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Erschienen in: Herz 3/2015

01.05.2015 | Main topic

Physiologic and pathophysiologic changes in the right heart in highly trained athletes

verfasst von: A. D’Andrea, MD, A. La Gerche, E. Golia, R. Padalino, R. Calabrò, M.G. Russo, E. Bossone

Erschienen in: Herz | Ausgabe 3/2015

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Abstract

Exercise causes changes in the heart in response to the hemodynamic demands of increased systemic and pulmonary requirements during exercise. Understanding these adaptations is of great importance, since they may overlap with those caused by pathological conditions. Initial descriptions of athlete’s heart focused mainly on chronic adaptation of the left heart to training. In recent years, the substantial structural and functional adaptations of the right heart have been documented, highlighting the complex interplay with left heart. Moreover, there is evolving evidence of acute and chronic cardiac damage, mainly involving the right heart, which may predispose subjects to atrial and ventricular arrhythmias, configuring an exercise-induced cardiomyopathy. The aim of this article is to review the current knowledge on the physiologic and pathophysiologic changes in the right heart in highly trained athletes.
Literatur
1.
Zurück zum Zitat Morganroth J, Maron BJ, Henry WL, Epstein SE (1975) Comparative left ventricular dimensions in trained athletes. Ann Intern Med 82:521–524CrossRefPubMed Morganroth J, Maron BJ, Henry WL, Epstein SE (1975) Comparative left ventricular dimensions in trained athletes. Ann Intern Med 82:521–524CrossRefPubMed
2.
Zurück zum Zitat D’Andrea A, Galderisi M, Sciomer S et al (2009) Echocardiographic evaluation of the athlete’s heart: from morphological adaptations to myocardial function. G Ital Cardiol (Rome) 10(8):533–544 D’Andrea A, Galderisi M, Sciomer S et al (2009) Echocardiographic evaluation of the athlete’s heart: from morphological adaptations to myocardial function. G Ital Cardiol (Rome) 10(8):533–544
3.
Zurück zum Zitat Luijkx T, Cramer MJ, Prakken NH et al (2012) Sport category is an important determinant of cardiac adaptation: an MRI study. Br J Sports Med 46(16):1119–1124CrossRefPubMed Luijkx T, Cramer MJ, Prakken NH et al (2012) Sport category is an important determinant of cardiac adaptation: an MRI study. Br J Sports Med 46(16):1119–1124CrossRefPubMed
4.
Zurück zum Zitat Wernstedt P, Sjöstedt C, Ekman I et al (2002) Adaptation of cardiac morphology and function to endurance and strength training. A comparative study using MR imaging and echocardiography in males and females. Scand J Med Sci Sports 2:17–25CrossRef Wernstedt P, Sjöstedt C, Ekman I et al (2002) Adaptation of cardiac morphology and function to endurance and strength training. A comparative study using MR imaging and echocardiography in males and females. Scand J Med Sci Sports 2:17–25CrossRef
5.
Zurück zum Zitat La Gerche A, Burns AT, Mooney DJ et al (2012) Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 33(8):998–1006CrossRef La Gerche A, Burns AT, Mooney DJ et al (2012) Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 33(8):998–1006CrossRef
6.
Zurück zum Zitat La Gerche A, Claessen G, Van de Bruaene A et al (2013) Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise. Circ Cardiovasc Imaging 6:329–338CrossRef La Gerche A, Claessen G, Van de Bruaene A et al (2013) Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise. Circ Cardiovasc Imaging 6:329–338CrossRef
8.
Zurück zum Zitat Argiento P, Chesler N, Mule M et al (2010). Exercise stress echocardiography for the study of the pulmonary circulation. Eur Respir J 35:1273–1278CrossRefPubMedCentralPubMed Argiento P, Chesler N, Mule M et al (2010). Exercise stress echocardiography for the study of the pulmonary circulation. Eur Respir J 35:1273–1278CrossRefPubMedCentralPubMed
9.
Zurück zum Zitat Dawson CA (1984) Role of pulmonary vasomotion in physiology of the lung. Physiol Rev 64(2):544–616PubMed Dawson CA (1984) Role of pulmonary vasomotion in physiology of the lung. Physiol Rev 64(2):544–616PubMed
10.
