Does endurance exercise promote life-threatening changes in athletes' hearts?

RV (end-diastolic volume, EDV), the volume of blood left in the RV after the heart had contracted (end-systolic volume, ESV) and the fraction of blood pumped out of the RV in each heart beat (ejection fraction, EF). In addition, they measured the change in the diameter of the part of the RV where the blood flows out to the arteries (RV outflow tract shortening fraction, SF), and the thickness of the ventricular walls.

Hein Heidbchel, professor of cardiology/electrophysiology and director of the clinical EP laboratory who led the team, explained: "Although arrhythmogenic right ventricular cardiomyopathy is a known cause of arrhythmias in athletes, we found that we could diagnose it unequivocally in only six of the 22 athletes (27%). However, we could assign arrhythmias as definitely or probably originating from the right ventricle in 82% of the patients an RV origin of the arrhythmia was manifest in 12 (55%) of the 22 and probable in six (27%) of them.

"All athletes had a higher end-diastolic RV volume compared to controls, as expected in an athlete's heart. Importantly, we found that athletes with VA had an RV end-systolic volume that was significantly higher than athletes without VA, and, accordingly, athletes with VA had a significantly lower RV ejection fraction. This significance remained after we had excluded two athletes with presumed ARVC because of a family history of arrhythmias or sudden death."

The decrease in EF was not profound (down by approximately a fifth) but consistent among all athletes with VA and consistent across all measurement methods. The difference between the two groups of athletes indicated that the RV was not fulfilling its function of pumping blood out from the heart effectively in those with VA.

Prof Heidbchel said: "Our study clearly demonstrates RV functional abnormalities in high-level endurance athletes with VA. The observed RV dysfunction is more subtle than in familial or overt ARVC. ARVC was

Contact: Emma Mason
Oxford University Press

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