The term 'athletés heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athletés heart aims to differentiate physiological changes due to intensive training in the athletés heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athletés heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athletés LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (.55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is , 50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. Whenechocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern inHCMand a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMRmay be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use ofCCTand nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR.
Galderisi, M., Cardim, N., D'Andrea, A., Bruder, O., Cosyns, B., Davin, L., et al. (2015). Themulti-modality cardiac imaging approach to the Athletés heart: An expert consensus of the European Association of Cardiovascular Imaging. EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING, 16(4), 353-353 [10.1093/ehjci/jeu323].
Themulti-modality cardiac imaging approach to the Athletés heart: An expert consensus of the European Association of Cardiovascular Imaging
MURARU D;
2015
Abstract
The term 'athletés heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athletés heart aims to differentiate physiological changes due to intensive training in the athletés heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athletés heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athletés LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (.55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is , 50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. Whenechocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern inHCMand a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMRmay be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use ofCCTand nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.