Left Ventricular Trabeculation: Arrhythmogenic and Clinical Significance in Elite Athletes

Di Gioia, Giuseppe; Crispino, Simone Pasquale; Monosilio, Sara; Maestrini, Viviana; Nenna, Antonio; Spinelli, Alessandro; Lemme, Erika; Squeo, Maria Rosaria; Pelliccia, Antonio

doi:10.1016/j.echo.2024.03.003

Journal of the American Society of Echocardiography

2024

DOI: 10.1016/j.echo.2024.03.003

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Left Ventricular Trabeculation: Arrhythmogenic and Clinical Significance in Elite Athletes

Giuseppe Di Gioia,

Simone Pasquale Crispino,

Sara Monosilio

et al.

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2024

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Cited by 2 publications

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Is It Finally Time to Untangle Elite Athletes From the Controversial Web of Left Ventricular Trabeculations?

Lander,

Hoit

2024

Journal of the American Society of Echocardiography

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Is It Finally Time to Untangle Elite Athletes From the Controversial Web of Left Ventricular Trabeculations?

Lander,

Hoit

2024

Journal of the American Society of Echocardiography

View full text Add to dashboard Cite

Left Ventricular Hypertrabeculation (LVHT) in Athletes: A Negligible Finding?

Jagminas,

Šerpytis,

Šerpytis

et al. 2024

Medicina

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Left ventricular hypertrabeculation (LVHT) used to be a rare phenotypic trait. With advances in diagnostic imaging techniques, LVHT is being recognised in an increasing number of people. The scientific data show the possibility of the overdiagnosis of this cardiomyopathy in a population of people who have very high levels of physical activity. We describe the case of a young athlete with no medical history, who presented with syncope during a marathon running race. Initial evaluation showed elevated troponin I; transthoracic echocardiography showed a trabeculated ventricle and subsequent cardiac magnetic resonance (CMR) revealed left ventricular hypertrabeculation (LVHT). During subsequent evaluation by tilt table testing, vasovagal syncope was identified as the likely aetiology of the syncope. The patient was advised to cease sports and stimulants like caffeine use. At the 29-month follow-up, CMR showed the normalisation of the non-compacted to compacted myocardial ratio and an improvement in left ventricular function, with no further syncopal episodes reported. This is an example of the physiological hypertrabeculation of the LV apex in a recreational endurance athlete, with the normalisation of the non-compacted to compacted myocardial layer ratio after detraining. Physiological hypertrabeculation, a benign component of exercise-induced cardiac remodelling, must be differentiated from non-compaction cardiomyopathy and other pathologies causing syncope. This case underscores the importance of distinguishing physiological hypertrabeculation from pathological LVHT in athletes, highlighting that exercise-induced cardiac remodelling can normalise with detraining.

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Left Ventricular Trabeculation: Arrhythmogenic and Clinical Significance in Elite Athletes

Cited by 2 publications

References 30 publications

Is It Finally Time to Untangle Elite Athletes From the Controversial Web of Left Ventricular Trabeculations?

Is It Finally Time to Untangle Elite Athletes From the Controversial Web of Left Ventricular Trabeculations?

Left Ventricular Hypertrabeculation (LVHT) in Athletes: A Negligible Finding?

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