Athletic Training and Arrhythmogenic Right Ventricular Cardiomyopathy

Area of Science:

• Cardiology
• Sports Medicine
• Genetics

Background:

• Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited condition causing ventricular arrhythmias and sudden death, particularly in young individuals and athletes.
• Intense physical exercise is known to worsen ARVC outcomes, but can also mimic its early signs in healthy athletes.
• The overlap between athlete's heart adaptations and ARVC pathology presents diagnostic challenges.

Purpose of the Study:

• To delineate the key differences between athlete's heart and ARVC.
• To review diagnostic tools aiding in the differential diagnosis of these conditions.
• To clarify sports eligibility implications for individuals with suspected ARVC.

Main Methods:

• Literature review focusing on distinguishing features of ARVC and athlete's heart.
• Analysis of diagnostic criteria and imaging findings.
• Evaluation of exercise's role in ARVC progression and athlete cardiac adaptation.

Main Results:

• Significant overlap exists between physiological cardiac changes in athletes and pathological findings in ARVC.
• Specific imaging and electrocardiographic features can help differentiate the two conditions.
• Exercise can unmask or exacerbate ARVC, even in individuals without a clear genetic predisposition.

Conclusions:

• Differentiating ARVC from athlete's heart requires careful clinical evaluation, considering genetic history, imaging, and electrophysiological data.
• Exercise recommendations must be individualized based on the diagnosis to prevent adverse outcomes.
• Clear guidelines are needed for sports participation in athletes with potential ARVC.