Cor Vasa 2020, 62(4):373-378 | DOI: 10.33678/cor.2020.051

(Dilated cardiomyopathy and myocarditis in an athlete)

Anna Chaloupka
I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně;
Cardiology Department, Guy's and St Thomas' NHS Foundation Trust, Londýn, Velká Británie

Dilated cardiomyopathy and myocarditis are associated with an increased risk of cardiac arrhythmias. They represent one of the leading causes of sudden cardiac death in young athletes <35 years of age. Cardiac adaptation to an intense physical exercise is by itself linked to an array of electric, morphologic and functional changes comprising what is known as athletic heart. Discrimination of this physiologic adaptation from pathological findings is essential for risk stratification. The aim of this work is an overview of the current knowledge in differential diagnostics of dilated cardiomyopathy and myocarditis from the athletic heart, identification of individuals in high risk of sudden cardiac death, and a summary of recommendations regarding sports activity.

Keywords: Athlete, Athletic heart, Dilated cardiomyopathy, Myocarditis, Sudden cardiac death

Received: April 19, 2020; Revised: April 19, 2020; Accepted: May 22, 2020; Published: September 16, 2020  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Chaloupka A. (Dilated cardiomyopathy and myocarditis in an athlete). Cor Vasa. 2020;62(4):373-378. doi: 10.33678/cor.2020.051.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Singh R, Pattisapu A, Emery MS. US Physical Activity Guidelines: Current state, impact and future directions [published online ahead of print, 2019 Oct 17]. Trends Cardiovasc Med 2019;S1050-1738(19)30140-9. doi: 10.1016/j.tcm.2019.10.002 Go to original source... Go to PubMed...
    2. Corrado D, Basso C, Rizzoli G, et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003;42:1959-1963. Go to original source... Go to PubMed...
    3. Maron BJ, Haas TS, Ahluwalia A, et al. Demographics and Epidemiology of Sudden Deaths in Young Competitive Athletes: From the United States National Registry. Am J Med 2016;129:1170-1177. Go to original source... Go to PubMed...
    4. Pelliccia A, Maron BJ, Spataro A, et al. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991;324:295-301. Go to original source... Go to PubMed...
    5. Elliott P, Andersson B, Arbustini E, et al. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2008;29:270-276. Go to original source... Go to PubMed...
    6. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure [published correction appears in Rev Esp Cardiol (Engl Ed) 2017;70:309-310]. Rev Esp Cardiol (Engl Ed) 2016;69:1167. Go to PubMed...
    7. Priori SG, Blomström-Lundqvist C, Mazzanti A, et al. [2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac Death. The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology]. G Ital Cardiol (Rome) 2016;17:108-170. Go to PubMed...
    8. Abergel E, Chatellier G, Hagege AA, et al. Serial left ventricular adaptations in world-class professional cyclists: implications for disease screening and follow-up. J Am Coll Cardiol 2004;44;144-149. Go to original source... Go to PubMed...
    9. Drezner JA, Sharma S, Baggish A, et al. International criteria for electrocardiographic interpretation in athletes: Consensus statement. Br J Sports Med 2017;51:704-731. Go to original source... Go to PubMed...
    10. Cordero-Reyes AM, Youker K, Estep JD, et al. Molecular and cellular correlates of cardiac function in end-stage DCM: a study using speckle tracking echocardiography. JACC Cardiovasc Imaging 2014;7:441-452. Go to original source... Go to PubMed...
    11. Pelliccia A, Culasso F, Di Paolo FM, Maron BJ. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med 1999;130:23-31. Go to original source...
    12. D'Andrea A, Riegler L, Golia E, et al. Range of right heart measurements in top-level athletes: the training impact. Int J Cardiol 2013;164:48-57. Go to original source... Go to PubMed...
    13. Pelliccia A, Maron BJ, De Luca R, et al. Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation 2002;105:944-949. Go to original source... Go to PubMed...
    14. Gulati A, Jabbour A, Ismail TF, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA 2013;309:896-908. Go to original source... Go to PubMed...
    15. Pelliccia A, Solberg EE, Papadakis M, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2019;40:19-33. Go to original source... Go to PubMed...
    16. Pelliccia A, Caselli S, Sharma S, et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur Heart J 2018;39:1949-1969. Go to original source... Go to PubMed...
    17. Drezner JA, Ackerman MJ, Anderson J, et al. Electrocardiographic interpretation in athletes: the 'Seattle criteria'. Br J Sports Med 2013;47:122-124. Go to original source... Go to PubMed...
    18. Spezzacatene A, Sinagra G, Merlo M, et al. Arrhythmogenic Phenotype in Dilated Cardiomyopathy: Natural History and Predictors of Life-Threatening Arrhythmias. J Am Heart Assoc 2015;4:e002149. Go to original source... Go to PubMed...
    19. Parks SB, Kushner JD, Nauman D, et al. Lamin A/C mutation analysis in a cohort of 324 unrelated patients with idiopathic or familial dilated cardiomyopathy. Am Heart J 2008;156:161-169. Go to original source... Go to PubMed...
    20. Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013;34:2636-2648d. Go to original source... Go to PubMed...
    21. Finocchiaro G, Papadakis M, Robertus JL, et al. Etiology of Sudden Death in Sports: Insights From a United Kingdom Regional Registry. J Am Coll Cardiol 2016;67:2108-2115. Go to original source... Go to PubMed...
    22. Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation 2015;132:10-19. Go to original source... Go to PubMed...
    23. Sedaghat-Hamedani F, Kayvanpour E, Frankenstein L, et al. Biomarker changes after strenuous exercise can mimic pulmonary embolism and cardiac injury - a metaanalysis of 45 studies. Clin Chem 2015;61:1246-1255. Go to original source... Go to PubMed...
    24. Friedrich MG, Sechtem U, Schulz-Menger J, et al. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol 2009;53:1475-1487. Go to original source... Go to PubMed...
    25. Mewton N, Dernis A, Bresson D, et al. Myocardial biomarkers and delayed enhanced cardiac magnetic resonance relationship in clinically suspected myocarditis and insight on clinical outcome. J Cardiovasc Med (Hagerstown) 2015;16:696-703. Go to original source... Go to PubMed...
    26. Gräni C, Eichhorn C, Bière L, et al. Prognostic Value of Cardiac Magnetic Resonance Tissue Characterization in Risk Stratifying Patients With Suspected Myocarditis. J Am Coll Cardiol 2017;70:1964-1976. Go to original source... Go to PubMed...
    27. Damm S, Andersson LG, Henriksen E, et al. Wall motion abnormalities in male elite orienteers are aggravated by exercise. Clin Physiol 1999;19:121-126. Go to original source... Go to PubMed...
    28. Eichhorn C, Bière L, Schnell F, et al. Myocarditis in Athletes Is a Challenge: Diagnosis, Risk Stratification, and Uncertainties. JACC Cardiovasc Imaging 2020;13:494-507. Go to original source... Go to PubMed...
    29. Bohm P, Scharhag J, Meyer T. Data from a nationwide registry on sports-related sudden cardiac deaths in Germany. Eur J Prev Cardiol 2016;23:649-656. Go to original source... Go to PubMed...
    30. Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015;36:2921-2964. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content


    Cor et Vasa

    You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

    I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.


    No
    Yes