Sports Cardiology

Abstract

Athletes heart was first described atthe beginning of the 20th century and since then has been an area of active debate. In the last decades its conditions and implications have been revealed thanksto modern imaging technology. Therefore the European Association of Preventive Cardiology (EAPC) and the European Association of Cardiovascular Imaging (EACVI) published a joint position statement for the use and interpretation of cardiovascular imaging in the evaluation of athletes heart. Cardiac adaptation or remodeling due to intensive exercise training can be influenced by physiological or pathological factors. Athletes heart is per definition described asa harmonic and consistent increase in dimension of all four cardiac chambers, wherebyfemale athletes display only moderate cardiac changes compared to their male counterparts. This paper will present recent scientific data with current echocardiographic cut-off parameters for athletes heart and secondly will deal with the right ventricle, more specifically, with the echocardiographic differentiation between athletes heart and arrhythmogenic right ventricular cardiomyopathy (ARVC). ARVC is an inherited heart muscle disease characterized by progressive fibrofatty replacement of the right ventricular -and in up to 50% of the cases also of the left ventricular -myocardium. This pathological remodeling is aggravated by sports and might be the substrate for ventricular arrhythmias as well as sudden cardiac death. Clinical experience with the 2010 International Task Force diagnostic score system has identified some limitations potentially resulting in overdiagnosis - especially in athletes - due to e. g. misinterpretation of electrocardiographic and imaging findings. Hence this paper will provide an overview ofthe latest literature with echocardiographic parameters for a better distinction between ARVC and sports-related remodeling of the right ventricle in athletes.KEY WORDS: Sports-Related Cardiac Remodeling, Cardiac Imaging, Arrhythmogenic Cardiomyopathie