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Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members

Saberniak, Jorg; Hasselberg, Nina E.; Borgquist, Rasmus LU ; Platonov, Pyotr LU ; Sarvari, Sebastian I.; Smith, Hans-Jorgen; Ribe, Margareth; Holst, Anders G.; Edvardsen, Thor and Haugaa, Kristina H. (2014) In European Journal of Heart Failure 16(12). p.1337-1344
Abstract
AimsExercise increases risk of ventricular arrhythmia in subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the impact of exercise on myocardial function in ARVC subjects. Methods and ResultsWe included 110 subjects (age 4217years), 65 ARVC patients and 45 mutation-positive family members. Athletes were defined as subjects with 4h vigorous exercise/week [1440 metabolic equivalents (METsxminutes/week)] during a minimum of 6 years. Athlete definition was fulfilled in 37/110 (34%) subjects. We assessed right ventricular (RV) and left ventricular (LV) myocardial function by echocardiography, and by magnetic resonance imaging (MRI). The RV function by RV fractional area change (FAC), RV global... (More)
AimsExercise increases risk of ventricular arrhythmia in subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the impact of exercise on myocardial function in ARVC subjects. Methods and ResultsWe included 110 subjects (age 4217years), 65 ARVC patients and 45 mutation-positive family members. Athletes were defined as subjects with 4h vigorous exercise/week [1440 metabolic equivalents (METsxminutes/week)] during a minimum of 6 years. Athlete definition was fulfilled in 37/110 (34%) subjects. We assessed right ventricular (RV) and left ventricular (LV) myocardial function by echocardiography, and by magnetic resonance imaging (MRI). The RV function by RV fractional area change (FAC), RV global longitudinal strain (GLS) by echocardiography, and RV ejection fraction (EF) by MRI was reduced in athletes compared with non-athletes (FAC 34 +/- 9% vs. 40 +/- 11%, RVGLS -18.3 +/- 6.1% vs. -22.0 +/- 4.8%, RVEF 32 +/- 8% vs. 43 +/- 10%, all P<0.01). LV function by LVEF and LVGLS was reduced in athletes compared with non-athletes (LVEF by echocardiography 50 +/- 10% vs. 57 +/- 5%, LVEF by MRI 46 +/- 6% vs. 53 +/- 8%, and LVGLS -16.7 +/- 4.2% vs. -19.4 +/- 2.9%, all P<0.01). The METsxminutes/week correlated with reduced RV and LV function by echocardiography and MRI (all P<0.01). The LVEF by MRI was also reduced in subgroups of athlete index patients (46 +/- 7% vs. 54 +/- 10%, P=0.02) and in athlete family members (47 +/- 3% vs. 52 +/- 6%, P<0.05). Conclusion<p id="ejhf181-para-0003">Athletes showed reduced biventricular function compared with non-athletes in ARVC patients and in mutation-positive family members. The amount and intensity of exercise activity was associated with impaired LV and RV function. Exercise may aggravate and accelerate myocardial dysfunction in ARVC. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arrhythmogenic cardiomyopathy, Heart failure, Exercise, Myocardial, function, Ventricular arrhythmia
in
European Journal of Heart Failure
volume
16
issue
12
pages
1337 - 1344
publisher
Elsevier
external identifiers
  • wos:000345755200013
  • scopus:84913588827
ISSN
1879-0844
DOI
10.1002/ejhf.181
language
English
LU publication?
yes
id
4b469df4-9c3a-4ddc-914d-592be03d3851 (old id 4962671)
date added to LUP
2015-02-03 07:03:55
date last changed
2017-10-22 03:19:43
@article{4b469df4-9c3a-4ddc-914d-592be03d3851,
  abstract     = {AimsExercise increases risk of ventricular arrhythmia in subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the impact of exercise on myocardial function in ARVC subjects. Methods and ResultsWe included 110 subjects (age 4217years), 65 ARVC patients and 45 mutation-positive family members. Athletes were defined as subjects with 4h vigorous exercise/week [1440 metabolic equivalents (METsxminutes/week)] during a minimum of 6 years. Athlete definition was fulfilled in 37/110 (34%) subjects. We assessed right ventricular (RV) and left ventricular (LV) myocardial function by echocardiography, and by magnetic resonance imaging (MRI). The RV function by RV fractional area change (FAC), RV global longitudinal strain (GLS) by echocardiography, and RV ejection fraction (EF) by MRI was reduced in athletes compared with non-athletes (FAC 34 +/- 9% vs. 40 +/- 11%, RVGLS -18.3 +/- 6.1% vs. -22.0 +/- 4.8%, RVEF 32 +/- 8% vs. 43 +/- 10%, all P&lt;0.01). LV function by LVEF and LVGLS was reduced in athletes compared with non-athletes (LVEF by echocardiography 50 +/- 10% vs. 57 +/- 5%, LVEF by MRI 46 +/- 6% vs. 53 +/- 8%, and LVGLS -16.7 +/- 4.2% vs. -19.4 +/- 2.9%, all P&lt;0.01). The METsxminutes/week correlated with reduced RV and LV function by echocardiography and MRI (all P&lt;0.01). The LVEF by MRI was also reduced in subgroups of athlete index patients (46 +/- 7% vs. 54 +/- 10%, P=0.02) and in athlete family members (47 +/- 3% vs. 52 +/- 6%, P&lt;0.05). Conclusion&lt;p id="ejhf181-para-0003"&gt;Athletes showed reduced biventricular function compared with non-athletes in ARVC patients and in mutation-positive family members. The amount and intensity of exercise activity was associated with impaired LV and RV function. Exercise may aggravate and accelerate myocardial dysfunction in ARVC.},
  author       = {Saberniak, Jorg and Hasselberg, Nina E. and Borgquist, Rasmus and Platonov, Pyotr and Sarvari, Sebastian I. and Smith, Hans-Jorgen and Ribe, Margareth and Holst, Anders G. and Edvardsen, Thor and Haugaa, Kristina H.},
  issn         = {1879-0844},
  keyword      = {Arrhythmogenic cardiomyopathy,Heart failure,Exercise,Myocardial,function,Ventricular arrhythmia},
  language     = {eng},
  number       = {12},
  pages        = {1337--1344},
  publisher    = {Elsevier},
  series       = {European Journal of Heart Failure},
  title        = {Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members},
  url          = {http://dx.doi.org/10.1002/ejhf.181},
  volume       = {16},
  year         = {2014},
}