PHENOMENON OF ATHLETE’S HEART, POSITIVE PHYSIOLOGICAL ADAPTATION TO EXERCISE: WHEN AND HOW?

2020 ◽  
Vol 9 ◽  
pp. 103-108
Author(s):  
Jasmina Pluncevic Gligoroska
Keyword(s):  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Athlete's Heart ◽  
Adaptation To Exercise

Cardiovascular adaptation to exercise and sport: (according to type of sport, gender, and ethnicity)

ESC CardioMed ◽  
2018 ◽  
pp. 2913-2916
Author(s):  
Michael Papadakis ◽  
Sanjay Sharma
Keyword(s):  
Female Athletes ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Endurance Athletes ◽  
Physiological Adaptation ◽  
Imaging Studies ◽  
Eccentric Hypertrophy ◽  
Athlete's Heart ◽  
Adaptation To Exercise

‘Athlete’s heart’ is associated with several structural and electrophysiological adaptations, which are reflected on the 12-lead electrocardiogram (ECG) and imaging studies. Most studies investigating cardiac remodelling in athletes are based on cohorts of white, adult, male athletes competing in the most popular sports. Evidence suggests, however, that sporting discipline and the athlete’s gender and ethnicity are important determinants of cardiovascular adaptation to exercise. Athletes competing in endurance sports demonstrate more pronounced adaptations in comparison to athletes performing static or resistance training. The ECG of endurance athletes is more likely to demonstrate repolarization anomalies in the anterior leads and ventricular dilatation on imaging studies, causing considerable overlap with arrhythmogenic right ventricular cardiomyopathy and dilated cardiomyopathy. Female athletes exhibit less pronounced adaptations compared to males, in terms of the prevalence of ECG changes and absolute cardiac dimensions. Importantly, female endurance athletes are more likely to demonstrate eccentric hypertrophy compared to males, suggesting that concentric remodelling or hypertrophy in female endurance athletes is unlikely to be the consequence of physiological adaptation to training. The most pronounced paradigm of ethnically distinct cardiovascular adaptation to exercise stems from black athletes, who exhibit a significantly higher prevalence of repolarization anomalies and left ventricular hypertrophy compared to white athletes, making the differentiation between athlete’s heart and hypertrophic cardiomyopathy challenging in this ethnic group.

Cardiovascular adaptation to exercise and sport: (according to type of sport, gender, and ethnicity)

ESC CardioMed ◽  
2018 ◽  
pp. 2913-2916
Author(s):  
Michael Papadakis ◽  
Sanjay Sharma
Keyword(s):  
Female Athletes ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Endurance Athletes ◽  
Physiological Adaptation ◽  
Imaging Studies ◽  
Eccentric Hypertrophy ◽  
Athlete's Heart ◽  
Adaptation To Exercise

‘Athlete’s heart’ is associated with several structural and electrophysiological adaptations, which are reflected on the 12-lead electrocardiogram (ECG) and imaging studies. Most studies investigating cardiac remodelling in athletes are based on cohorts of white, adult, male athletes competing in the most popular sports. Evidence suggests, however, that sporting discipline and the athlete’s gender and ethnicity are important determinants of cardiovascular adaptation to exercise. Athletes competing in endurance sports demonstrate more pronounced adaptations in comparison to athletes performing static or resistance training. The ECG of endurance athletes is more likely to demonstrate repolarization anomalies in the anterior leads and ventricular dilatation on imaging studies, causing considerable overlap with arrhythmogenic right ventricular cardiomyopathy and dilated cardiomyopathy. Female athletes exhibit less pronounced adaptations compared to males, in terms of the prevalence of ECG changes and absolute cardiac dimensions. Importantly, female endurance athletes are more likely to demonstrate eccentric hypertrophy compared to males, suggesting that concentric remodelling or hypertrophy in female endurance athletes is unlikely to be the consequence of physiological adaptation to training. The most pronounced paradigm of ethnically distinct cardiovascular adaptation to exercise stems from black athletes, who exhibit a significantly higher prevalence of repolarization anomalies and left ventricular hypertrophy compared to white athletes, making the differentiation between athlete’s heart and hypertrophic cardiomyopathy challenging in this ethnic group.

