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Arrhythmogenic Cardiomyopathy and Athletes: A Dangerous Relationship

Fernando de la Guía-Galipienso1, Koldo Ugedo-Alzaga2, Gonzalo Grazioli3

  • 1The Glorieta Policlinic, Denia, Alicante, Spain; REMA-Sports Cardiology Clinic, Denia, Alicante, Spain; Cardiology Service, Hospital HCB Benidorm, Alicante, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.

Current Problems in Cardiology
|May 12, 2023
PubMed

Insights

Arrhythmogenic cardiomyopathy (ACM) affects the heart muscle, increasing risks for arrhythmias and sudden cardiac death (SCD), particularly in athletes. Exercise can worsen RV function in hereditary ACM cases.

Area of Science:

  • Cardiology
  • Genetics
  • Sports Medicine

Background:

  • Arrhythmogenic cardiomyopathy (ACM) involves fibro-adipose tissue replacing myocardium, leading to ventricular arrhythmias (VA) and sudden cardiac death (SCD).
  • ACM affects 1:2000 to 1:5000 individuals, predominantly males, with onset typically in the 2nd to 4th decade.
  • ACM is a significant cause of SCD in young individuals, especially athletes, with reported incidence in SCD victims ranging from 3% to 20%.

Purpose of the Study:

  • To review the impact of exercise on the clinical course of hereditary arrhythmogenic cardiomyopathy.
  • To discuss diagnostic tools, risk stratification methods, and therapeutic strategies for managing ACM.
  • To highlight the challenges in estimating SCD incidence due to ACM in athletic populations.

Main Methods:

  • Literature review focusing on arrhythmogenic cardiomyopathy, exercise, and sudden cardiac death.
  • Analysis of studies investigating the relationship between physical activity and ACM progression.
  • Synthesis of current knowledge on diagnostic and therapeutic approaches for ACM.

Main Results:

  • Competitive sports and high-intensity training can exacerbate cardiac events in ACM patients.
  • Exercise may worsen right ventricular (RV) function in hereditary ACM.
  • Estimating SCD incidence in athletes with ACM presents significant challenges.

Conclusions:

  • Exercise has complex implications for individuals with arrhythmogenic cardiomyopathy, potentially worsening outcomes.
  • Comprehensive management strategies including risk stratification and tailored therapies are crucial for ACM patients.
  • Further research is needed to clarify the precise role of exercise and improve management protocols for ACM, especially in athletes.

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