Zurück zum Zitat West JB (1998) Left ventricular filling pressures during exercise: a cardiological blind spot? Chest 113(6):1695–1697CrossRefPubMed West JB (1998) Left ventricular filling pressures during exercise: a cardiological blind spot? Chest 113(6):1695–1697CrossRefPubMed
11.
Zurück zum Zitat La Gerche A, Roberts T, Claessen G (2014). The response of the pulmonary circulation and right ventricle to exercise: exercise-induced right ventricular dysfunction and structural remodeling in endurance athletes (2013 Grover Conference series). Pulm Circ 4(3):407–416CrossRef La Gerche A, Roberts T, Claessen G (2014). The response of the pulmonary circulation and right ventricle to exercise: exercise-induced right ventricular dysfunction and structural remodeling in endurance athletes (2013 Grover Conference series). Pulm Circ 4(3):407–416CrossRef
12.
Zurück zum Zitat D’Andrea A, Caso P, Sarubbi B et al (2003) Right ventricular myocardial adaptation to different training protocols in top-level athletes. Echocardiography 20(4):329–336CrossRef D’Andrea A, Caso P, Sarubbi B et al (2003) Right ventricular myocardial adaptation to different training protocols in top-level athletes. Echocardiography 20(4):329–336CrossRef
13.
Zurück zum Zitat Oxborough D, Sharma S, Shave R et al (2012) The right ventricle of the endurance atlete: the relationship between morphology and deformation. J Am Soc Echocardiogr 25:263–271CrossRefPubMed Oxborough D, Sharma S, Shave R et al (2012) The right ventricle of the endurance atlete: the relationship between morphology and deformation. J Am Soc Echocardiogr 25:263–271CrossRefPubMed
14.
Zurück zum Zitat Pollak SJ, McMillan SA, Knopff WD et al (1988) Cardiac evaluation of women distance runners by echocardiographic Doppler flow mapping. J Am Coll Cardiol 11:89–93CrossRefPubMed Pollak SJ, McMillan SA, Knopff WD et al (1988) Cardiac evaluation of women distance runners by echocardiographic Doppler flow mapping. J Am Coll Cardiol 11:89–93CrossRefPubMed
15.
Zurück zum Zitat D’Andrea A, Naeije R, D’Alto M et al (2011) Range in pulmonary artery systolic pressure among highly trained athletes. Chest 139(4):788–794CrossRef D’Andrea A, Naeije R, D’Alto M et al (2011) Range in pulmonary artery systolic pressure among highly trained athletes. Chest 139(4):788–794CrossRef
16.
Zurück zum Zitat Shave R, George K, Whyte G et al (2008) Postexercise changes in left ventricular function: the evidence so far. Med Sci Sports Exerc 40(8):1393–1399CrossRefPubMed Shave R, George K, Whyte G et al (2008) Postexercise changes in left ventricular function: the evidence so far. Med Sci Sports Exerc 40(8):1393–1399CrossRefPubMed
17.
Zurück zum Zitat La Gerche A, Connelly KA, Mooney DJ et al (2008) Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise. Heart 94(7):860–866CrossRef La Gerche A, Connelly KA, Mooney DJ et al (2008) Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise. Heart 94(7):860–866CrossRef
18.
Zurück zum Zitat Oxborough D, Shave R, Warburton D et al (2011) Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise: exploratory insights from conventional two-dimensional and speckle tracking echocardiography. Circ Cardiovasc Imaging 4(3):253–263CrossRefPubMed Oxborough D, Shave R, Warburton D et al (2011) Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise: exploratory insights from conventional two-dimensional and speckle tracking echocardiography. Circ Cardiovasc Imaging 4(3):253–263CrossRefPubMed
19.
Zurück zum Zitat Neilan TG, Januzzi JL, Lee-Lewandrowski E et al (2006) Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation 114(22):2325–2333CrossRefPubMed Neilan TG, Januzzi JL, Lee-Lewandrowski E et al (2006) Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation 114(22):2325–2333CrossRefPubMed
20.
Zurück zum Zitat Kasikcioglu E, Oflaz H, Akhan H, Kayserilioglu A (2005) Right ventricular myocardial performance index and exercise capacity in athletes. Heart Vessels 20:147–152CrossRefPubMed Kasikcioglu E, Oflaz H, Akhan H, Kayserilioglu A (2005) Right ventricular myocardial performance index and exercise capacity in athletes. Heart Vessels 20:147–152CrossRefPubMed
21.
