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Lynsey Forsythe Keith George David Oxborough 《Current treatment options in cardiovascular medicine》2018,20(10):83
Purpose of review
To describe the use of speckle tracking echocardiography (STE) in the biventricular assessment of athletes’ heart (AH). Can STE aid differential diagnosis during pre-participation cardiac screening (PCS) of athletes?Recent findings
Data from recent patient, population and athlete studies suggest potential discriminatory value of STE, alongside standard echocardiographic measurements, in the early detection of clinically relevant systolic dysfunction. STE can also contribute to subsequent prognosis and risk stratification.Summary
Despite some heterogeneity in STE data in athletes, left ventricular global longitudinal strain (GLS) and right ventricular longitudinal strain (RV ?) indices can add to differential diagnostic protocols in PCS. STE should be used in addition to standard echocardiographic tools and be conducted by an experienced operator with significant knowledge of the AH. Other indices, including left ventricular circumferential strain and twist, may provide insight, but further research in clinical and athletic populations is warranted. This review also raises the potential role for STE measures performed during exercise as well as in serial follow-up as a method to improve diagnostic yield.3.
Clea Simone S. S. Colombo Gherardo Finocchiaro 《Current treatment options in cardiovascular medicine》2018,20(12):101
Purpose of the review
For many years, competitive sport has been dominated by men. Recent times have witnessed a significant increase in women participating in elite sports. As most studies investigated male athletes, with few reports on female counterparts, it is crucial to have a better understanding on physiological cardiac adaptation to exercise in female athletes, to distinguish normal phenotypes from potentially fatal cardiac diseases. This review reports on cardiac adaptation to exercise in females.Recent findings
Recent studies show that electrical, structural, and functional cardiac changes due to physiological adaptation to exercise differ in male and female athletes. Women tend to exhibit eccentric hypertrophy, and while concentric hypertrophy or concentric remodeling may be a normal finding in male athletes, it should be evaluated carefully in female athletes as it may be a sign of pathology. Although few studies on veteran female athletes are available, women seem to be affected by atrial fibrillation, coronary atherosclerosis, and myocardial fibrosis less than male counterparts.Summary
Males and females exhibit many biological, anatomical, and hormonal differences, and cardiac adaptation to exercise is no exception. The increasing participation of women in sports should stimulate the scientific community to develop large, longitudinal studies aimed at a better understanding of cardiac adaptation to exercise in female athletes.4.
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Sudden cardiac death (SCD) is the leading cause of death in athletes. A large proportion of these deaths are associated with undiagnosed cardiovascular disease. Screening for high-risk individuals enables early detection of pathology, as well as permitting lifestyle modification or therapeutic intervention.ECG changes in athletes occur as a result of electrical and structural adaptations secondary to repeated bouts of exercise. Such changes are common and may overlap with patterns suggestive of underlying cardiovascular disease. Correct interpretation is therefore essential, in order to differentiate physiology from pathology. Erroneous interpretation may result in false reassurance or expensive investigations for further evaluation and unnecessary disqualification from competitive sports.Interpretation of the athlete’s ECG has evolved over the past 12 years, beginning with the 2005 European Society of Cardiology (ESC) consensus, progressing to the ESC recommendations (2010), Seattle Criteria (2013) and the ‘refined’ criteria (2014). This evolution culminated in the recently published international recommendations for ECG interpretation in athletes (2017), which has led to a significant reduction in false positives and screening-associated costs. This review aims to describe the evolution of the current knowledge on ECG interpretation as well as future directions. 相似文献
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Lampros Papadimitriou Carine E. Hamo Javed Butler 《Trends in Cardiovascular Medicine》2017,27(5):316-323
Heart Failure is a global epidemic, affecting approximately 5 million adults in the U.S.A. The cornerstone of contemporary pharmacological therapy targets the over activated renin-angiotensin-aldosterone and sympathetic autonomic systems. The 2016 focused pharmacologic update on the current Heart Failure Guidelines introduces the use of two newly approved regimens valsartan/sacubitril and ivabradine. Over the last two decades, guideline directed medical therapy has accomplished significant improvement in survival rates among heart failure patients; however these novel compounds were reported to exert additional mortality and morbidity benefits, in heart failure subpopulations with reduced ejection fraction. 相似文献
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Chronic physical training may induce morphological and useful functional adaptations which affect all cardiac chambers. Morphological modifications are mainly modest and far from pathologic ones. All these adaptations seem helpful for sport's performance. Hemodynamic and neurohumoral stresses depend on the muscular exercise type performed, static or dynamic. However, sports-specific adaptive cardiac structural changes are yet debated. Actually, it appears that highly trained athletes develop a left ventricular fair combination of cavity dilatation and increased wall thickness. Thus, it is not possible to clearly separate a strength-trained from an endurance-trained athlete's heart. However, this review shows that some specific cardiac adaptations mainly linked to the specific training stimulus may be observed. Dilatation slightly predominates in dynamic endurance-trained athletes whereas increased wall thickness slightly predominates in dynamic resistance- and static-trained athletes. Thus, assessment of athletes' echocardiographic parameters should take into account both sport and training specificities practiced, in terms of quantity and contents. 相似文献
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Flavio D’Ascenzi Marco Solari Domenico Corrado Alessandro Zorzi Sergio Mondillo 《JACC: Cardiovascular Imaging》2018,11(9):1327-1339
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden cardiac death (SCD) in youth and athletes. In the last decade, several studies focused on right ventricular (RV) remodeling in athletes and revealed that features of the physiological adaptation of the right heart to training, such as RV dilation, may overlap with those of ARVC. Therefore, a careful multiparametric evaluation is required for differential diagnosis in order to avoid false diagnosis of ARVC or, in contrast, fail to identify the risk of causing SCD. This review summarizes physiological adaptation of the RV to exercise and describes features that could help distinguishing between athlete’s heart and ARVC. 相似文献
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Piotr R Slawinski Keith L Obstein Pietro Valdastri 《World journal of gastroenterology : WJG》2015,21(37):10528-10541
Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review,we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings.Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years. 相似文献
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Marcello Ricardo Paulista Markus Till Ittermann Christine Julia Drzyzga Martin Bahls Sabine Schipf Ulrike Siewert-Markus Sebastian Edgar Baumeister Ralf Ewert Henry Völzke Elisabeth Steinhagen-Thiessen Robin Bülow Heribert Schunkert Ramachandran S. Vasan Stephan Burkhard Felix Marcus Dörr 《JACC: Cardiovascular Imaging》2021,14(1):310-313
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