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Athlete’s Heart : Diagnostic Challenges and Future Perspectives

De Innocentiis, Carlo ; Ricci, Fabrizio LU ; Khanji, Mohammed Y. ; Aung, Nay ; Tana, Claudio ; Verrengia, Elvira ; Petersen, Steffen E. and Gallina, Sabina (2018) In Sports Medicine 48(11). p.2463-2477
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... (More)

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.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Sports Medicine
volume
48
issue
11
pages
15 pages
publisher
Springer
external identifiers
  • pmid:30251086
  • scopus:85053851151
ISSN
0112-1642
DOI
10.1007/s40279-018-0985-2
language
English
LU publication?
yes
id
2e872c07-ed95-4a6e-b7e2-fdda01bcee38
date added to LUP
2018-10-23 11:49:58
date last changed
2021-10-06 04:20:13
@article{2e872c07-ed95-4a6e-b7e2-fdda01bcee38,
  abstract     = {<p>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.</p>},
  author       = {De Innocentiis, Carlo and Ricci, Fabrizio and Khanji, Mohammed Y. and Aung, Nay and Tana, Claudio and Verrengia, Elvira and Petersen, Steffen E. and Gallina, Sabina},
  issn         = {0112-1642},
  language     = {eng},
  number       = {11},
  pages        = {2463--2477},
  publisher    = {Springer},
  series       = {Sports Medicine},
  title        = {Athlete’s Heart : Diagnostic Challenges and Future Perspectives},
  url          = {http://dx.doi.org/10.1007/s40279-018-0985-2},
  doi          = {10.1007/s40279-018-0985-2},
  volume       = {48},
  year         = {2018},
}