Zurück zum Zitat Prakken NH, Velthuis BK, Teske AJ et al (2010) Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex. Eur J Cardiovasc Prev Rehabil 17:198–203CrossRefPubMed Prakken NH, Velthuis BK, Teske AJ et al (2010) Cardiac MRI reference values for athletes and nonathletes corrected for body surface area, training hours/week and sex. Eur J Cardiovasc Prev Rehabil 17:198–203CrossRefPubMed
22.
Zurück zum Zitat D’Andrea A, Riegler L, Morra S et al (2012) Right ventricular morphology and function in top-level athletes: a three-dimensional echocardiographic study. J Am Soc Echocardiogr 25(12):1268–1276CrossRef D’Andrea A, Riegler L, Morra S et al (2012) Right ventricular morphology and function in top-level athletes: a three-dimensional echocardiographic study. J Am Soc Echocardiogr 25(12):1268–1276CrossRef
23.
Zurück zum Zitat King G, Almuntaser I, Murphy RT et al (2013) Reduced right ventricular myocardial strain in the elite athlete may not be a consequence of myocardial damage. “Cream masquerades as skimmed milk”. Echocardiography 30(8):929–935CrossRefPubMed King G, Almuntaser I, Murphy RT et al (2013) Reduced right ventricular myocardial strain in the elite athlete may not be a consequence of myocardial damage. “Cream masquerades as skimmed milk”. Echocardiography 30(8):929–935CrossRefPubMed
24.
Zurück zum Zitat Caso P, D’Andrea A, Galderisi M et al (2000) Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function. Am J Cardiol 85(9):1131–1136CrossRefPubMed Caso P, D’Andrea A, Galderisi M et al (2000) Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function. Am J Cardiol 85(9):1131–1136CrossRefPubMed
25.
Zurück zum Zitat Baggish AL, Wang F, Weiner RB et al (2008) Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes. J Appl Physiol (1985) 104(4):1121–1128 Baggish AL, Wang F, Weiner RB et al (2008) Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes. J Appl Physiol (1985) 104(4):1121–1128
26.
Zurück zum Zitat Bidart CM, Abbas AE, Parish JM et al (2007) The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance. J Am Soc Echocardiogr 20(3):270–275CrossRefPubMed Bidart CM, Abbas AE, Parish JM et al (2007) The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance. J Am Soc Echocardiogr 20(3):270–275CrossRefPubMed
27.
Zurück zum Zitat La Gerche A, Heidbuchel H, Burns AT et al (2011) Disproportionate exercise load and remodeling of the athlete’s right ventricle. Med Sci Sports Exerc 43(6):974–981CrossRef La Gerche A, Heidbuchel H, Burns AT et al (2011) Disproportionate exercise load and remodeling of the athlete’s right ventricle. Med Sci Sports Exerc 43(6):974–981CrossRef
28.
Zurück zum Zitat La Gerche A, MacIsaac AI, Burns AT et al (2010). Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise. J Appl Physiol 109(5):1307–1317CrossRef La Gerche A, MacIsaac AI, Burns AT et al (2010). Pulmonary transit of agitated contrast is associated with enhanced pulmonary vascular reserve and right ventricular function during exercise. J Appl Physiol 109(5):1307–1317CrossRef
29.
Zurück zum Zitat Bossone E, Rubenfire M, Bach DS et al (1999) Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: implications for the diagnosis of pulmonary hypertension. J Am Coll Cardiol 33(6):1662–1666CrossRefPubMed Bossone E, Rubenfire M, Bach DS et al (1999) Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: implications for the diagnosis of pulmonary hypertension. J Am Coll Cardiol 33(6):1662–1666CrossRefPubMed
30.
Zurück zum Zitat Lewis GD, Bossone E, Naeije R et al (2013). Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 128(13):1470–1479CrossRefPubMed Lewis GD, Bossone E, Naeije R et al (2013). Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 128(13):1470–1479CrossRefPubMed
31.
