Skip Navigation


European Heart Journal Advance Access originally published online on January 22, 2007
European Heart Journal 2007 28(3):345-353; doi:10.1093/eurheartj/ehl468
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
28/3/345    most recent
ehl468v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Ector, J.
Right arrow Articles by Heidbüchel, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ector, J.
Right arrow Articles by Heidbüchel, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment

Joris Ector, Javier Ganame, Nico van der Merwe, Bert Adriaenssens, Laurent Pison, Rik Willems, Marc Gewillig and Hein Heidbüchel*

Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Herestraat 49, B-3000 Leuven, Belgium

Received 4 November 2006; revised 13 November 2006; accepted 14 December 2006; online publish-ahead-of-print 22 January 2007.

* Corresponding author. Tel: +32 16 34 34 69; fax: +32 16 34 42 40. E-mail address: hein.heidbuchel{at}uz.kuleuven.ac.be

Aims Spontaneous or inducible sustained ventricular arrhythmias (VA) in endurance athletes frequently originate from the right ventricle (RV), even in the absence of familial arrhythmogenic RV cardiomyopathy (ARVC). The goal of this study was to determine whether the RV arrhythmogenic predilection in these patients is associated with RV functional abnormalities.

Methods and results Biplane RV angiography was performed in three groups: 22 endurance athletes with VA, 15 matched athletes without VA, and 10 non-athletes without VA. Four methods for quantitative RV angiographic analysis (area length, Boak, pyramid monoplane, and pyramid biplane) were used to calculate RV end-diastolic volume (EDV) and end-systolic volume (ESV) (both corrected for body surface area) and ejection fraction (EF). In addition RV outflow tract shortening fraction (SF) was determined. Although only 6 of 22 (27%) athletes with VA fulfilled the diagnostic criteria for ARVC, RV arrhythmogenic involvement was manifest or probable in 82%, based on a combination of electrophysiologic, electrocardiographic, and morphologic criteria. RV EDV in athletes was higher than in non-athletes (area length: 100.3 ± 26.9 vs. 69.6 ± 14.3 mL/m2, P = 0.001), without significant difference between athletes with and without VA. RV ESV, in contrast, was significantly higher in athletes with VA than in athletes without VA (52.6 ± 22.3 vs. 35.5 ± 11.2 mL/m2, P = 0.004), resulting in a significantly lower RV EF, a consistent finding across all methods (area length: 49.1 ± 10.4 vs. 63.7 ± 6.4%, P < 0.001). This functional impairment was also reflected in a lower RV outflow tract SF (SF right anterior oblique 32.2 ± 10.1 vs. 40.0 ± 11.6%, P = 0.09; SF left anterior oblique (LAO) 31.9 ± 7.8 vs. 39.0 ± 10.5%, P = 0.10).

Conclusion VA in high-level endurance athletes frequently originate from a mildly dysfunctional RV. This raises the question whether endurance exercise not only acts as a trigger for these arrhythmias but also as promoter of the RV changes.

Key Words: Athletes • Arrhythmia • Right ventricular function • Cineangiography


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
A. J. Teske, N. H. Prakken, B. W. De Boeck, B. K. Velthuis, E. P. Martens, P. A. Doevendans, and M. J. Cramer
Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes
Eur. Heart J., April 2, 2009; 30(8): 969 - 977.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol ImgHome page
A. La Gerche, A. J. Taylor, and D. L. Prior
Athlete's Heart: The Potential for Multimodality Imaging to Address the Critical Remaining Questions.
J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 350 - 363.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
K. George, R. Shave, D. Oxborough, T. Cable, E. Dawson, N. Artis, D. Gaze, T. Hew-Butler, K. Sharwood, and T. Noakes
Left ventricular wall segment motion after ultra-endurance exercise in humans assessed by myocardial speckle tracking
Eur J Echocardiogr, March 1, 2009; 10(2): 238 - 243.
[Abstract] [Full Text] [PDF]

Home page
 BMJ Case ReportsHome page
G. Whyte, M. Sheppard, K. George, R. Shave, S. Prasad, R. O'Hanlon, and S. Sharma
Post-mortem evidence of idiopathic left ventricular hypertrophy and idiopathic interstitial myocardial fibrosis: is exercise the cause?
BMJ Case Reports, February 2, 2009; 2009(jan27_1): bcr0820080758 - bcr0820080758.
[Abstract] [Full Text]

Home page
 Br. J. Sports. Med.Home page
G Whyte, M Sheppard, K George, R Shave, M Wilson, S Prasad, R O'Hanlon, and S Sharma
Post-mortem evidence of idiopathic left ventricular hypertrophy and idiopathic interstitial myocardial fibrosis: is exercise the cause?
Br. J. Sports Med., April 1, 2008; 42(4): 304 - 305.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
E. Kasikcioglu
The right ventricle: two roles for one actor
Eur. Heart J., December 2, 2007; 28(24): 3094 - 3094.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
J. Ector and H. Heidbuchel
Arrhythmias and the athlete: mechanisms and clinical significance: reply
Eur. Heart J., June 1, 2007; 28(11): 1401 - 1401.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
G. P. Whyte, M. Sheppard, K. P. George, R. E. Shave, M. Wilson, N. Stephens, R. Senior, and S. Sharma
Arrhythmias and the athlete: mechanisms and clinical significance
Eur. Heart J., June 1, 2007; 28(11): 1399 - 1400.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.