青少年足球运动员右心室评估。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Echo Research and Practice Pub Date : 2024-02-29 DOI:10.1186/s44156-023-00039-4
D X Augustine, J Willis, S Sivalokanathan, C Wild, A Sharma, A Zaidi, K Pearce, G Stuart, M Papadakis, S Sharma, A Malhotra
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引用次数: 0

摘要

导言:运动训练可导致右心室的电学和结构变化,这些变化可能会模仿致心律失常性右心室心肌病(ARVC)的表型特征,如 T 波倒置和右心扩张。错误的解释可能会造成各种后果,包括对易患心律失常的运动员的错误保证,以及对健康人不必要的运动限制。本研究的主要目的是为不同种族的青少年足球运动员定义正常的 RV 尺寸参考范围。次要目的包括分析该青少年群体与 ARVC 标准之间的潜在重叠,并与正常成人范围进行比较:分析了 1087 名参加强制性心脏筛查的 13 至 18 岁(平均年龄为 16.0 ± 0.5 岁)足球运动员的心电图(ECG)和超声心动图数据。种族分为白人(n = 826)、黑人(非洲/加勒比海人;n = 166)和混血儿(父母一方为白人,一方为黑人;n = 95)。队列中有 3.3% 的人患有 T 波倒置主要标准的致心律失常性右室心肌病。与混血足球运动员(6.3%)或白人足球运动员(1%)相比,黑人足球运动员(12%)的发病率更高:多达四分之一的青少年足球运动员的右心尺寸超过了公认的成人范围。结构适应性与前T波倒置可能会引起对ARVC的担忧,因此需要在专家的指导下进行评估。
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Right ventricular assessment of the adolescent footballer's heart.

Introduction: Athletic training can result in electrical and structural changes of the right ventricle that may mimic phenotypical features of arrhythmogenic right ventricular cardiomyopathy (ARVC), such as T-wave inversion and right heart dilatation. An erroneous interpretation may have consequences ranging from false reassurance in an athlete vulnerable to cardiac arrhythmias, to unnecessary sports restriction in a healthy individual. The primary aim of this study was to define normal RV dimension reference ranges for academy adolescent footballers of different ethnicities. Secondary aims include analysis of potential overlap between this adolescent group with ARVC criteria and comparison with normal adult ranges.

Results: Electrocardiographic (ECG) and echocardiographic data of 1087 academy male footballers aged between 13 and 18 years old (mean age 16.0 ± 0.5 years), attending mandatory cardiac screening were analysed. Ethnicity was categorised as white (n = 826), black (African/Caribbean; n = 166) and mixed-race (one parent white and one parent black; n = 95). Arrhythmogenic right ventricular cardiomyopathy major criteria for T-wave inversion was seen in 3.3% of the cohort. This was more prevalent in black footballers (12%) when compared to mixed race footballers (6.3%) or white footballers (1%), P < 0.05. Up to 59% of the cohort exceeded adult reference ranges for some of the right ventricular parameters, although values were similar to those seen in adult footballers. There were no differences in right ventricular dimensions between ethnicities. In particular, the right ventricular outflow tract diameter would fulfil major criteria for ARVC dimension in 12% of footballers. Overall, 0.2% of the cohort would fulfil diagnosis for 'definite' arrhythmogenic right ventricular cardiomyopathy and 2.2% would fulfil diagnosis for 'borderline' arrhythmogenic right ventricular cardiomyopathy for RV dimensions and ECG changes. This was seen more frequently in black footballers (9.9%) than mixed race footballers (3.9%) or white footballer (0.6%), P < 0.05. Among athletes meeting definite or borderline arrhythmogenic right ventricular cardiomyopathy criteria, no cardiomyopathy was identified after comprehensive clinical assessment, including with cardiac magnetic resonance imaging, exercise testing, ambulatory electrocardiograms and familial evaluation.

Conclusion: Right heart sizes in excess of accepted adult ranges occurred in as many as one in two adolescent footballers. Structural adaptations in conjunction with anterior T-wave inversion may raise concern for ARVC, highlighting the need for evaluation in expert settings.

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来源期刊
Echo Research and Practice
Echo Research and Practice CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.70
自引率
12.70%
发文量
11
审稿时长
8 weeks
期刊介绍: Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
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