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The Impact of Long-Term Endurance Sports on the Right Ventricle: Evidence for Exercise-Induced Arrhythmogenic RV Cardiomyopathy

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The Right Heart

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Abstract

As discussed in Chapter 7 of this book, the right ventricle (RV) undergoes a disproportionate increase in load during exercise. This leads to acute changes like dilatation and temporary dysfunction, and may be associated with minor cell damage as evidenced by cardiac enzyme elevations that are very commonly observed after endurance competition. In general, these changes seem to recover within a few days. This chapter reflects on the thesis that the RV can develop chronic sports injury, based on our hypothesis that was originally put forward in 2003. We speculate that repetitive acute injury may culminate in a chronic overload syndrome of the RV, which is very reminiscent of what is observed in patients with familial arrhythmogenic RV cardiomyopathy (ARVC), despite the absence of underlying demonstrable genetic abnormalities. The syndrome of ‘exercise-induced ARVC’ may easily be overlooked. It may even become more prevalent now that modern sports tries to push the limits of human performance in a much more ‘professionalised’ way and on a much larger scale. The aim of this chapter is to describe the pathophysiological findings of ‘exercise-induced ARVC’ and its relation with desmosomal ARVC.

Funding and potential conflicts of interest.

Publication of this article was not funded.

H.H. is holder of the AstraZeneca Chair in Cardiac Electrophysiology, University of Leuven. H.H. received research funding through the University of Leuven from Siemens Medical Solutions. H.H. is Coordinating Clinical Investigator for the Biotronik-sponsored EuroEco study on health-economics of remote device monitoring. H.H. is a member of the scientific advisory board of Siemens Medical Solutions, Boehringer-Ingelheim, Bayer, BMS/Pfizer, Daiichi Sankyo and Sanofi-Aventis, and receives unconditional research grants through the University of Leuven from St Jude Medical, Medtronic, Biotronik and Boston Scientific Inc.

A.LG receives a post-doctoral research scholarship from the Australian National Health and Medical Research Council.

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Authors and Affiliations

  1. Department of Cardiovascular Sciences – Arrhythmology, University Hospital Gasthuisberg, University of Leuven, Herestraat 49, Leuven, 3000, Belgium

    Hein Heidbuchel MD, PhD, FESC

  2. Department of Medicine, St Vincent’s Hospital, University of Melbourne, Fitzroy, VIC, Australia

    André La Gerche MD, PhD

  3. Department of Cardiovascular Medicine, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium

    André La Gerche MD, PhD

  4. Department of Cardiology, St. Vincent’s Hospital, 2900, Fitzroy, VIC, 3065, Australia

    André La Gerche MD, PhD

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  1. Hein Heidbuchel MD, PhD, FESC
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Correspondence to Hein Heidbuchel MD, PhD, FESC .

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  1. National Pulmonary Hypertension Unit, Mater Misericordiae University Hospital, Dublin, Ireland

    Sean P. Gaine

  2. Department of Cardiology, Erasme University Hospital, Brussels, Belgium

    Robert Naeije

  3. Scottish Pulmonary Vascular Unit, Regional Heart and Lung Centre, Glasgow, United Kingdom

    Andrew John Peacock

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Heidbuchel, H., La Gerche, A. (2014). The Impact of Long-Term Endurance Sports on the Right Ventricle: Evidence for Exercise-Induced Arrhythmogenic RV Cardiomyopathy. In: Gaine, S., Naeije, R., Peacock, A. (eds) The Right Heart. Springer, London. https://doi.org/10.1007/978-1-4471-2398-9_3

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