Right ventricular function in elite male athletes meeting the structural echocardiographic task force criteria for arrhythmogenic right ventricular cardiomyopathy

Abstract

Athlete pre-participation screening is focused on detecting pathological conditions like arrhythmogenic right ventricular cardiomyopathy (ARVC). The diagnosis of ARVC is established by applying the revised 2010 ARVC Task Force Criteria (TFC) that assesses RV structure and function. Some athletes may meet structural TFC without having ARVC but we do not know the consequences for RV function. This study compared RV structural and functional indices in male athletes that meet the structural TFC (MTFC) for ARVC and those that do not (NMTFC). We recruited 214 male elite athletes. All participants underwent 2D, Doppler, tissue Doppler and strain (ε) echocardiography with a focused and comprehensive assessment of the right heart. Athletes were grouped on RV structural data: MTFC n = 34; NMTFC n = 180. Functional data were compared between groups. By selection, MTFC had larger absolute and scaled RV outflow tract (RVOT) diameter compared to NMTFC (P ˂0.05) but these athletes did not develop a proportional increase in the RV inflow dimensions. There was no difference in global conventional RV systolic function between both groups however, there was significantly lower global RV ε in athletes that MTFC which can be explained, in part, by the RVOT dimension.

A Novel Diagnostic Score Integrating Atrial Dimensions to Differentiate between the Athlete’s Heart and Arrhythmogenic Right Ventricular Cardiomyopathy

“…There is a significant overlap between myocardial RV morphologic alterations described in ARVC and the athlete’s heart [ 5 , 6 , 7 ]. The revised 2010 TFC were developed in order to improve the diagnosis of ARVC.…”

“…Until now, observational echocardiographic studies reported contrasting findings for cardiac function and dimensions in athletes compared to ARVC [ 5 , 6 , 7 ]. Data about the physiological exercise-induced alterations involving the right atrium (RA) in athletes compared to patients with ARVC is scarce.…”

Comparative characteristics of changes in central hemodynamics during early recovery after different exercise regimes

“…Based on the analysis of the data obtained at the first stage of the study, we have reason to believe that the registration of TRP during the Martine test allowed a deeper study of the nature of the central hemodynamic response to DL and describe the physiological picture of hemodynamic response in normotonic response as follows: muscles, in particular, oxygen demand, should be provided by increase in MVB; reduction of vascular resistance of blood flow and increase of pulse blood pressure improve the state of perfusion of the capillary bed of working muscles, and the stability of adBP ensures optimal conditions for metabolism of water, nutrients and other components between blood and tissue fluid [1,3,13,17,21].…”

Differentiating right ventricular remodelling from cardiac pathology in athletes

“…Zaidi et al showed that a ratio of ≤0.9 could be used as a parameter to distinguish between physiological remodelling and ARVC (Figure 5A). 24,27,29 …”