 3: 773-777.
Mont L, Sambola A, Brugada B et al. Long lasting sport practice and atrial fibrillation. Eur Heart J. 2002; 23: 477-482.
Corrado D, Basso C, Rizzoli G et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003; 42: 1959-1963.
Webster’s Third new international dictionary. Merriam Webster Ed. 1966, pp: 138.
Encyclopaedia Britannica. Vol 2. William Benton Pub co.; 1969: pp. 681.
Asensio E, Brugada J, Narváez R et al. Aspectos relevantes para el internista sobre la muerte súbita. Med Int Mex. 2003; 19: 78-88.
Asensio E, Narváez R, Dorantes J et al. Conceptos actuales sobre la muerte súbita. Gac Med Mex. 2005; 141: 89-98.
Asensio E, Castillo L, Orea A et al. Changes in the arrhythmic profile of patients treated for heart failure are associated to modifications in their myocardial perfusión conditions. Cardiol J. 2008; 15: 261-267.
Halawa B. Cardiovascular diseases as a cause of sudden death in athletes. Pol Merkur Lekarski. 2004; 16: 5-7.
Pugh A, Bourke J, Kunadian V. Sudden cardiac death among competitive adult athletes: A review. Postgrad Med J. 2012; 88: 382-390.
Durakovic Z, Durakovic M, Skavic J. Arrhythmogenic right ventricular dysplasia and sudden cardiac death in Croatia’s young athletes in 25 years. Coll Antropol. 2011; 35: 793-796.
Cross B, Estes M 3rd, Link M. Sudden cardiac death in young athletes and non-athletes. Curr Opin Crit Care. 2011; 17: 328-334.
Maron B. The paradox of exercise. N Eng J Med. 2000; 343: 1409-1411.
Thompson P, Furk E, Carleton R et al. Incidence of death during jogging in Rhode island from 1975 through 1980. JAMA. 1982; 247: 2535-2538.
Van Camp S, Bloor C, Mueller F et al. Non-traumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995; 27: 641-647.
Chevalier L, Hajjar M, Douard H et al. Sports-related acute cardiovascular events in a general population: A French prospective study. Eur J Cardiovasc Prev Rehab. 2009; 16: 365-370.
Corrado D, Basso C, Pavei A et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006; 296: 1593-1601.
Eckart R, Scoville S, Campbell C et al. Sudden death in young adults: A 25-year review of autopsies in military recruits. Ann Intern Med. 2004; 141: 1618-1622.
Corrado D, Basso C, Schiavo M et al. Screening for hypertrophic cardiomyopathy in young athletes. N Eng J Med. 1998; 339: 364-369.
Tabib A, Miras A, Taniere P et al. Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity. Eur Heart J. 1999; 20: 900-903.
Suárez M, Aguilera B. Causes of sudden death during sports activities in Spain. Rev Esp Cardiol. 2002; 55: 347-358.
Maron B, Doerer J, Haas T et al. Sudden deaths in young competitive athletes. Analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009; 119: 1085-92.
Fagard R. Athlete’s Heart. Heart. 2003; 89: 1455-1461.
Maron B, Pellicia A. The heart of trained athletes: Cardiac remodeling and the risks of sports, including sudden death. Circulation. 2006; 114: 1633-1644.
Thiene G, Corrado D, Basso C. Arrhythmogenic right ventricular cardiomyopathy/dysplasia. Orphanet J Rare Dis. 2007; 2: 45.
Benito B, Gay G, Serrano A et al. Cardiac arrhythmogenic remodeling in a rat model of long term intensive exercise training. Circulation. 2011; 123: 13-22.
Heidbüchel H, Hoogsteen J, Fagard R et al. High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic test in risk stratification. Eur Heart J. 2003; 24: 1473-1480.
LaGerche A, Prior D, Heidbüchel H. Clinical consequences of intense endurance exercise must include assessment of the right ventricle. J Am Coll Cardiol. 2010; 56: 1263.
