Exercise-induced right ventricular dysfunction is associated with ventricular arrhythmias in endurance athletes

European Heart Journal

Volumn 36, Issue 30, 2015, Pages 1998-2010

  La Gerche, Andre ^a,b,c   Claessen, Guido ^a   Dymarkowski, Steven ^a   Voigt, Jens Uwe ^a   De Buck, Frederik ^a   Vanhees, Luc ^d   Droogne, Walter ^a   Van Cleemput, Johan ^a   Claus, Piet ^d   Heidbuchel, Hein ^e  

^a UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^b BAKER IDI HEART AND DIABETES INSTITUTE   (Australia)

^c ST VINCENT S HOSPITAL   (Australia)

^d UNIVERSITY OF LEUVEN   (Belgium)

^e HASSELT UNIVERSITY   (Belgium)

Author keywords

Arrhythmias; Arrhythmogenic Right ventricular cardiomyopathy; Athletes; Cardiac magnetic resonance imaging; Echocardiography; Exercise; Right ventricle; Sports cardiology

Indexed keywords

AMIODARONE; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CIBENZOLINE; FLECAINIDE; SOTALOL;

ADULT; ARTICLE; ATHLETE; BIVENTRICULAR VOLUME; CARDIOVASCULAR MAGNETIC RESONANCE; CARDIOVASCULAR PARAMETERS; CLINICAL ARTICLE; CONTROLLED STUDY; DISEASE ASSOCIATION; ECHOCARDIOGRAPHY; END SYSTOLIC PRESSURE AREA RATIO; EXERCISE; HEART EJECTION FRACTION; HEART LEFT VENTRICLE ENDDIASTOLIC PRESSURE; HEART RIGHT VENTRICLE ENDDIASTOLIC PRESSURE; HEART RIGHT VENTRICLE FUNCTION; HEART VENTRICLE ARRHYTHMIA; HUMAN; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR; PRIORITY JOURNAL; RIGHT VENTRICLE FRACTIONAL AREA CHANGE; SYSTOLIC TRICUSPID ANNULAR VELOCITY; ARRHYTHMIAS, CARDIAC; EXERCISE TEST; HEART OUTPUT; HEART VOLUME; HEMODYNAMICS; MAGNETIC RESONANCE ANGIOGRAPHY; MALE; PATHOPHYSIOLOGY; PHYSIOLOGY; RISK FACTOR; SPORT;

ADULT; ARRHYTHMIAS, CARDIAC; CARDIAC OUTPUT; CARDIAC VOLUME; ECHOCARDIOGRAPHY; EXERCISE; EXERCISE TEST; HEMODYNAMICS; HUMANS; MAGNETIC RESONANCE ANGIOGRAPHY; MALE; RISK FACTORS; SPORTS; VENTRICULAR DYSFUNCTION, RIGHT; VENTRICULAR FUNCTION, RIGHT;

EID: 84939645692     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehv202     Document Type: Article

References (26)

