Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy.
Sports Medicine Centre, Colle di Val d'Elsa, Siena, Italy.
Int J Cardiol. 2021 May 1;330:59-64. doi: 10.1016/j.ijcard.2021.02.021. Epub 2021 Feb 12.
Premature ventricular beats (PVBs) are not an unusual finding and their interpretation is sometimes challenging. Unfortunately, few data on the characteristics of PVBs that correlate with the risk of an underlying heart disease are available in athletes.
The aim of this prospective study was to investigate the diagnostic and prognostic value of PVBs characteristics in competitive athletes.
From a cohort of 1751 athletes evaluated at our sports cardiology centre, we enrolled 112 competitive athletes <40 years of age (mean age 21 ± 10 years) and with no known heart disease referred for PVBs. All athletes underwent physical examination, ECG, 12‑lead ambulatory ECG monitoring, exercise testing, and echocardiography. Further investigations including cardiac magnetic resonance were performed for abnormal findings at first-line evaluation or for specific PVBs characteristics.
The majority (79%) of athletes exhibited monomorphic PVBs with a fascicular or infundibular pattern (common morphologies). A definitive diagnosis of cardiac disease was reached in 26 athletes (23% of the entire population) and correlated with uncommon PVBs morphology (p < 0.001) and arrhythmia complexity (p < 0.001). The number of PVBs/24-h was lower in athletes with cardiac disease than in those with normal heart (p < 0.05). During the follow-up a spontaneous reduction of PVBs and no adverse events were observed.
Infundibular and fascicular PVBs were the most common morphologies observed in athletes with ventricular arrhythmias referred for cardiological evaluation. Morphology and complexity of PVBs, but not their number, predicted the probability of an underlying disease. Athletes with PVBs and negative investigation showed a good prognosis.
室性期前收缩（PVCs）并不罕见，其解读有时具有挑战性。不幸的是，关于与潜在心脏病相关的 PVC 特征的数据在运动员中很少。
本前瞻性研究旨在探讨 PVC 特征在竞技运动员中的诊断和预后价值。
我们从在我们的运动心脏病中心评估的 1751 名运动员队列中，纳入了 112 名年龄<40 岁（平均年龄 21 ± 10 岁）且无已知心脏病的竞技运动员，因 PVC 就诊。所有运动员均接受了体格检查、心电图、12 导联动态心电图监测、运动试验和超声心动图检查。对于一线评估中的异常发现或特定 PVC 特征，进一步进行了包括心脏磁共振在内的检查。
大多数（79%）运动员表现出形态单一的 PVC，呈束支或漏斗状（常见形态）。26 名运动员（整个人群的 23%）确诊为心脏病，与不常见的 PVC 形态（p<0.001）和心律失常复杂性（p<0.001）相关。与心脏正常的运动员相比，患有心脏病的运动员 24 小时内 PVC 数量较少（p<0.05）。在随访期间，观察到 PVC 自发减少且无不良事件。
在因心律失常而接受心脏病评估的运动员中，漏斗状和束支 PVC 是最常见的形态。PVC 的形态和复杂性，但不是数量，预测了潜在疾病的可能性。有 PVC 且检查结果为阴性的运动员预后良好。