La Gerche A, Robberecht C, Kuiperi C et al. Lower than expected desmosomal gene mutation prevalence in endurance athletes with complex ventricular arrhythmias of right ventricular origin. Heart. 2010; 96: 1268-74.
Douglas P, O’Toole M, Hiller D et al. Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol. 1990; 15: 64-69.
La Gerche A, Connelly K, Mooney D et al. Biochemical and functional abnormalities of left and right ventricular function after ultraendurance exercise. Heart. 2008; 94: 860-866.
Neilan T, Januzzi J, Lee E et al. Myocardial injury and ventricular dysfunction related to training levels among non-elite participants in the Boston marathon. Circulation. 2006; 114: 2325-2333.
Mousavi N, Czarnecki A, Kumar K et al. Relation of biomarkers and cardiac magnetic resonance imaging after marathon running. Am J Cardiol. 2009; 103: 1467-1472.
Ector J, Ganame J, Van der Merwe N et al. Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment. Eur Heart J. 2007; 28: 345-353.
Oxborough D, Shave R, Warburton D et al. Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise. Exploratory insights from conventional two-dimensional and speckle tracking echocardiography. Circ Cardiovasc Imaging. 2011; 4: 253-263.
La Gerche A, Heidbüchel H, Burns A et al. Disproportionate exercise load and remodeling of the athlete’s right ventricle. Med Sci Sports Exerc. 2011; 43: 974-981.
La Gerche A, Burns A, Mooney D et al. Exercise induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J. 2012; 33: 998-1006.
Heidbüchel H, La Gerche A. The right heart in athletes. Evidence for exercise induced arrhythmogenic right ventricular cardiomyopathy. Herz schrittmacherter elektrophysiol. 2012; 23: 82-86.
Slonim N, Ravin A, Balchum O et al. The effect of mild exercise in the supine position on the pulmonary arterial pressure of five normal human subjects. J Clin Invest. 1954; 33: 1022-30.
Sancetta S, Rakita L, Heckman G et al. Response of pulmonary artery pressure and total pulmonary resistance of untrained, convalescent man to prolonged mild steady state exercise. J Clin Invest. 1957; 36: 1138-1149.
Newman J, Cochran C, Roselli R et al. Pressure and flow changes in the pulmonary circulation in exercising sheep: evidence for elevated microvascular pressure. Am Rev Respir Dis. 1993; 147: 921-926.
White M, Lykidis C, Balanos G. The pulmonary vascular response to combined activation of the muscle metaboreflex and mechanoreflex. Exp Physiol. 2013; 98: 758-767.
Waxman A. Exercise physiology and pulmonary arterial hypertension. Prog Cardiovasc Dis. 2012; 55: 172-179.
Bossone E, Naeije R. Exercise–induced pulmonary hypertension. Heart Fail Clin. 2012; 8: 485-495.
Bombardini T, Sicari R, Bianchini E et al. Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure. Cardiovasc Ultrasound. 2011; 9: 36.
Fowler R, Maiorana A, Jenkins S et al. A comparison of the acute haemodynamic response to aerobic and resistance exercise in subjects with exercise–induced pulmonary arterial hypertension. Eur J Prev Cardiol. 2013; 20(4): 605-12
Saggar R, Khanna D, Shapiro S et al. Exercise induced pulmonary hypertension in systemic sclerosis and treatment with ambrisentan. A prospective single center, open label, pilot study. Arthritis Rheum. 2012; 64: 4072-4077.
Provencher S, Chemla D, Hervé P. Resting and exercise hemodynamics in pulmonary arterial hypertension. Presse Med. 2011; 40: S28-38.
Fowler R. Measurement properties of the 6-min walk test in individuals with exercise-induced pulmonary arterial hypertension. Intern Med J. 2011; 41: 679-687.
Adachi H, Sakurai S, Tanehata M et al. Effect of long term exercise training on blood viscosity during endurance exercise at ananaerobic threshold intensity. Jpn Circ J. 2000; 64: 848-850.