1. Biffi A, Pelliccia A, Verdile L, Fernando F, Spataro A, Caselli S, Santini M, Maron BJ. Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 2002;40:446-452.
2. Heidbuchel H, Hoogsteen J, Fagard R, Vanhees L, Ector H, Willems R, Van Lierde J. High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J 2003;24:1473-1480.
3. La Gerche A, Robberecht C, Kuiperi C, Nuyens D, Willems R, de Ravel T, Matthijs G, Heidbuchel H. Lower than expected desmosomal gene mutation prevalence in endurance athletes with complex ventricular arrhythmias of right ventricular origin. Heart 2010;96:1268-1274.
4. Sawant AC, Bhonsale A, Te Riele AS, Tichnell C, Murray B, Russell SD, Tandri H, Tedford RJ, Judge DP, Calkins H, James CA. Exercise has a Disproportionate Role in the Pathogenesis of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy in Patients Without Desmosomal Mutations. J Am Heart Assoc 2014;3:e001471.
5. La Gerche A, Heidbuchel H, Burns AT, Mooney DJ, Taylor AJ, Pfluger HB, Inder WJ, Macisaac AI, Prior DL. Disproportionate exercise load and remodeling of the athlete's right ventricle. Med Sci Sports Exerc 2011;43:974-981.
6. Claessen G, Claus P, Ghysels S, Vermeersch P, Dymarkowski S, La Gerche A, Heidbuchel H. Right ventricular fatigue developing during endurance exercise: an exercise cardiac magnetic resonance study. Med Sci Sports Exerc 2014;46:1717-1726.
7. La Gerche A, Burns AT, Mooney DJ, Inder WJ, Taylor AJ, Bogaert J, Macisaac AI, Heidbuchel H, Prior DL. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 2012;33:998-1006.
8. Oxborough D, Shave R, Warburton D, Williams K, Oxborough A, Charlesworth S, Foulds H, Hoffman MD, Birch K, George K. Dilatation and dysfunction of the right ventricle immediately after ultraendurance exercise: exploratory insights from conventional two-dimensional and speckle tracking echocardiography. Circ Cardiovasc Imaging 2011;4:253-263.
9. Douglas PS, O'Toole ML, Hiller WD, Reichek N. Different effects of prolonged exercise on the right and left ventricles. J Am Coll Cardiol 1990;15:64-69.
10. Trivax JE, Franklin BA, Goldstein JA, Chinnaiyan KM, Gallagher MJ, deJong AT, Colar JM, Haines DE, McCullough PA. Acute cardiac effects of marathon running. J Appl Physiol 2010;108:1148-1153.
11. Teske AJ, Prakken NH, De Boeck BW, Velthuis BK, Martens EP, Doevendans PA, Cramer MJ. Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes. Eur Heart J 2009;30:969-977.
12. Benito B, Gay-Jordi G, Serrano-Mollar A, Guasch E, Shi Y, Tardif JC, Brugada J, Nattel S, Mont L. Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 2011;123:13-22.
13. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, Calkins H, Corrado D, Cox MG, Daubert JP, Fontaine G, Gear K, Hauer R, Nava A, Picard MH, Protonotarios N, Saffitz JE, Sanborn DM, Steinberg JS, Tandri H, Thiene G, Towbin JA, Tsatsopoulou A, Wichter T, Zareba W. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation 2010;121:1533-1541.
14. La Gerche A, Claessen G, Van de Bruaene A, Pattyn N, Van Cleemput J, Gewillig M, Bogaert J, Dymarkowski S, Claus P, Heidbuchel H. Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise. Circ Cardiovasc Imaging 2013;6:329-338.
15. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-1463.
16. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
17. La Gerche A, Burns AT, D'Hooge J, Macisaac AI, Heidbuchel H, Prior DL. Exercise strain rate imaging demonstrates normal right ventricular contractile reserve and clarifies ambiguous resting measures in endurance athletes. J Am Soc Echocardiogr 2012;25:253-262 e1.
18. Sanz J, Garcia-Alvarez A, Fernandez-Friera L, Nair A, Mirelis JG, Sawit ST, Pinney S, Fuster V. Right ventriculo-arterial coupling in pulmonary hypertension: a magnetic resonance study. Heart 2012;98:238-243.
19. Kelly RP, Ting CT, Yang TM, Liu CP, Maughan WL, Chang MS, Kass DA. Effective arterial elastance as index of arterial vascular load in humans. Circulation 1992;86:513-521.
20. Metz CE. Basic principles of ROC analysis. Semin Nucl Med 1978;8:283-298.
21. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988;44:837-845.
22. La Gerche A, Heidbuchel H. Can intensive exercise harm the heart? You can get too much of a good thing. Circulation 2014;130:992-1002.
23. Lewis GD, Bossone E, Naeije R, Grunig E, Saggar R, Lancellotti P, Ghio S, Varga J, Rajagopalan S, Oudiz R, Rubenfire M. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 2013;128:1470-1479.
24. Dello Russo A, Pieroni M, Santangeli P, Bartoletti S, Casella M, Pelargonio G, Smaldone C, Bianco M, Di Biase L, Bellocci F, Zeppilli P, Fiorentini C, Natale A, Tondo C. Concealed cardiomyopathies in competitive athletes with ventricular arrhythmias and an apparently normal heart: role of cardiac electroanatomical mapping and biopsy. Heart Rhythm 2011;8:1915-1922.
25. Ector J, Ganame J, van der Merwe N, Adriaenssens B, Pison L, Willems R, Gewillig M, Heidbuchel H. Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment. Eur Heart J 2007;28:345-353.
26. Zipes DP, Ackerman MJ, Estes NA III, Grant AO, Myerburg RJ, Van Hare G. Task Force 7: arrhythmias. J Am Coll Cardiol 2005;45:1354-1363.