Mascia Giuseppe, Arbelo Elena, Porto Italo, Brugada Ramon, Brugada Josep
Department of Internal Medicine (DIMI) Clinic of Cardiovascular Diseases, University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Italian IRCCS Cardiovascular Network, Genoa, Italy.
J Cardiovasc Electrophysiol. 2020 Jul;31(7):1836-1843. doi: 10.1111/jce.14526. Epub 2020 May 11.
Intense exercise-induced right ventricular remodeling is a potential adaptation of cardiac function and structure. The features of the remodeling may overlap with those of a very early form of arrhythmogenic right ventricular cardiomyopathy (ARVC): at this early stage, it could be difficult to discriminate ARVC, from exercise-induced cardiac adaptation that may develop in normal individuals. The purpose of this paper is to discuss which exercise-induced remodeling may be a pathological or a physiological finding. A complete evaluation may be required to identify the pathological features of ARVC that would include potential risk of sudden cardiac death during sport or, to avoid the false diagnosis of ARVC. The most recent expert assessment of arrhythmogenic cardiomyopathy focuses on endurance athletes presenting with clinical features indistinguishable from ARVC.
剧烈运动诱发的右心室重塑是心脏功能和结构的一种潜在适应性变化。这种重塑的特征可能与致心律失常性右心室心肌病（ARVC）非常早期形式的特征重叠：在这个早期阶段，可能难以将ARVC与正常个体中可能发生的运动诱发的心脏适应性变化区分开来。本文的目的是讨论哪些运动诱发的重塑可能是病理性或生理性发现。可能需要进行全面评估以识别ARVC的病理特征，这包括运动期间心脏性猝死的潜在风险，或者避免对ARVC的误诊。最近对致心律失常性心肌病的专家评估集中在具有与ARVC难以区分的临床特征的耐力运动员身上。
