University Hospital Leipzig Department for Internal Medicine Neurology and Dermatology, Department of Cardiology, University Hospital Leipzig, Leipzig, Sachsen, Germany.
RasenBallsport Leipzig GmbH, Leipzig, Germany.
Int J Cardiovasc Imaging. 2020 Oct;36(10):1855-1885. doi: 10.1007/s10554-020-01899-1. Epub 2020 May 27.
Exclusion of cardiac abnormalities should be performed at the beginning of the athlete's career. Myocarditis, right ventricular remodeling and coronary anomalies are well-known causes of life-threatening events of athletes, major cardiovascular events and sudden cardiac death. The feasibility of an extended comprehensive echocardiographic protocol for the detection of structural cardiac abnormalities in athletes should be tested. This standardized protocol of transthoracic echocardiography includes two- and three-dimensional imaging, tissue Doppler imaging, and coronary artery scanning. Post processing was performed for deformation analysis of all compounds including layer strain. During 2017 and 2018, the feasibility of successful image acquisition and post processing analysis was retrospectively analyzed in 54 male elite athletes. In addition, noticeable findings inside the analyzed cohort are described. The extended image acquisition and data analyzing was feasible from 74 to 100%, depending on the used modalities. One case of myocarditis was detected in the present cohort. Coronary anomalies were not found. Right ventricular size and function were within normal ranges. Isovolumetric right ventricular relaxation time showed significant regional differences. One case of hypertrophic cardiomyopathy and two subjects with bicuspid aortic valves were found. Due to the excessive cardiac stress in highly competitive sports, high-quality and precise screening modalities are necessary, especially with respect to acquired cardiac diseases like acute myocarditis and pathological changes of left ventricular and RV geometry. The documented feasibility of the proposed extended protocol underlines the suitability to detect distinct morphological and functional cardiac alterations and documents the potential added value of a comprehensive echocardiography.
在运动员职业生涯的早期就应排除心脏异常。心肌炎、右心室重构和冠状动脉异常是运动员发生危及生命的事件、重大心血管事件和心源性猝死的已知原因。应检验用于检测运动员结构性心脏异常的扩展综合超声心动图方案的可行性。该经胸超声心动图标准化方案包括二维和三维成像、组织多普勒成像和冠状动脉扫描。对所有复合层的应变进行变形分析的后处理。在 2017 年至 2018 年期间，回顾性分析了 54 名男性精英运动员成功进行图像采集和后处理分析的可行性。此外，还描述了分析队列中的显著发现。根据所使用的模态，扩展的图像采集和数据分析的可行性为 74%至 100%。本队列中检测到 1 例心肌炎。未发现冠状动脉异常。右心室大小和功能均在正常范围内。等容右心室舒张时间显示出明显的区域性差异。发现 1 例肥厚型心肌病和 2 例二叶主动脉瓣。由于在高度竞争的运动中对心脏的过度压力，需要高质量和精确的筛查方式，尤其是对于急性心肌炎和左心室和 RV 几何形状的病理性改变等获得性心脏病。所记录的提出的扩展方案的可行性强调了检测明显形态和功能心脏改变的适用性，并证明了全面超声心动图的潜在附加价值。
