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Some Topical Aspects of the "Sports Heart" Problem (Literature Review). Part I
Alexander V Korotkikh1, Julia V Vakhnenko1, Maksim G Kashtanov2
1Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russia.
Insights
Elite athletes may experience pathological heart remodeling, detectable via echocardiography. Identifying these changes is crucial for preventing sudden cardiac death and guiding training eligibility.
Area of Science:
- Sports Cardiology
- Cardiovascular Physiology
- Exercise Medicine
Background:
- Elite athletes' cardiovascular systems face significant overload, leading to morphological and functional changes.
- Some athletes develop nonadaptive (pathological) cardiac remodeling, distinct from normal training adaptations.
- This pathological remodeling can manifest as cardiac hypertrophy, dilatation, or hypertension, impacting athletic participation.
Purpose of the Study:
- To review expert consensus on criteria for pathological cardiac remodeling in athletes.
- To highlight the role of echocardiography in diagnosing these cardiac changes.
- To discuss the implications for athlete health, including sudden cardiac death risk and training eligibility.
Main Methods:
- Review of authoritative specialist views in sports medicine.
- Analysis of echocardiography indicators for pathological remodeling.
- Discussion of normal physiological responses versus pathological changes in blood pressure and cardiac structure.
- Examination of causes of sudden cardiac death in athletes.
- Exploration of genetic selection in sports.
Main Results:
- Echocardiography provides objective features for identifying pathological cardiac remodeling.
- Deviations from the norm (e.g., pronounced hypertrophy, hypertension) can indicate myocardial dysfunction.
- Certain structural and electrical abnormalities are predictors of severe complications, including sudden cardiac death.
- Distinguishing normal adaptation from pathological remodeling is critical for athlete management.
Conclusions:
- Echocardiography is vital for diagnosing pathological cardiac remodeling in athletes.
- Identifying nonadaptive changes is essential for preventing adverse cardiovascular events.
- Clear criteria are needed to guide decisions on athlete training and competition admission.
- Understanding pathological remodeling impacts the future of sports medicine and athlete selection.
Abstract:
The cardiovascular system experiences the greatest overload, morphological and functional changes inelite sport, which in a number of athletes undergoes nonadaptive (pathological) remodeling both functional and morphological. The latter is characterized by certain objective features, including echocardiography indicators, which occupies a special place in sports cardiology. Structural and functional changes beyond the generally accepted norm (pronounced cardiac hypertrophy or dilatation, high arterial hypertension) can be associated with systolic or diastolic myocardial dysfunction and impaired electrical properties, some of which are predictors of severe complications up to sudden cardiac death and pose a serious problem regarding the admission of athletes to training and competition. This review is devoted to summarizing the views of authoritative specialists in the field of sports medicine on the criteria of pathological remodeling of the heart muscle, the role of echocardiography in its diagnosis, the discussion of the limits of the norm of response to blood pressure load, the analysis of the main causes of sudden cardiac death of athletes, the realities and prospects of genetic selection in sports.
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