Carbone Andreina, D'Andrea Antonello, Riegler Lucia, Scarafile Raffaella, Pezzullo Enrica, Martone Francesca, America Raffaella, Liccardo Biagio, Galderisi Maurizio, Bossone Eduardo, Calabrò Raffaele
Andreina Carbone, Antonello D'Andrea, Lucia Riegler, Raffaella Scarafile, Enrica Pezzullo, Francesca Martone, Raffaella America, Biagio Liccardo, Raffaele Calabrò, Chair of Cardiology, Second University of Naples, Monaldi Hospital, AORN Ospedali dei Colli, 80131 Naples, Italy.
World J Cardiol. 2017 Jun 26;9(6):470-480. doi: 10.4330/wjc.v9.i6.470.
Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete's blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete's heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.
剧烈运动可能会导致心脏重塑，通过增加肌肉质量来代偿血压或血容量的增加。心脏变化不仅涉及左心室，还包括所有心腔。运动员的生理性心脏重塑与正常或增强的心脏功能相关，但最近的研究记录了剧烈运动期间左心室功能的下降以及运动员血液中具有不确定意义的心肌坏死标志物的释放。此外，心脏重塑可能使运动员易患心脏病并导致电重塑，引发心律失常。运动员心脏是一种生理状况，不需要特殊治疗。在某些情况下，区分生理性适应与病理性状况（如肥厚型心肌病、右心室致心律失常性发育异常和心肌致密化不全）很重要，因为这些状况有更高的心脏性猝死风险。此外，一些药物和提高成绩的药物会导致结构改变和心律失常，因此应排除使用。
