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RV Remodeling in Olympic Athletes.

Flavio D'Ascenzi1, Cataldo Pisicchio2, Stefano Caselli2

  • 1Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.

JACC. Cardiovascular Imaging
|August 22, 2016
PubMed
Summary

Right ventricular (RV) remodeling is common in Olympic athletes, particularly in males and endurance athletes. New reference values are proposed as many athletes exceed current diagnostic criteria for arrhythmogenic RV cardiomyopathy.

Keywords:
arrhythmogenic right ventricular dysplasiaathlete’s heartexercise conditioning

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Physiology

Background:

  • Right ventricular (RV) remodeling in athletes is not fully understood.
  • Existing diagnostic criteria for arrhythmogenic RV cardiomyopathy may misclassify athletes due to physiological remodeling.

Purpose of the Study:

  • To assess the impact of sex and sport type on RV remodeling in Olympic athletes.
  • To compare observed RV dimensions with established Task Force (TF) reference values.

Main Methods:

  • Echocardiography and Doppler/tissue Doppler imaging were used to evaluate 1,009 Olympic athletes.
  • Measurements included RV outflow tract dimensions, fractional area change, and s' velocity.
  • Morphological features were also assessed.

Main Results:

  • RV remodeling was observed, with significant differences based on sex and sport type (endurance sports showed greater remodeling).
  • The 95th percentiles for RV dimensions were established (RVOT PLAX: 18 mm/m², RVOT short-axis: 20 mm/m²).
  • Up to 32% of athletes exceeded minor TF criteria for arrhythmogenic RV cardiomyopathy.

Conclusions:

  • Male sex and endurance sports are associated with greater RV remodeling in athletes.
  • The study recommends using the derived 95th percentiles as updated reference values.
  • Alternatively, only major TF criteria should be considered for diagnosing arrhythmogenic RV cardiomyopathy in athletes.