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Title: | Exercise-induced right ventricular dysfunction is associated with ventricular arrhythmias in endurance athletes | Authors: | La Gerche, Andre Claessen, Guido Dymarkowski, Steven Voigt, Jens-Uwe De Buck, Frederik Vanhees, Luc Droogne, Walter Van Cleemput, Johan Claus, Piet HEIDBUCHEL, Hein |
Issue Date: | 2015 | Publisher: | OXFORD UNIV PRESS | Source: | EUROPEAN HEART JOURNAL, 36 (30), p. 1998-2010 | Abstract: | Aims Intense exercise places disproportionate strain on the right ventricle (RV) which may promote pro-arrhythmic remodelling in some athletes. RV exercise imaging may enable early identification of athletes at risk of arrhythmias. Methods and results Exercise imaging was performed in 17 athletes with RV ventricular arrhythmias (EA-VAs), of which eight (47%) had an implantable cardiac defibrillator (ICD), 10 healthy endurance athletes (EAs), and seven non-athletes (NAs). Echocardiographic measures included the RV end-systolic pressure-area ratio (ESPAR), RV fractional area change (RVFAC), and systolic tricuspid annular velocity (RV S'). Cardiac magnetic resonance (CMR) measures combined with invasive measurements of pulmonary and systemic artery pressures provided left-ventricular (LV) and RV end-systolic pressure-volume ratios (SP/ESV), biventricular volumes, and ejection fraction (EF) at rest and during intense exercise. Resting measures of cardiac function were similar in all groups, as was LV function during exercise. In contrast, exercise-induced increases in RVFAC, RV S', and RVESPAR were attenuated in EA-VAs during exercise when compared with EAs and NAs (rho < 0.0001 for interaction group x workload). During exercise-CMR, decreases in RVESV and augmentation of both RVEF and RV SP/ESV were significantly less in EA-VAs relative to EAs and NAs (rho < 0.01 for the respective interactions). Receiver-operator characteristic curves demonstrated that RV exercise measures could accurately differentiate EA-VAs from subjects without arrhythmias [AUC for Delta RVESPAR = 0.96 (0.89-1.00), rho < 0.0001]. Conclusion Among athletes with normal cardiac function at rest, exercise testing reveals RV contractile dysfunction among athletes with RV arrhythmias. RV stress testing shows promise as a non-invasive means of risk-stratifying athletes. | Notes: | [La Gerche, Andre; Claessen, Guido; Voigt, Jens-Uwe; Droogne, Walter; Van Cleemput, Johan] Univ Hosp Leuven, Dept Cardiovasc Med, Leuven, Belgium. [La Gerche, Andre] Baker IDI Heart & Diabet Inst, Sports Cardiol, Melbourne, Vic 3004, Australia. [La Gerche, Andre] St Vincents Hosp Melbourne, Fitzroy, Vic, Australia. [Dymarkowski, Steven] Univ Hosp Leuven, Dept Radiol, Leuven, Belgium. [De Buck, Frederik] Univ Hosp Leuven, Dept Anesthesiol, Leuven, Belgium. [Vanhees, Luc] Katholieke Univ Leuven, Dept Rehabil Sci, Leuven, Belgium. [Claus, Piet] Katholieke Univ Leuven, Dept Cardiovasc Imaging & Dynam, Leuven, Belgium. [Heidbuchel, Hein] Hasselt Univ, Hasselt, Belgium. [Heidbuchel, Hein] Jessa Hosp, Ctr Heart, Hasselt, Belgium. | Keywords: | athletes; right ventricle; arrhythmias; sports cardiology; cardiac magnetic resonance imaging; exercise; arrhythmogenic right ventricular cardiomyopathy; echocardiography;Athletes; Right ventricle; Arrhythmias; Sports cardiology; Cardiac magnetic resonance imaging; Exercise; Arrhythmogenic Right ventricular cardiomyopathy; Echocardiography | Document URI: | http://hdl.handle.net/1942/19883 | ISSN: | 0195-668X | e-ISSN: | 1522-9645 | DOI: | 10.1093/eurheartj/ehv202 | ISI #: | 000359670100017 | Rights: | © The Author 2015. For permissions please email: journals.permissions@oup.com. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2016 |
Appears in Collections: | Research publications |
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