Zurück zum Zitat Lewis GD, Murphy RM, Shah RV et al (2011) Pulmonary vascular response patterns during exercise in left ventricular systolic dysfunction predict exercise capacity and outcomes. Circ Heart Fail 4(3):276–285CrossRefPubMedCentralPubMed Lewis GD, Murphy RM, Shah RV et al (2011) Pulmonary vascular response patterns during exercise in left ventricular systolic dysfunction predict exercise capacity and outcomes. Circ Heart Fail 4(3):276–285CrossRefPubMedCentralPubMed
32.
Zurück zum Zitat Kovacs G, Berghold A, Scheidl S, Olschewski H (2009) Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review. Eur Respir J 34(4):888–894CrossRefPubMed Kovacs G, Berghold A, Scheidl S, Olschewski H (2009) Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review. Eur Respir J 34(4):888–894CrossRefPubMed
33.
Zurück zum Zitat La Gerche A, Burns AT, D’Hooge J et al (2012) Exercise strain rate imaging demonstrates normal right ventricular contractile reserve and clarifies ambiguous resting measures in endurance athletes. J Am Soc Echocardiogr 25(3):253–262 e1CrossRef La Gerche A, Burns AT, D’Hooge J et al (2012) Exercise strain rate imaging demonstrates normal right ventricular contractile reserve and clarifies ambiguous resting measures in endurance athletes. J Am Soc Echocardiogr 25(3):253–262 e1CrossRef
34.
Zurück zum Zitat Trivax JE, Franklin BA, Goldstein JA et al (2010) Acute cardiac effects of marathon running. J Appl Physiol 108(5):1148–1153CrossRefPubMed Trivax JE, Franklin BA, Goldstein JA et al (2010) Acute cardiac effects of marathon running. J Appl Physiol 108(5):1148–1153CrossRefPubMed
35.
Zurück zum Zitat Neilan TG, Yoerger DM, Douglas PS et al (2006) Persistent and reversible cardiac dysfunction among amateur marathon runners. Eur Heart J 27(9):1079–1084CrossRefPubMed Neilan TG, Yoerger DM, Douglas PS et al (2006) Persistent and reversible cardiac dysfunction among amateur marathon runners. Eur Heart J 27(9):1079–1084CrossRefPubMed
36.
Zurück zum Zitat Mousavi N, Czarnecki A, Kumar K et al (2009) Relation of biomarkers and cardiac magnetic resonance imaging after marathon running. Am J Cardiol 103(10):1467–1472CrossRefPubMed Mousavi N, Czarnecki A, Kumar K et al (2009) Relation of biomarkers and cardiac magnetic resonance imaging after marathon running. Am J Cardiol 103(10):1467–1472CrossRefPubMed
37.
Zurück zum Zitat Douglas PS, O’Toole ML, Hiller WD, Reichek N (1990) Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol 15(1):64–69CrossRefPubMed Douglas PS, O’Toole ML, Hiller WD, Reichek N (1990) Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol 15(1):64–69CrossRefPubMed
38.
Zurück zum Zitat Elliott AD, La Gerche A (2014) The right ventricle following prolonged endurance exercise: are we overlooking the more important side of the heart? A meta-analysis. Br J Sports Med. pii: bjsports-2014-093895. doi:10.1136/bjsports-2014-093895 (Epub ahead of print) Elliott AD, La Gerche A (2014) The right ventricle following prolonged endurance exercise: are we overlooking the more important side of the heart? A meta-analysis. Br J Sports Med. pii: bjsports-2014-093895. doi:10.1136/bjsports-2014-093895 (Epub ahead of print)
39.
Zurück zum Zitat Shave R, Baggish A, George K et al (2010) Exercise-induced cardiac troponin elevation: evidence, mechanisms, and implications. J Am Coll Cardiol 56(3):169–176CrossRefPubMed Shave R, Baggish A, George K et al (2010) Exercise-induced cardiac troponin elevation: evidence, mechanisms, and implications. J Am Coll Cardiol 56(3):169–176CrossRefPubMed
40.
Zurück zum Zitat Shave R, George KP, Atkinson G et al (2007) Exercise-induced cardiac troponin T release: a meta-analysis. Med Sci Sports Exerc 39(12):2099–2106CrossRefPubMed Shave R, George KP, Atkinson G et al (2007) Exercise-induced cardiac troponin T release: a meta-analysis. Med Sci Sports Exerc 39(12):2099–2106CrossRefPubMed
41.
