The hearts of competitive athletes: an up-to-date overview of exercise-induced cardiac adaptations

Hélder Alexandre Correia Dores; António Freitas; Aneil   Malhotra; Miguel  Mendes; Sanjay Sharma

doi:10.1016/j.repc.2014.07.010

The hearts of competitive athletes: an up-to-date overview of exercise-induced cardiac adaptations

Título traduzido da contribuição: O coração dos atletas: revisão e atualização das adaptações cardíacas induzidas pelo exercício

Hélder Alexandre Correia Dores^*
, António Freitas
, Aneil Malhotra
, Miguel Mendes
, Sanjay Sharma

^*Autor correspondente para este trabalho

Resultado de pesquisa › revisão de pares

34 Citações (Scopus)

Resumo

A prática intensa e regular de exercício físico é responsável por diversas alterações cardíacas, desde eléctricas, estruturais ou funcionais, que representam adaptações fisiológicas ao exercício. Esta remodelagem, frequentemente denominada por coração de atleta, pode mimetizar alterações típicas de diversas patologias, nas quais a morte súbita pode ser a primeira apresentação clínica. Apesar do rastreio pré-competição poder identificar atletas com alterações cardíacas potencialmente fatais, os programas de rastreio não estão estandardizados e aqueles já implementados permanecem controversos. Dados da história clínica pessoal e familiar, achados do exame físico e alterações no eletrocardiograma de 12 derivações, podem aumentar a suspeita de doença cardíaca e levar à deteção precoce de entidades como a miocardiopatia hipertrófica. Contudo, a interpretação do eletrocardiograma é frequentemente desafiante porque várias alterações são consideradas fisiológicas em atletas. Assim, as decisões clínicas são por vezes difíceis: não diagnóstico de condições associadas a um risco aumentado de eventos fatais, ou por outro lado, o diagnóstico errado de patologia cardíaca em atletas saudáveis pode originar a realização de exames de diagnóstico desnecessários ou a desqualificação inapropriada do atleta. Este artigo fornece uma revisão atualizada dos efeitos cardíacos fisiológicos do exercício físico e realça pontos-chave que deverão ser tidos em consideração na avaliação de atletas jovens de competição.

Título traduzido da contribuição	O coração dos atletas: revisão e atualização das adaptações cardíacas induzidas pelo exercício
Idioma original	English
Páginas (de-até)	51-64
Número de páginas	14
Revista	Revista Portuguesa de Cardiologia
Volume	34
Número de emissão	1
DOIs	https://doi.org/10.1016/j.repc.2014.07.010
Estado da publicação	Publicado - 1 jan. 2015
Publicado externamente	Sim

Keywords

Coração de atleta
Adaptação fisiológica
Morte súbita
Rastreio

Acesso ao documento

10.1016/j.repc.2014.07.010Licença:

Outros arquivos e links

Link to publication in Scopus

Citação

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title = "The hearts of competitive athletes: an up-to-date overview of exercise-induced cardiac adaptations",

abstract = "Intense and regular physical exercise is responsible for various cardiac changes (electrical, structural and functional) that represent physiological adaptation to exercise training. This remodeling, commonly referred to as 'athlete's heart', can overlap with several pathological entities, in which sudden cardiac death may be the first clinical presentation. Although pre-competitive screening can identify athletes with life-threatening cardiovascular abnormalities, there are no widely used standardized pre-participation programs and those currently implemented are controversial. Data from personal and family history, features of physical examination and changes in the 12-lead electrocardiogram can raise the suspicion of cardiac disease and lead to early detection of entities such as hypertrophic cardiomyopathy. However, interpreting the electrocardiogram is often challenging, because some changes are considered physiological in athletes. Thus, clinical decision-making in such cases can prove difficult: missing a condition associated with an increased risk of life-threatening events, or conversely, mislabeling an athlete with a disease that leads to unnecessary disqualification, are both situations to avoid. This paper provides an up-to-date review of the physiological cardiac effects of exercise training and highlights key points that should be taken into consideration in the assessment of young competitive athletes.",

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AU - Dores, Hélder Alexandre Correia

AU - Freitas, António

AU - Malhotra, Aneil

AU - Mendes, Miguel

AU - Sharma, Sanjay

PY - 2015/1/1

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N2 - Intense and regular physical exercise is responsible for various cardiac changes (electrical, structural and functional) that represent physiological adaptation to exercise training. This remodeling, commonly referred to as 'athlete's heart', can overlap with several pathological entities, in which sudden cardiac death may be the first clinical presentation. Although pre-competitive screening can identify athletes with life-threatening cardiovascular abnormalities, there are no widely used standardized pre-participation programs and those currently implemented are controversial. Data from personal and family history, features of physical examination and changes in the 12-lead electrocardiogram can raise the suspicion of cardiac disease and lead to early detection of entities such as hypertrophic cardiomyopathy. However, interpreting the electrocardiogram is often challenging, because some changes are considered physiological in athletes. Thus, clinical decision-making in such cases can prove difficult: missing a condition associated with an increased risk of life-threatening events, or conversely, mislabeling an athlete with a disease that leads to unnecessary disqualification, are both situations to avoid. This paper provides an up-to-date review of the physiological cardiac effects of exercise training and highlights key points that should be taken into consideration in the assessment of young competitive athletes.

AB - Intense and regular physical exercise is responsible for various cardiac changes (electrical, structural and functional) that represent physiological adaptation to exercise training. This remodeling, commonly referred to as 'athlete's heart', can overlap with several pathological entities, in which sudden cardiac death may be the first clinical presentation. Although pre-competitive screening can identify athletes with life-threatening cardiovascular abnormalities, there are no widely used standardized pre-participation programs and those currently implemented are controversial. Data from personal and family history, features of physical examination and changes in the 12-lead electrocardiogram can raise the suspicion of cardiac disease and lead to early detection of entities such as hypertrophic cardiomyopathy. However, interpreting the electrocardiogram is often challenging, because some changes are considered physiological in athletes. Thus, clinical decision-making in such cases can prove difficult: missing a condition associated with an increased risk of life-threatening events, or conversely, mislabeling an athlete with a disease that leads to unnecessary disqualification, are both situations to avoid. This paper provides an up-to-date review of the physiological cardiac effects of exercise training and highlights key points that should be taken into consideration in the assessment of young competitive athletes.

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KW - Rastreio

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KW - Screening

KW - Sudden cardiac death

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M3 - Short survey

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The hearts of competitive athletes: an up-to-date overview of exercise-induced cardiac adaptations

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Keywords

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