Van Camp S, Bloor C, Mueller F et al. Non-traumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995; 27: 641-647.
Corrado D, Schmied C, Basso C et al. Risk of sports: Do we need a preparticipation screening for competitive and leisure athletes? Eur Heart J. 2011; 32: 934-944.
Maron B, Thompson P, Ackerman M. et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity and Metabolism. Circulation. 2007; 115: 1643-1655.
Fuller C, McNulty C, Spring D et al. Prospective screening of 5,615 high school athletes for risk of sudden cardiac death. Med Sci Sports Exerc. 1997; 29: 1131-1138.
Thiene G, Carturan E, Corrado D, Basso C. Prevention of sudden cardiac death in the young and in athletes: Dream or reality? Cardiovasc Pathol. 2010; 19: 207-217.
Maron B, Zipes D. 36th Bethesda conference: Recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. J Am Coll Cardiol. 2005; 45: 1373-1375.
Baggish A, Hutter A, Wang F et al. Cardiovascular screening in college athletes with and without electrocardiography. A cross sectional study. Ann Intern Med. 2010; 152: 269-275.
Pellicia A, Di Paolo F, Corrado D et al. Evidence for efficacy of the Italian national preparticipation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes. Eur Heart J. 2006; 27: 2196-2200.
Chaitman B. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation. 2007: 116: 2610-2614.
Myerburg R, Vetter V. Electrocardiogram should be included in preparticipation screening of athletes. Circulation. 2007; 116: 2616-2626.
Fuller C. Cost-effectiveness analysis of screening high-school athletes for risk of sudden cardiac death. Med Sci Sports Exerc. 2000; 32: 887-890.
Tanaka Y, Yoshinaga M, Anan R et al. Usefulness and cost-effectiveness of cardiovascular screening of young adolescents. Med Sci Sports Exerc. 2006; 38: 2-6.
Wheeler M, Heidenreich P, Froelicher V, Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med. 2010; 152: 276-286.
Chevalier L, Hajjar M, Douard H et al. Sports-related acute cardiovascular events in a general population: A French prospective study. Eur J Cardiovasc Prev Rehab. 2009; 16: 365-370.
Corrado D, Basso C, Pavei A et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006; 296: 1593-1601.
Eckart R, Scoville S, Campbell C et al. Sudden death in young adults: A 25-year review of autopsies in military recruits. Ann Intern Med. 2004; 141: 1618-1622.
Corrado D, Basso C, Schiavo M et al. Screening for hypertrophic cardiomyopathy in young athletes. N Eng J Med. 1998; 339: 364-369.
Tabib A, Miras A, Taniere P et al. Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity. Eur Heart J. 1999; 20: 900-903.
Kayser B, Mauron A, Miah A. Current anti-doping policy: a critical appraisal. BMC Medical Ethics. 2007,8: 2.
Moore R, Shapiro L, Gibson D. Relation between electrocardiographic repolarization changes and mechanical events in left ventricular hypertrophy. Br Heart J. 1984; 52: 516-523.
Haïssaguerre M, Derval N, Sacher F et al. Sudden cardiac arrest associated with early repolarization. N Eng J Med. 2008; 358: 2016-2023.
Tikkanen J, Anttonen O, Junttila M et al. Long term outcome associated with early repolarization on electrocardiography. N Eng J Med. 2009; 361: 2529-2537.
Noseworthy P, Weiner R, Kim J et al. Early repolarization pattern in competitive athletes. Clinical correlates and the effects of exercise training. Circ Arrhythm Electrophysiol. 2011; 4: 432-440.
Baggish AL. Wood M. Athlete’s heart and cardiovascular care of the athlete. Scientific and clinical update. Circulation. 2011; 123: 2723-2735.
Boraita A, Serratosa L. El corazón del deportista: Hallazgos electrocardiográficos más frecuentes. Rev Esp Cardiol. 1998; 51: 356-368.