Zurück zum Zitat La Gerche A, Robberecht C, Kuiperi C et al (2010)Lower than expected desmosomal gene mutation prevalence in endurance athletes with complex ventricular arrhythmias of right ventricular origin. Heart 96(16):1268–1274CrossRef La Gerche A, Robberecht C, Kuiperi C et al (2010)Lower than expected desmosomal gene mutation prevalence in endurance athletes with complex ventricular arrhythmias of right ventricular origin. Heart 96(16):1268–1274CrossRef
42.
Zurück zum Zitat Dello Russo A, Pieroni M, Santangeli P et al (2011) Concealed cardiomyopathies in competitive athletes with ventricular arrhythmias and an apparently normal heart: role of cardiac electroanatomical mapping and biopsy. Heart Rhythm 8(12):1915–1922CrossRef Dello Russo A, Pieroni M, Santangeli P et al (2011) Concealed cardiomyopathies in competitive athletes with ventricular arrhythmias and an apparently normal heart: role of cardiac electroanatomical mapping and biopsy. Heart Rhythm 8(12):1915–1922CrossRef
43.
Zurück zum Zitat Zeppilli P, Santini C, Palmieri V et al (1994) Role of myocarditis in athletes with minor arrhythmias and/or echocardiographic abnormalities. Chest 106(2):373–380CrossRefPubMed Zeppilli P, Santini C, Palmieri V et al (1994) Role of myocarditis in athletes with minor arrhythmias and/or echocardiographic abnormalities. Chest 106(2):373–380CrossRefPubMed
44.
Zurück zum Zitat O’Hanlon R, Wilson M, Wage R et al (2010) Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 12:38CrossRef O’Hanlon R, Wilson M, Wage R et al (2010) Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 12:38CrossRef
45.
Zurück zum Zitat Breuckmann F, Mohlenkamp S, Nassenstein K et al (2009) Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology 251(1):50–57CrossRefPubMed Breuckmann F, Mohlenkamp S, Nassenstein K et al (2009) Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology 251(1):50–57CrossRefPubMed
46.
Zurück zum Zitat Mohlenkamp S, Lehmann N, Breuckmann F et al (2008) Running: the risk of coronary events: prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J 29(15):1903–1910CrossRefPubMed Mohlenkamp S, Lehmann N, Breuckmann F et al (2008) Running: the risk of coronary events: prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J 29(15):1903–1910CrossRefPubMed
47.
Zurück zum Zitat Wilson M, O’Hanlon R, Prasad S et al (2011) Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol 110(6):1622–1626CrossRefPubMedCentralPubMed Wilson M, O’Hanlon R, Prasad S et al (2011) Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol 110(6):1622–1626CrossRefPubMedCentralPubMed
48.
Zurück zum Zitat Benito B, Gay-Jordi G, Serrano-Mollar A et al (2011) Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 123(1):13–22CrossRefPubMed Benito B, Gay-Jordi G, Serrano-Mollar A et al (2011) Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 123(1):13–22CrossRefPubMed
49.
Zurück zum Zitat Pelliccia A, Maron BJ, De Luca R et al (2002) Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation 105(8):944–949CrossRefPubMed Pelliccia A, Maron BJ, De Luca R et al (2002) Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation 105(8):944–949CrossRefPubMed
50.
Zurück zum Zitat Luthi P, Zuber M, Ritter M et al (2008) Echocardiographic findings in former professional cyclists after long-term deconditioning of more than 30 years. Eur J Echocardiogr 9(2):261–267PubMed Luthi P, Zuber M, Ritter M et al (2008) Echocardiographic findings in former professional cyclists after long-term deconditioning of more than 30 years. Eur J Echocardiogr 9(2):261–267PubMed
51.
Zurück zum Zitat Karjalainen J, Kujala UM, Kaprio J et al (1998) Lone atrial fibrillation in vigorously exercising middle aged men: case-control study. BMJ 316(7147):1784–1785CrossRefPubMedCentralPubMed Karjalainen J, Kujala UM, Kaprio J et al (1998) Lone atrial fibrillation in vigorously exercising middle aged men: case-control study. BMJ 316(7147):1784–1785CrossRefPubMedCentralPubMed
52.
