Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
Stadium Sports Medicine Center, University of Washington, Seattle, Washington, USA.
Br J Sports Med. 2020 Oct;54(19):1142-1148. doi: 10.1136/bjsports-2018-100529. Epub 2019 Sep 3.
Although premature ventricular beats (PVBs) in young people and athletes are usually benign, they may rarely mark underlying heart disease and risk of sudden cardiac death during sport. This review addresses the prevalence, clinical meaning and diagnostic/prognostic assessment of PVBs in the athlete. The article focuses on the characteristics of PVBs, such as the morphological pattern of the ectopic QRS and the response to exercise, which accurately stratify risk. We propose an algorithm to help the sport and exercise physician manage the athlete with PVBs. We also address (1) which athletes need more indepth investigation, including cardiac MRI to exclude an underlying pathological myocardial substrate, and (2) which athletes can remain eligible to competitive sports and who needs to be excluded.
虽然年轻人和运动员中的室性早搏（PVBs）通常是良性的，但它们很少提示潜在的心脏病，并可能增加运动时发生心源性猝死的风险。本综述讨论了运动员中 PVBs 的发生率、临床意义和诊断/预后评估。本文重点介绍了 PVBs 的特征，如异位 QRS 的形态模式和对运动的反应，这些特征可以准确地分层风险。我们提出了一种算法，帮助运动和锻炼医生管理有 PVBs 的运动员。我们还讨论了（1）哪些运动员需要更深入的检查，包括心脏 MRI 以排除潜在的病理性心肌底物，以及（2）哪些运动员可以继续参加竞技运动，哪些运动员需要被排除。
