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Running the Risk: Exercise and Arrhythmogenic Cardiomyopathy
Lauren Eberly1,2,3, Lohit Garg1, Mahesh Vidula1
1Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Intense exercise can worsen arrhythmogenic right ventricular cardiomyopathy (ARVC) by increasing disease onset, penetrance, and progression. Individuals with or at risk for ARVC should avoid high-intensity and endurance activities to prevent adverse outcomes like sudden cardiac death.
Area of Science:
- Cardiology
- Sports Medicine
- Genetics
Background:
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic heart condition.
- Exercise can influence ARVC onset, diagnosis, progression, and severity.
- Understanding the exercise-ARVC relationship is crucial for management.
Purpose of the Study:
- To review the current knowledge on exercise's impact on ARVC.
- To inform clinical recommendations for physical activity in ARVC patients.
Main Methods:
- Literature review of studies on exercise and ARVC.
- Analysis of diagnostic criteria and imaging modalities.
- Evaluation of clinical outcomes related to exercise participation.
Main Results:
- Distinguishing athletic heart remodeling from ARVC requires specific diagnostic tools.
- Endurance and competitive sports increase adverse outcomes in ARVC.
- Exercise intensity shows a dose-dependent relationship with ARVC penetrance and progression.
Conclusions:
- High-intensity exercise accelerates ARVC onset, penetrance, and progression.
- Exercise amount and intensity correlate with arrhythmias and biventricular dysfunction.
- Individuals with ARVC should undergo risk stratification and avoid competitive/high-intensity exercise to prevent sudden cardiac death.
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