Zurück zum Zitat Grimsmo J, Grundvold I, Maehlum S, Arnesen H (2010) High prevalence of atrial fibrillation in long-term endurance cross-country skiers: echocardiographic findings and possible predictors – a 28–30 years follow-up study. Eur J Cardiovasc Prev Rehabil 17(1):100–105CrossRefPubMed Grimsmo J, Grundvold I, Maehlum S, Arnesen H (2010) High prevalence of atrial fibrillation in long-term endurance cross-country skiers: echocardiographic findings and possible predictors – a 28–30 years follow-up study. Eur J Cardiovasc Prev Rehabil 17(1):100–105CrossRefPubMed
53.
Zurück zum Zitat Molina L, Mont L, Marrugat J et al (2008) Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study. Europace 10(5):618–623CrossRefPubMed Molina L, Mont L, Marrugat J et al (2008) Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study. Europace 10(5):618–623CrossRefPubMed
54.
Zurück zum Zitat Mont L, Sambola A, Brugada J et al (2002) Long-lasting sport practice and lone atrial fibrillation. Eur Heart J 23(6):477–482CrossRefPubMed Mont L, Sambola A, Brugada J et al (2002) Long-lasting sport practice and lone atrial fibrillation. Eur Heart J 23(6):477–482CrossRefPubMed
55.
Zurück zum Zitat Elosua R, Arquer A, Mont L et al (2006) Sport practice and the risk of lone atrial fibrillation: a case-control study. Int J Cardiol 108(3):332–337CrossRefPubMed Elosua R, Arquer A, Mont L et al (2006) Sport practice and the risk of lone atrial fibrillation: a case-control study. Int J Cardiol 108(3):332–337CrossRefPubMed
56.
Zurück zum Zitat Baldesberger S, Bauersfeld U, Candinas R et al (2008) Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists. Eur Heart J 29(1):71–78CrossRefPubMed Baldesberger S, Bauersfeld U, Candinas R et al (2008) Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists. Eur Heart J 29(1):71–78CrossRefPubMed
57.
Zurück zum Zitat Heidbuchel H, Anne W, Willems R et al (2006) Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter. Int J Cardiol 107(1):67–72CrossRefPubMed Heidbuchel H, Anne W, Willems R et al (2006) Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter. Int J Cardiol 107(1):67–72CrossRefPubMed
58.
Zurück zum Zitat La Gerche A, Schmied CM (2013) Atrial fibrillation in athletes and the interplay between exercise and health. Eur Heart J 34(47):3599–3602CrossRef La Gerche A, Schmied CM (2013) Atrial fibrillation in athletes and the interplay between exercise and health. Eur Heart J 34(47):3599–3602CrossRef
59.
Zurück zum Zitat Abdulla J, Nielsen JR (2009) Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace 11(9):1156–1159CrossRefPubMed Abdulla J, Nielsen JR (2009) Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace 11(9):1156–1159CrossRefPubMed
60.
Zurück zum Zitat Biffi A, Maron BJ, Verdile L et al (2004) Impact of physical deconditioning on ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 44(5):1053–1058CrossRefPubMed Biffi A, Maron BJ, Verdile L et al (2004) Impact of physical deconditioning on ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 44(5):1053–1058CrossRefPubMed
61.
Zurück zum Zitat Biffi A, Pelliccia A, Verdile L et al (2002) Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 40(3):446–452CrossRefPubMed Biffi A, Pelliccia A, Verdile L et al (2002) Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 40(3):446–452CrossRefPubMed
62.
Zurück zum Zitat Heidbuchel H, Hoogsteen J, Fagard R et al (2003) High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J 24(16):1473–1480CrossRefPubMed Heidbuchel H, Hoogsteen J, Fagard R et al (2003) High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J 24(16):1473–1480CrossRefPubMed
63.
Zurück zum Zitat La Gerche A (2015) Defining the interaction between exercise and arrhythmogenic right ventricular cardiomyopathy. Eur J Heart Fail 17(2):128–131CrossRef La Gerche A (2015) Defining the interaction between exercise and arrhythmogenic right ventricular cardiomyopathy. Eur J Heart Fail 17(2):128–131CrossRef
64.
Zurück zum Zitat Galderisi M, Cardim N, D’Andrea A et al (2015). The multi-modality cardiac imaging approach to the Athlete’s heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. pii: jeu323 (Epub ahead of print) Galderisi M, Cardim N, D’Andrea A et al (2015). The multi-modality cardiac imaging approach to the Athlete’s heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. pii: jeu323 (Epub ahead of print)
65.
