Department of Radiology, Special Hospital Agram, Zagreb, Croatia.
Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
Echocardiography. 2024 Nov;41(11):e70021. doi: 10.1111/echo.70021.
All structural and functional alterations the heart experiences due to intense sports training are collectively called the "athlete's heart" (AH). One of the main diagnostic dilemmas of today's sports cardiology is the so-called "gray zone"-the structural and functional overlap between the physiological adaptation of the AH and the pathological process of cardiomyopathy. The importance of accurate differentiation between these two entities cannot be highlighted enough-it is estimated that half of the cases of sudden cardiac death in young athletes aged 19-29 are caused by cardiomyopathies, primarily hypertrophic cardiomyopathy (HCM). In the last few years, cardiac magnetic resonance imaging (MRI) has positioned itself as the gold standard for diagnosing structural heart disease, emphasizing the role of the cardiac imaging expert. This brief literature review provides the cardiac MRI findings and techniques that aid in distinguishing the AH from the most common cardiomyopathy-HCM. We will discuss the contributions, as well as current challenges and limitations of each technique, hoping to assist imaging experts and clinicians in solving one of the biggest dilemmas of sports cardiology.
由于高强度体育训练而导致的心脏结构和功能的所有改变都被统称为“运动员心脏”（AH）。当今运动心脏病学的主要诊断难题之一是所谓的“灰色地带”——AH 的生理性适应与心肌病的病理性过程之间的结构和功能重叠。准确区分这两个实体的重要性怎么强调都不为过——据估计，在 19-29 岁的年轻运动员中，一半的心脏性猝死病例是由心肌病引起的，主要是肥厚型心肌病（HCM）。在过去几年中，心脏磁共振成像（MRI）已成为诊断结构性心脏病的金标准，凸显了心脏成像专家的作用。本文献综述简要介绍了有助于区分 AH 和最常见的心肌病——HCM 的心脏 MRI 发现和技术。我们将讨论每种技术的贡献以及当前的挑战和局限性，希望能帮助影像专家和临床医生解决运动心脏病学中最大的难题之一。
