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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/19883

Title: Exercise-induced right ventricular dysfunction is associated with ventricular arrhythmias in endurance athletes
Authors: La Gerche, Andre
Claessen, Guido
Dymarkowski, Steven
Voigt, Jens-Uwe
De Buck, Frederik
Vanhees, Luc
Droogne, Walter
Van Cleemput, Johan
Claus, Piet
Heidbuchel, Hein
Issue Date: 2015
Publisher: OXFORD UNIV PRESS
Citation: EUROPEAN HEART JOURNAL, 36 (30), p. 1998-2010
Abstract: Aims Intense exercise places disproportionate strain on the right ventricle (RV) which may promote pro-arrhythmic remodelling in some athletes. RV exercise imaging may enable early identification of athletes at risk of arrhythmias. Methods and results Exercise imaging was performed in 17 athletes with RV ventricular arrhythmias (EA-VAs), of which eight (47%) had an implantable cardiac defibrillator (ICD), 10 healthy endurance athletes (EAs), and seven non-athletes (NAs). Echocardiographic measures included the RV end-systolic pressure-area ratio (ESPAR), RV fractional area change (RVFAC), and systolic tricuspid annular velocity (RV S'). Cardiac magnetic resonance (CMR) measures combined with invasive measurements of pulmonary and systemic artery pressures provided left-ventricular (LV) and RV end-systolic pressure-volume ratios (SP/ESV), biventricular volumes, and ejection fraction (EF) at rest and during intense exercise. Resting measures of cardiac function were similar in all groups, as was LV function during exercise. In contrast, exercise-induced increases in RVFAC, RV S', and RVESPAR were attenuated in EA-VAs during exercise when compared with EAs and NAs (rho < 0.0001 for interaction group x workload). During exercise-CMR, decreases in RVESV and augmentation of both RVEF and RV SP/ESV were significantly less in EA-VAs relative to EAs and NAs (rho < 0.01 for the respective interactions). Receiver-operator characteristic curves demonstrated that RV exercise measures could accurately differentiate EA-VAs from subjects without arrhythmias [AUC for Delta RVESPAR = 0.96 (0.89-1.00), rho < 0.0001]. Conclusion Among athletes with normal cardiac function at rest, exercise testing reveals RV contractile dysfunction among athletes with RV arrhythmias. RV stress testing shows promise as a non-invasive means of risk-stratifying athletes.
Notes: [La Gerche, Andre; Claessen, Guido; Voigt, Jens-Uwe; Droogne, Walter; Van Cleemput, Johan] Univ Hosp Leuven, Dept Cardiovasc Med, Leuven, Belgium. [La Gerche, Andre] Baker IDI Heart & Diabet Inst, Sports Cardiol, Melbourne, Vic 3004, Australia. [La Gerche, Andre] St Vincents Hosp Melbourne, Fitzroy, Vic, Australia. [Dymarkowski, Steven] Univ Hosp Leuven, Dept Radiol, Leuven, Belgium. [De Buck, Frederik] Univ Hosp Leuven, Dept Anesthesiol, Leuven, Belgium. [Vanhees, Luc] Katholieke Univ Leuven, Dept Rehabil Sci, Leuven, Belgium. [Claus, Piet] Katholieke Univ Leuven, Dept Cardiovasc Imaging & Dynam, Leuven, Belgium. [Heidbuchel, Hein] Hasselt Univ, Hasselt, Belgium. [Heidbuchel, Hein] Jessa Hosp, Ctr Heart, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/19883
DOI: 10.1093/eurheartj/ehv202
ISI #: 000359670100017
ISSN: 0195-668X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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