Zurück zum Zitat Cardim N, Galderisi M, Edvardsen T et al (2015) Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: an expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. Eur Heart J Cardiovasc Imaging. pii: jeu291 (Epub ahead of print) Cardim N, Galderisi M, Edvardsen T et al (2015) Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: an expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. Eur Heart J Cardiovasc Imaging. pii: jeu291 (Epub ahead of print)
66.
Zurück zum Zitat Kim JH, Noseworthy PA, McCarty D et al (2011) Significance of electrocardiographic right bundle branch block in trained athletes. Am J Cardiol 107(7):1083–1089CrossRefPubMed Kim JH, Noseworthy PA, McCarty D et al (2011) Significance of electrocardiographic right bundle branch block in trained athletes. Am J Cardiol 107(7):1083–1089CrossRefPubMed
67.
Zurück zum Zitat Brosnan M, La Gerche A, Kalman J et al (2014) Comparison of frequency of significant electrocardiographic abnormalities in endurance versus nonendurance athletes. Am J Cardiol 113(9):1567–1573CrossRefPubMed Brosnan M, La Gerche A, Kalman J et al (2014) Comparison of frequency of significant electrocardiographic abnormalities in endurance versus nonendurance athletes. Am J Cardiol 113(9):1567–1573CrossRefPubMed
68.
Zurück zum Zitat Whitman I, Patel VV, Soliman EZ et al (2013) Validity of the surfaceelectrocardiogram criteria for right ventricular hypertrophy: the MESA-RV Study (Multi-Ethnic Study of Atherosclerosis-Right Ventricle). J Am Coll Cardiol 63:672e68 1 Whitman I, Patel VV, Soliman EZ et al (2013) Validity of the surfaceelectrocardiogram criteria for right ventricular hypertrophy: the MESA-RV Study (Multi-Ethnic Study of Atherosclerosis-Right Ventricle). J Am Coll Cardiol 63:672e68 1
69.
Zurück zum Zitat Zaidi A, Ghani S, Sheikh N et al (2013) Clinical significance of electrocardiographic right ventricular hypertrophy in athletes: comparison with arrhythmogenic right ventricular cardiomyopathy and pulmonary hypertension. Eur Heart J 34:3649e3656 Zaidi A, Ghani S, Sheikh N et al (2013) Clinical significance of electrocardiographic right ventricular hypertrophy in athletes: comparison with arrhythmogenic right ventricular cardiomyopathy and pulmonary hypertension. Eur Heart J 34:3649e3656
70.
Zurück zum Zitat Schattke S, Wagner M, Hättasch R et al (2012) Single beat 3D echocardiography for the assessment of right ventricular dimension and function after endurance exercise: intraindividual comparison with magnetic resonance imaging. Cardiovasc Ultrasound 10:6CrossRefPubMedCentralPubMed Schattke S, Wagner M, Hättasch R et al (2012) Single beat 3D echocardiography for the assessment of right ventricular dimension and function after endurance exercise: intraindividual comparison with magnetic resonance imaging. Cardiovasc Ultrasound 10:6CrossRefPubMedCentralPubMed
71.
Zurück zum Zitat Prakken NH, Teske AJ, Cramer MJ et al (2012) Head-to-head comparison between echocardiography and cardiac MRI in the evaluation of the athlete’s heart. Br J Sports Med 46(5):348–354CrossRefPubMed Prakken NH, Teske AJ, Cramer MJ et al (2012) Head-to-head comparison between echocardiography and cardiac MRI in the evaluation of the athlete’s heart. Br J Sports Med 46(5):348–354CrossRefPubMed
72.
Zurück zum Zitat Oomah SR, Mousavi N, Bhullar N et al (2011) The role of three-dimensional echocardiography in the assessment of right ventricular dysfunction after a half marathon: comparison with cardiac magnetic resonance imaging. J Am Soc Echocardiogr 24(2):207–213CrossRefPubMed Oomah SR, Mousavi N, Bhullar N et al (2011) The role of three-dimensional echocardiography in the assessment of right ventricular dysfunction after a half marathon: comparison with cardiac magnetic resonance imaging. J Am Soc Echocardiogr 24(2):207–213CrossRefPubMed
73.
