Tsampasian Vasiliki, Androulakis Emmanuel, Catumbela Ricardo, Gati Sabiha, Papadakis Michael, Vassiliou Vassilios S
Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7UG, UK.
Norfolk and Norwich University Hospital, Norwich NR4 7TJ, UK.
J Clin Med. 2024 Jun 3;13(11):3290. doi: 10.3390/jcm13113290.
Competitive sports and high-level athletic training result in a constellation of changes in the myocardium that comprise the 'athlete's heart'. With the spread of the COVID-19 pandemic, there have been concerns whether elite athletes would be at higher risk of myocardial involvement after infection with the virus. This systematic review and meta-analysis evaluated the prevalence of abnormal cardiovascular magnetic resonance (CMR) findings in elite athletes recovered from COVID-19 infection. The PubMed, Cochrane and Web of Science databases were systematically search from inception to 15 November 2023. The primary endpoint was the prevalence of abnormal cardiovascular magnetic resonance findings, including the pathological presence of late gadolinium enhancement (LGE), abnormal T1 and T2 values and pericardial enhancement, in athletes who had recovered from COVID-19 infection. Out of 3890 records, 18 studies with a total of 4446 athletes were included in the meta-analysis. The pooled prevalence of pathological LGE in athletes recovered from COVID-19 was 2.0% (95% CI 0.9% to 4.4%, 90%). The prevalence of elevated T1 and T2 values was 1.2% (95% CI 0.4% to 3.6%, 87%) and 1.2% (95% CI 0.4% to 3.7%, 89%), respectively, and the pooled prevalence of pericardial involvement post COVID-19 infection was 1.1% (95% CI 0.5% to 2.5%, 85%). The prevalence of all abnormal CMR findings was much higher among those who had a clinical indication of CMR. Among athletes who have recently recovered from COVID-19 infection, there is a low prevalence of abnormal CMR findings. However, the prevalence is much higher among athletes with symptoms and/or abnormal initial cardiac screening. Further studies and longer follow up are needed to evaluate the clinical relevance of these findings and to ascertain if they are associated with adverse events.
竞技体育和高水平运动训练会导致心肌出现一系列变化，构成“运动员心脏”。随着新冠疫情的蔓延，人们担心精英运动员在感染该病毒后心肌受累的风险是否更高。本系统评价和荟萃分析评估了从新冠感染中康复的精英运动员心血管磁共振（CMR）检查异常结果的发生率。从数据库建立至2023年11月15日，对PubMed、Cochrane和科学网数据库进行了系统检索。主要终点是从新冠感染中康复的运动员心血管磁共振检查异常结果的发生率，包括钆延迟强化（LGE）的病理表现、T1和T2值异常以及心包强化。在3890条记录中，18项研究共纳入4446名运动员进行荟萃分析。从新冠感染中康复的运动员中，病理性LGE的合并发生率为2.0%（95%CI 0.9%至4.4%，90%）。T1和T2值升高的发生率分别为1.2%（95%CI 0.4%至3.6%，87%）和1.2%（95%CI 0.4%至3.7%，89%），新冠感染后心包受累的合并发生率为1.1%（95%CI 0.5%至2.5%，85%）。在有CMR临床指征的运动员中，所有CMR检查异常结果的发生率要高得多。在近期从新冠感染中康复的运动员中，CMR检查异常结果的发生率较低。然而，在有症状和/或初始心脏筛查异常的运动员中，发生率要高得多。需要进一步研究和更长时间的随访来评估这些结果的临床相关性，并确定它们是否与不良事件相关。
