D'Ascenzi Flavio, Zorzi Alessandro, Alvino Federico, Bonifazi Marco, Mondillo Sergio, Corrado Domenico
Cardiologia, Dipartimento di Biotecnologie Mediche, Università degli Studi, Siena.
Dipartimento di Scienze Cardiache, Toraciche, Vascolari e di Sanità Pubblica, Università degli Studi, Padova.
G Ital Cardiol (Rome). 2019 Apr;20(4):229-241. doi: 10.1714/3126.31076.
Adolescents and adults with cardiovascular disease who are engaged in sports activity have an increased risk of sudden cardiac death (SCD) related to the sports practice that acts as a trigger for life-threatening ventricular arrhythmias. Premature ventricular beats (PVBs) detected in athletes at the time of pre-participation screening may be a sign of heart disease at risk of SCD but are also found in athletes without cardiovascular abnormalities. Thus, the interpretation of PVBs could represent a clinical dilemma. However, while some characteristics of PVBs can be considered common and benign, others occur uncommonly in the athletic population and raise the suspicion of underlying cardiovascular disease. This review discusses the prevalence and the clinical significance of PVBs in the athlete, with a focus on exercise-induced PVBs, on the analysis of PVB's morphology at 12-lead ECG, and on the morphological substrates identified by imaging techniques. The implications on eligibility for competitive sports participation are also discussed, according to the relevance of PVBs detection for disqualifying athletes from competitions.
患有心血管疾病的青少年和成年人在进行体育活动时,因运动引发危及生命的室性心律失常而导致心源性猝死(SCD)的风险增加。在运动员参加赛前筛查时检测到的室性早搏(PVB)可能是有SCD风险的心脏病迹象,但也见于无心血管异常的运动员。因此,对PVB的解读可能是一个临床难题。然而,虽然PVB的一些特征可被视为常见且良性的,但其他特征在运动员群体中较少见,并引发对潜在心血管疾病的怀疑。本综述讨论了运动员中PVB的患病率及临床意义,重点关注运动诱发的PVB、12导联心电图上PVB形态的分析以及通过成像技术确定的形态学基质。还根据PVB检测对运动员取消比赛资格的相关性,讨论了其对竞技体育参赛资格的影响。