Athlete's heart in the practice of a family doctor

2020 ◽  
pp. 43-50
Author(s):  
Margarita Ustinova ◽  
Vsevolod Skvortsov
Keyword(s):  
Sports Medicine ◽  
Family Doctor ◽  
Professional Sports ◽  
Cardiovascular Complications ◽  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Low Intensity ◽  
Adaptation Mechanisms ◽  
Common Causes ◽  
Athlete's Heart

The term “athlete's heart” was first described in 1899 by S. Henschen. This concept refers to the activation of physiological adaptation mechanisms and structural remodeling of the heart in sports medicine. The article presents the basic concepts used in sports medicine, signs of an "athlete's heart", physiological manifestations and pathological abnormalities that require attention from a doctor are highlighted. The most common causes of cardiovascular complications in professional sports are indicated. Today, the fact that physical activity of low intensity favorably affects the state of the cardiovascular system causes no doubt, while overloads or their absence of any loads are of no use.

Clinical assessment of the athlete’s heart: normal and abnormal ECGs in athletes

ESC CardioMed ◽  
2018 ◽  
pp. 2916-2920
Author(s):  
Alessandro Zorzi ◽  
Domenico Corrado
Keyword(s):  
Cardiovascular Disease ◽  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Ecg Changes ◽  
Increased Risk ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities ◽  
Work Up ◽  
And Training ◽  
Athlete's Heart

The electrocardiogram (ECG) of trained athletes may show changes that represent the consequence of the heart’s adaptation to physical exercise (‘athlete’s heart’) such as enlarged cardiac chamber size and increased vagal tone. Physiological ECG changes must be differentiated from the ECG abnormalities secondary to an underlying cardiovascular disease that may be responsible for sudden cardiac death during exercise. The ECG changes of athletes are classified according to their prevalence, relation to exercise training, association with an increased risk of cardiovascular disease, and the need for further investigations: common ECG changes should be considered as a benign sign of physiological adaptation to exercise and do not require additional evaluation; on the other hand, in case of uncommon and training-unrelated abnormalities, which may be associated with an underlying cardiovascular disease, further work-up should be performed. This chapter reviews the abnormalities that may be found in an athlete’s ECG and proposes criteria for interpretation of such changes as normal or abnormal findings.

Overlap ECG patterns in the athlete’s heart and cardiomyopathies

2019 ◽  
pp. 77-84
Author(s):  
Harshil Dhutia ◽  
Michael Papadakis
Keyword(s):  
Clinical Practice ◽  
Cardiac Death ◽  
Physiological Adaptation ◽  
Young Athletes ◽  
Comprehensive Overview ◽  
Practical Algorithms ◽  
Surface Ecg ◽  
Erroneous Diagnosis ◽  
Athlete's Heart ◽  
Adaptation To Exercise

Physiological adaptation to exercise manifests on the surface ECG with phenotypes that occasionally overlap with those present in patients with cardiomyopathy, one of the leading causes of exercise-related cardiac death in young athletes. In the era of pre-participation screening, differentiation of physiology from pathology is crucial given the potential consequences of an erroneous diagnosis or false reassurance. This chapter provides a comprehensive overview of the ECG anomalies that may cause diagnostic dilemmas in clinical practice, delineates the size of the ‘ECG grey zones’, and provides practical algorithms for ascertaining which ECG phenotypes require further evaluation.

Athlete’s heart and prevention of sudden cardiac death in athletes

2018 ◽  
pp. 387-396
Author(s):  
Jürgen Scharhag ◽  
Katherine C Wu ◽  
Philipp Bohm ◽  
Cristina Basso
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
High Sensitivity ◽  
Athlete’S Heart ◽  
Endurance Athletes ◽  
Physiological Adaptation ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Exercise Induced ◽  
Athlete's Heart

Athlete’s heart is a physiological adaptation to regular exercise. It is characterized by harmonic, eccentric dilatation of all cardiac chambers, typically seen in endurance athletes and athletes who engage in disciplines with high volumes of endurance exercise. In contrast to eccentric hypertrophy of the heart in endurance athletes, which has been demonstrated in echocardiographic and cardiovascular magnetic resonance (CMR) studies, the early hypothesis of concentric hypertrophy in strength athletes has not been confirmed by most of the newer echocardiographic and CMR studies. Because CMR offers high sensitivity and specificity to differentiate between physiological and pathological cardiac adaptations, CMR has become an important tool to examine athlete’s heart and to evaluate athletes’ sports eligibility. Therefore, modern CMR plays an important role in the scientific and clinical assessment of exercise-induced cardiac adaptations and the prevention of sudden cardiac death in athletes.

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