{"id":63400,"date":"2024-05-02T12:48:42","date_gmt":"2024-05-02T07:18:42","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=63400"},"modified":"2024-05-02T16:36:33","modified_gmt":"2024-05-02T11:06:33","slug":"what-is-athletes-heart","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/what-is-athletes-heart\/","title":{"rendered":"What is athlete\u2019s heart?"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/qQBon7j0nXQ?si=yILBIkF0QM14ulIJ\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><br \/>\nAthlete\u2019s heart denotes structural, functional, and electrical remodeling seen in trained athletes. It is a physiological adaptation helping athletes perform physical tasks better than non-athletes. Though most of the findings in athlete\u2019s heart are related to the left ventricle, changes do occur in the right ventricle as well.<br \/>\nDuring aerobic exercise which is isotonic, the heart rate and stroke volume increases. Systemic vascular resistance falls, but slight to moderate increase in blood pressure can occur due to the increased cardiac output.<br \/>\nAs the cardiac output increases, it is a mostly a volume overload situation and left ventricle can develop eccentric hypertrophy with enlargement of cavity and proportionate increase in wall thickness.<br \/>\nIsometric exercise or weight training on the other hand causes only slight increase in cardiac output due to increase in heart rate. But there is significant rise in blood pressure leading to pressure overload to the left ventricle.<br \/>\nThis causes concentric left ventricular hypertrophy in which increase in wall thickness predominates, without much increase in cavity size. These cardiac adaptations tend to normalize left ventricular wall stress.<br \/>\nA study evaluating 947 elite, highly trained athletes has reported echocardiographic left ventricular dimensions. Highest left ventricular wall thickness noted was 16 mm.<br \/>\nWall thickness of 13 mm or more were noted in only 16 of the 947 athletes. All these persons had increased left ventricular end diastolic dimensions ranging from 55 to 63 mm. The hypertrophy was noted only in rowers, canoeists and cyclists.<br \/>\nEnlargement of the left ventricular cavity, increased wall thickness and increased trabeculations in athlete\u2019s heart will have to be differentiated from conditions like dilated cardiomyopathy, hypertrophic cardiomyopathy and isolated left ventricular non-compaction.<br \/>\nEffect of exercise on right ventricle. Due to limitations of echocardiogram in evaluating the right ventricle, magnetic resonance imaging study of the right ventricle along with that of the left ventricle has been reported. Twenty-one male endurance athletes were compared with untrained control subjects.<br \/>\nSimilar changes in left and right ventricular mass, volume and function were noted in endurance athletes. Authors concluded that the athlete\u2019s heart is a balanced enlarged heart. ECG and imaging changes noted in endurance athletes may overlap with findings in arrhythmogenic right ventricular cardiomyopathy.<br \/>\nAthlete\u2019s bradycardia due to increased parasympathetic tone and decreased sympathetic tone is a well-known observation. Though sinus bradycardia is usual, other abnormalities like sinus arrhythmia, sinus arrest, wandering atrial pacemaker and coronary sinus rhythm have been described.<br \/>\nFirst degree and second degree Mobitz type I atrioventricular block may be seen occasionally. Increase in QRS voltages satisfying criteria for left or right ventricular hypertrophy can be present. J point elevation and early repolarization pattern has been reported.<br \/>\nBiphasic T waves and T wave inversions can occur in athlete\u2019s heart syndrome. Most of the ECG changes due to increased parasympathetic tone disappear on exercise ECG, usually indicating their benign nature.<br \/>\nIn a study of 1005 athletes 14% had distinctly abnormal ECG pattern. 26% had mildly abnormal pattern and 60% had normal or minor alterations in ECG. Structural cardiac abnormalities were identified in 5% of athletes in this study. Larger LV end diastolic dimensions and wall thickness were associated with abnormalities in ECG.<br \/>\nECG abnormalities were associated with endurance sports like cycling, rowing\/canoeing and cross-country skiing. Study had 75% males and abnormal ECGs were associated with male gender and age below 20 years.<br \/>\nA curious finding was that 5% of athletes had significantly abnormal or bizarre ECG patterns without evidence of structural cardiovascular abnormalities or increase in cardiac dimensions.<br \/>\nA multimodality imaging approach to differentiate physiological changes due to athlete\u2019s heart from significant cardiac ailment has been suggested by an expert consensus from the European Association of Cardiovascular Imaging.<br \/>\nECG, echocardiography and cardiac magnetic resonance imaging with late gadolinium enhancing are important investigative modalities to be used.<br \/>\nThese are useful in suspected myocardial diseases like cardiomyopathy and myocarditis. When there is a suspicion of coronary artery disease, exercise ECG and exercise stress echocardiography have been suggested.<br \/>\nNuclear cardiology imaging, cardiac computed tomography and CMR may be needed in selected cases.<br \/>\nAs there is radiation exposure, considering the young age of most athletes, use of cardiac CT and nuclear cardiology imaging should be limited to athletes with unclear stress echocardiography or CMR.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<p>1.Prior DL et al. The athlete\u2019s heart. Heart. 2012 Jun;98(12):947-55.<\/p>\n<p>2.Fagard R. Athlete\u2019s heart. Heart. 2003 Dec;89(12):1455-61.<\/p>\n<p>3.Pelliccia A et al. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991 Jan 31;324(5):295-301.<\/p>\n<p>4.Brosnan MJ et al. Differentiating Athlete\u2019s Heart From Cardiomyopathies \u2013 The Left Side. Heart Lung Circ. 2018 Sep;27(9):1052-1062.<\/p>\n<p>5.Scharhag J et al. Athlete\u2019s heart: right and left ventricular mass and function in male endurance athletes and untrained individuals determined by magnetic resonance imaging. J Am Coll Cardiol. 2002 Nov 20;40(10):1856-63.<\/p>\n<p>6.Prior D. Differentiating Athlete\u2019s Heart from Cardiomyopathies \u2013 The Right Side. Heart Lung Circ. 2018 Sep;27(9):1063-1071.<\/p>\n<p>7.Pelliccia A et al. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation. 2000 Jul 18;102(3):278-84.<\/p>\n<p>8.Galderisi M et al. The multi-modality cardiac imaging approach to the Athlete\u2019s heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015 Apr;16(4):353.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Athlete\u2019s heart denotes structural, functional, and electrical remodeling seen in trained athletes. It is a physiological adaptation helping athletes perform physical tasks better than non-athletes. Though most of the findings in athlete\u2019s heart are related to the left ventricle, changes do occur in the right ventricle as well. During aerobic exercise which is isotonic, the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":63402,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-63400","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What is athlete\u2019s heart? - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/what-is-athletes-heart\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is athlete\u2019s heart? - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Athlete\u2019s heart denotes structural, functional, and electrical remodeling seen in trained athletes. It is a physiological adaptation helping athletes perform physical tasks better than non-athletes. Though most of the findings in athlete\u2019s heart are related to the left ventricle, changes do occur in the right ventricle as well. During aerobic exercise which is isotonic, the [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/what-is-athletes-heart\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2024-05-02T07:18:42+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-05-02T11:06:33+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2024\/05\/What-is-athletes-heart-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1203\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"What is athlete\u2019s heart?\",\"datePublished\":\"2024-05-02T07:18:42+00:00\",\"dateModified\":\"2024-05-02T11:06:33+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/\"},\"wordCount\":853,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2024\\\/05\\\/What-is-athletes-heart-1.jpg\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/what-is-athletes-heart\\\/\",\"name\":\"What is athlete\u2019s heart? 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