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The Right Heart: Acute and Chronic Issues.

Timothy W Churchill1, Aaron L Baggish2

  • 1Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA, 02114, USA.

Current Treatment Options in Cardiovascular Medicine
|September 27, 2017
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Summary

Exercise can cause changes in the right ventricle (RV), known as cardiac remodeling. While often benign in athletes, intense exercise may lead to RV issues, requiring careful clinical evaluation.

Keywords:
ARVCAthlete’s heartExercise-induced cardiac remodelingRight ventricleSports cardiology

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Area of Science:

  • Cardiovascular Physiology
  • Sports Cardiology
  • Cardiac Imaging

Background:

  • Cardiovascular remodeling is a known response to exercise, with prior focus on the left ventricle.
  • Right ventricle (RV) remodeling is gaining attention, with documented changes after exercise.
  • The hypothesis that intense exercise may cause pathological RV changes, including fibrosis and arrhythmia, is under investigation.

Purpose of the Study:

  • To review the current understanding of right ventricle (RV) adaptation to exercise.
  • To discuss the clinical implications of exercise-induced RV remodeling.
  • To provide guidance on evaluating RV dilation in athletes.

Main Methods:

  • Literature review of studies on exercise and cardiac remodeling.
  • Analysis of morphologic and functional changes in the RV.
  • Discussion of clinical case considerations for RV dilation in athletes.

Main Results:

  • RV dilation is frequently observed in endurance athletes.
  • Asymptomatic RV dilation without significant functional decline or other abnormalities is typically benign.
  • Symptomatic RV dilation or dilation in athletes with a family history of genetic heart disease warrants comprehensive cardiovascular assessment.

Conclusions:

  • Exercise-induced RV remodeling is a complex phenomenon with potential for both adaptive and pathological changes.
  • Clinical evaluation of RV dilation in athletes should be individualized based on symptoms, family history, and functional status.
  • Further research is needed to clarify the long-term consequences of intense exercise on RV health.