Zurück zum Zitat Valsangiacomo Buechel ER, Mertens LL (2012) Imaging the right heart: the use of integrated multimodality imaging. Eur Heart J 33(8):949–960CrossRef Valsangiacomo Buechel ER, Mertens LL (2012) Imaging the right heart: the use of integrated multimodality imaging. Eur Heart J 33(8):949–960CrossRef
74.
Zurück zum Zitat Karlstedt E, Chelvanathan A, Da Silva M et al (2012) The impact of repeated marathon running on cardiovascular function in the aging population. J Cardiovasc Magn Reson 14:58CrossRefPubMedCentralPubMed Karlstedt E, Chelvanathan A, Da Silva M et al (2012) The impact of repeated marathon running on cardiovascular function in the aging population. J Cardiovasc Magn Reson 14:58CrossRefPubMedCentralPubMed
75.
Zurück zum Zitat Franzen E, Mangold S, Erz G et al (2013) Comparison of morphological and functional adaptations of the heart in highly trained triathletes and long-distance runners using cardiac magnetic resonance imaging. Heart Vessels 28(5):626–631CrossRefPubMed Franzen E, Mangold S, Erz G et al (2013) Comparison of morphological and functional adaptations of the heart in highly trained triathletes and long-distance runners using cardiac magnetic resonance imaging. Heart Vessels 28(5):626–631CrossRefPubMed
76.
Zurück zum Zitat Kalliokoski KK, Nuutila P, Laine H et al (2002) Myocardial perfusion and perfusion reserve in endurance-trained men. Med Sci Sports Exerc 34(6):948–953CrossRefPubMed Kalliokoski KK, Nuutila P, Laine H et al (2002) Myocardial perfusion and perfusion reserve in endurance-trained men. Med Sci Sports Exerc 34(6):948–953CrossRefPubMed
77.
Zurück zum Zitat Laaksonen MS, Kalliokoski KK, Luotolahti M et al (2007) Myocardial perfusion during exercise in endurance-trained and untrained humans. Am J Physiol Regul Integr Comp Physiol 293(2):R837–R843CrossRefPubMed Laaksonen MS, Kalliokoski KK, Luotolahti M et al (2007) Myocardial perfusion during exercise in endurance-trained and untrained humans. Am J Physiol Regul Integr Comp Physiol 293(2):R837–R843CrossRefPubMed
78.
Zurück zum Zitat Kjaer A, Meyer C, Wachtell K et al (2005) Positron emission tomographic evaluation of regulation of myocardial perfusion in physiological (elite athletes) and pathological (systemic hypertension) left ventricular hypertrophy. Am J Cardiol 96(12):1692–1698CrossRefPubMed Kjaer A, Meyer C, Wachtell K et al (2005) Positron emission tomographic evaluation of regulation of myocardial perfusion in physiological (elite athletes) and pathological (systemic hypertension) left ventricular hypertrophy. Am J Cardiol 96(12):1692–1698CrossRefPubMed
79.
Zurück zum Zitat Gargiulo P, Cuocolo A, Dellegrottaglie S et al (2015) Nuclear assessment of right ventricle. Echocardiography 32(Suppl 1):69–74CrossRef Gargiulo P, Cuocolo A, Dellegrottaglie S et al (2015) Nuclear assessment of right ventricle. Echocardiography 32(Suppl 1):69–74CrossRef
80.
Zurück zum Zitat Nichols KJ, Jain D (2007) Right ventricular parameters: prospect for routine assessment by equilibrium radionuclide angiographic SPECT. Nucl Med Commun 28:155–157CrossRefPubMed Nichols KJ, Jain D (2007) Right ventricular parameters: prospect for routine assessment by equilibrium radionuclide angiographic SPECT. Nucl Med Commun 28:155–157CrossRefPubMed
Metadaten
Titel
Physiologic and pathophysiologic changes in the right heart in highly trained athletes
verfasst von
A. D’Andrea, MD
A. La Gerche
E. Golia
R. Padalino
R. Calabrò
M.G. Russo
E. Bossone
Publikationsdatum
01.05.2015
Verlag
Urban & Vogel
Erschienen in
Herz / Ausgabe 3/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-015-4220-8

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