Volpato Giovanni, Falanga Umberto, Cipolletta Laura, Conti Manuel Antonio, Grifoni Gino, Ciliberti Giuseppe, Urbinati Alessia, Barbarossa Alessandro, Stronati Giulia, Fogante Marco, Bergonti Marco, Catto Valentina, Guerra Federico, Giovagnoni Andrea, Dello Russo Antonio, Casella Michela, Compagnucci Paolo
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti Umberto I-Lancisi-Salesi", Marche Polytechnic University, 60100 Ancona, Italy.
Department of Radiology, University Hospital "Ospedali Riuniti Umberto I-Lancisi-Salesi", Marche Polytechnic University, 60100 Ancona, Italy.
Medicina (Kaunas). 2021 Mar 25;57(4):308. doi: 10.3390/medicina57040308.
The prediction and prevention of sudden cardiac death is the philosopher's stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competitive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.
心脏性猝死的预测与预防是临床心脏电生理学的点金石。运动可能触发致命性心律失常，因此，及时识别有风险的运动员并仔细评估其参与竞技和休闲体育活动的适宜性至关重要。晕厥或心悸病史、室性早搏或更复杂心律失常的存在、左心室收缩功能降低，或已知或家族性心脏病的存在，均应促使进行二级检查的全面评估。在这方面，心脏磁共振成像和电生理研究在诊断检查中发挥着重要作用。遗传学在心肌病和离子通道病中的作用日益增加，必须对基因型阳性/表型阴性的受试者进行仔细评估。除了在某些心肌病中作为致命性心律失常的触发因素外，运动在疾病本身的进展中也起作用，尤其是在致心律失常性右心室心肌病的情况下。在本文中，我们回顾了欧洲关于心血管疾病患者运动心脏病学的最新指南，重点关注心律失常风险分层以及心肌病和离子通道病的管理。
