Causes of sudden cardiac death in young athletes and non-athletes: systematic review and meta-analysis

D’Ascenzi, Flavio; Valentini, Francesca; Pistoresi, Simone; Frascaro, Federica; Piu, Pietro; Cavigli, Luna; Valente, Serafina; Focardi, Marta; Cameli, Matteo; Bonifazi, Marco; Metra, Marco; Mondillo, Sergio

doi:10.1016/j.tcm.2021.06.001

Cited by 51 publications

(44 citation statements)

References 42 publications

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“…In a large cohort of ACM patients, the mean age at first evaluation was 36 ± 14 years with a median age of cardiac arrest of 25 years (1). Accounting for up to 20% of the cases, ACM is one of the leading causes of SCD in the young (2) and it is responsible between 4.7 and 27% of SCD in athletes (3)(4)(5). The incidence and severity of ACM is higher in men than in women (male/female ratio 2.7:1) (6)(7)(8).…”

Section: Introduction Demographicsmentioning

confidence: 99%

Histopathological Features and Protein Markers of Arrhythmogenic Cardiomyopathy

Bueno-Betí

Asimaki

2021

Front. Cardiovasc. Med.

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Arrhythmogenic cardiomyopathy (ACM) is a heritable heart muscle disease characterized by syncope, palpitations, ventricular arrhythmias and sudden cardiac death (SCD) especially in young individuals. It is estimated to affect 1:5,000 individuals in the general population, with >60% of patients bearing one or more mutations in genes coding for desmosomal proteins. Desmosomes are intercellular adhesion junctions, which in cardiac myocytes reside within the intercalated disks (IDs), the areas of mechanical and electrical cell-cell coupling. Histologically, ACM is characterized by fibrofatty replacement of cardiac myocytes predominantly in the right ventricular free wall though left ventricular and biventricular forms have also been described. The disease is characterized by age-related progression, vast phenotypic manifestation and incomplete penetrance, making proband diagnosis and risk stratification of family members particularly challenging. Key protein redistribution at the IDs may represent a specific diagnostic marker but its applicability is still limited by the need for a myocardial sample. Specific markers of ACM in surrogate tissues, such as the blood and the buccal epithelium, may represent a non-invasive, safe and inexpensive alternative for diagnosis and cascade screening. In this review, we shall cover the most relevant biomarkers so far reported and discuss their potential impact on the diagnosis, prognosis and management of ACM.

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Section: Introduction Demographicsmentioning

confidence: 99%

Histopathological Features and Protein Markers of Arrhythmogenic Cardiomyopathy

Bueno-Betí

Asimaki

2021

Front. Cardiovasc. Med.

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“…SCD is associated with cardiomyopathies, channelopathies, myocarditis, ischemic heart disease, atherosclerotic coronary artery disease, anomalous origin of coronary arteries, aortic dissections, mitral valve prolapse, valvopathies, idiopathic left ventricular hypertrophy, non-ischemic left a ventricular scar, or structurally normal heart [9]. A meta-analysis by D'Ascenzi et al [10] reported that the anomalous origin of coronary arteries accounts for 7.2% of the cause of SCD among athletes and 1.9% of SCD among non-athletes [10]. The anomalous origin of the RCA from the left coronary sinus accounts for 0.02% to 0.2% of anomalous coronary artery origins [11].…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Right Coronary Artery: An Uncommon Presentation

Shaban¹,

Budhathoki²,

Bhatt³

et al. 2022

Cureus

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The anomalous origin of the coronary artery is a relatively uncommon condition with a variant incidence depending on the modality of the imaging techniques such as transesophageal echocardiography (TEE), computed tomography angiography (CTA), magnetic resonance angiography (MRA), or invasive coronary angiography (ICA). The importance of diagnosing ectopic coronary artery origin comes from its possible relation to sudden cardiac death (SCD) cases in young populations. The anomalous origin of the coronary artery could cause myocardial ischemia and fibrosis; this would, in turn, increase the chances of fatal ventricular arrhythmias. In this report, we present a 40-year-old male, incidentally found to have persistent tachycardia and a gradually decreasing left ventricular ejection fraction (LVEF). He denied any symptoms or changes in his baseline, unlimited, functional capacity. However, his records were remarkable for persistent tachycardia over more than six months, raising concerns about tachyarrhythmia-induced cardiomyopathy related to his anatomical variations. We also discussed the guideline-directed therapeutic option for the abnormal origin of the coronary artery as per current guidelines.

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“…Since it is generally assumed that athletes are in great health, as in our case, symptoms commonly do not receive appropriate responses and consequently diagnosis of underlying cardiac disease is often delayed. CAA is the second most common cause of SCD in young adolescent athletes ( 3 ) and also present a risk factor for SCD in a non-athletic population ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Exertional Dyspnea as the Main Symptom in an Adolescent Athlete With Coronary Artery Anomaly – A Case Report

Sareban

Hergan

Covi

et al. 2022

Front. Cardiovasc. Med.

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Coronary artery anomalies (CAA) are associated with sudden cardiac death (SCD) and the majority of those events occur during exercise. Depending on the anatomic features and severity, CAA usually provoke clinical symptoms of coronary ischemia, mainly syncope and (exertional) chest pain. Here we present a case of a female adolescent athlete with a high-risk CAA variant and an unusual clinical presentation, which delayed diagnosis 2 years after first symptoms were reported. After successful surgical management of the anomalous artery, the patient was determined eligible for competitive sports with unremarkable follow-up examinations.

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Causes of sudden cardiac death in young athletes and non-athletes: systematic review and meta-analysis

Cited by 51 publications

References 42 publications

Histopathological Features and Protein Markers of Arrhythmogenic Cardiomyopathy

Histopathological Features and Protein Markers of Arrhythmogenic Cardiomyopathy

Anomalous Origin of the Right Coronary Artery: An Uncommon Presentation

Exertional Dyspnea as the Main Symptom in an Adolescent Athlete With Coronary Artery Anomaly – A Case Report

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