Segreti Andrea, Celeski Mihail, Monticelli Luigi Maria, Perillo Alfonso, Crispino Simone Pasquale, Di Gioia Giuseppe, Cammalleri Valeria, Fossati Chiara, Mega Simona, Papalia Rocco, Pigozzi Fabio, Ussia Gian Paolo, Grigioni Francesco
Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, 00135 Roma, Italy.
J Clin Med. 2023 May 19;12(10):3562. doi: 10.3390/jcm12103562.
Observing mitral or tricuspid valve disease in an athlete raises many considerations for the clinician. Initially, the etiology must be clarified, with causes differing depending on whether the athlete is young or a master. Notably, vigorous training in competitive athletes leads to a constellation of structural and functional adaptations involving cardiac chambers and atrioventricular valve systems. In addition, a proper evaluation of the athlete with valve disease is necessary to evaluate the eligibility for competitive sports and identify those requiring more follow-up. Indeed, some valve pathologies are associated with an increased risk of severe arrhythmias and potentially sudden cardiac death. Traditional and advanced imaging modalities help clarify clinical doubts, allowing essential information about the athlete's physiology and differentiating between primary valve diseases from those secondary to training-related cardiac adaptations. Remarkably, another application of multimodality imaging is evaluating athletes with valve diseases during exercise to reproduce the sport setting and better characterize the etiology and valve defect mechanism. This review aims to analyze the possible causes of atrioventricular valve diseases in athletes, focusing primarily on imaging applications in diagnosis and risk stratification.
在运动员中发现二尖瓣或三尖瓣疾病会引发临床医生的诸多思考。首先，必须明确病因，病因因运动员是年轻选手还是成年选手而有所不同。值得注意的是，竞技运动员的高强度训练会导致一系列涉及心腔和房室瓣系统的结构和功能适应性变化。此外，对患有瓣膜疾病的运动员进行恰当评估对于评估其参加竞技运动的资格以及识别那些需要更多随访的运动员是必要的。确实，一些瓣膜病变与严重心律失常风险增加以及潜在的心源性猝死有关。传统和先进的成像方式有助于消除临床疑虑，提供有关运动员生理状况的重要信息，并区分原发性瓣膜疾病与继发于训练相关心脏适应性变化的疾病。值得注意的是，多模态成像的另一个应用是在运动期间评估患有瓣膜疾病的运动员，以重现运动场景并更好地确定病因和瓣膜缺陷机制。本综述旨在分析运动员房室瓣疾病的可能病因，主要关注成像在诊断和风险分层中的应用。
