Coelho Sara Alcobia, Silva Filipe, Silva Joana, António Natália
ACeS Baixo Mondego, USF Mondego, Coimbra, Portugal.
Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Int J Sports Med. 2019 May;40(5):295-304. doi: 10.1055/a-0750-5848. Epub 2019 Mar 13.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by ventricular arrhythmias and sudden death in the young and in competitive athletes. The deleterious role of exercise in the natural history of ARVC is clear. Even in the absence of a demonstrated arrhythmogenic substrate, family history or mutations of ARVC, intense physical exercise may in some individuals lead to the development of right ventricular dysfunction and arrhythmogenicity. This led to question the benignity of some adaptive features of the athlete's heart. In fact, there is an overlap between typical aspects of the athlete's heart and pathological changes described in ARVC, being challenging to distinguish the two conditions. The aim of this review is to highlight the aspects that help to distinguish between athlete's heart and ARVC, to review the major findings on exams helping in the differential diagnosis and to determine the implications on eligibility for leisure and competitive sports.
致心律失常性右室心肌病（ARVC）是一种遗传性心肌病，其特征为年轻人和竞技运动员发生室性心律失常和猝死。运动在ARVC自然病程中的有害作用是明确的。即使在没有已证实的致心律失常基质、ARVC家族史或突变的情况下，剧烈体育锻炼在某些个体中也可能导致右室功能障碍和致心律失常性的发展。这使得人们对运动员心脏某些适应性特征的良性性质产生质疑。事实上，运动员心脏的典型特征与ARVC中描述的病理变化存在重叠，难以区分这两种情况。本综述的目的是强调有助于区分运动员心脏和ARVC的方面，回顾有助于鉴别诊断的检查的主要发现，并确定对休闲和竞技运动资格的影响。
