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Sport bei Myokarderkrankungen

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Sportkardiologie

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Zusammenfassung

Myokarderkankungen stellen die Hauptursachen des plötzlichen Herztodes bei jüngeren Personen dar. Bei Sportlern relevant sind vor allem die angeborenen Erkrankungen hypertrophische Kardiomoypathie (HCM), die arrhythmogene rechtsventrikuläre Kardiomyopathie (ARVC) sowie bei den erworbenen die Myokarditis. In der primären Diagnostik kommt neben der Klinik und (bei den angeborenen Erkrankungen) der familiären Anamnese dem Ruhe-EKG eine wichtige Bedeutung zu. Dieses wird zur Diagnosesicherung ergänzt durch eine Echokardiographie und vor allem ein kardiales MRT. Die Abgrenzung von sportbedingten myokardialen Anpassungen gelingt meist nichtinvasiv. Genetische Untersuchungen können insbesondere für das familiäre Screening hilfreich sein. Meist fehlen durch entsprechende klinische Studien abgesicherte Kriterien zur Risikostratifizierung. Aufgrund des hohen und durch körperliche Belastungen potenzierten Komplikationspotenzials fallen Empfehlungen zur sportlichen Aktivität eher vorsichtig aus. Bei den meisten Kardiomyopathien besteht allerdings eine klare Kontraindikation zum Leistungssport.

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Literatur

  1. Abdel-Aty H, Boye P, Zagrosek A et al. (2005) Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol 45:1815–1822

    Article  PubMed  Google Scholar 

  2. Ackerman M, Priori SG, Willems S et al. (2011) HRS/EHRA Expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies. Europace 13:1077–1109

    Article  PubMed  Google Scholar 

  3. Basso C, Thiene G, Corrado D et al. (1996) Arrhythmogenic right ventricular cardiomyopathy: dysplasia, dystrophy or myocarditis? Circulation 94:983–991

    Article  CAS  PubMed  Google Scholar 

  4. Bhonsale A, James CA, Tichnell C et al. (2013) Risk stratification in arrhythmogenic right ventricular dysplasia/ cardiomyopathy-associated desmosomal mutation carriers. Circ Arrhythm Electrophysiol 6:569–578

    Article  CAS  PubMed  Google Scholar 

  5. Biffi A, Maron BJ, Verdile L, Fernando F, Spataro A, Marcello G, Ciardo R, Ammirati F, Colivicchi F, Pelliccia A (2004) Impact of physical deconditioning on ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 44:1053–1058

    Article  PubMed  Google Scholar 

  6. Buja G, Nava A, Daliento L et al. (1993) Right ventricular cardiomyopathy in identical and nonidentical young twins. Am Heart J 126:1187–1193

    Article  CAS  PubMed  Google Scholar 

  7. Caforio AL, Iliceto S (2008) Genetically determined myocarditis: clinical presentation and immunological characteristics. Curr Opin Cardiol 23:219–226

    Article  PubMed  Google Scholar 

  8. Chandra N, Bastiaenen R, Papadakis M, Sharma S (2013) Sudden Cardiac Death in Young Athletes. J Am Coll Cardiol 61:1027–1040

    Article  PubMed  Google Scholar 

  9. Cooper LT, Baughman KL, Feldman AM et al. (2007) The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation 116:2216–2233

    Article  PubMed  Google Scholar 

  10. Corrado D, Basso C, Thiene G et al. (1997) Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. J Am Coll Cardiol 30: 1512–1520

    Article  CAS  PubMed  Google Scholar 

  11. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G (2006) Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 296:1593–1601

    Article  CAS  PubMed  Google Scholar 

  12. Coumel P, Leenhardt A, Haddad G (1994) Exercise ECG: prognostic implications of exercise induced arrhythmias. Pacing Clin Electrophysiol 17:417–427

    Article  CAS  PubMed  Google Scholar 

  13. Cox MG, Nelen MR, Wilde AA et al. (2008) Activation delay and VT parameters in arrhythmogenic right ventricular dysplasia/cardiomyopathy: toward improvement of diagnostic ECG criteria. J Cardiovasc Electrophysiol 19:775–781

    Article  PubMed  Google Scholar 

  14. den Haan AD, Tan, Zikusoka MN et al. (2009) Comprehensive desmosome mutation analysis in north americans with arrhythmogenic right ventricular dysplasia/ cardiomyopathy. Circ Cardiovasc Genet 2:428–435

    Article  CAS  PubMed  Google Scholar 

  15. Dennert R, Crijns H, Heymans S (2008) Acute viral myocarditis. Eur Heart J 29:2073–2082

    Article  PubMed  PubMed Central  Google Scholar 

  16. Drezner JA, Ackerman MJ, Anderson J, Ashley E et al. (2013) Electrocardiographic interpretation in athletes: the ‘Seattle Criteria. Br J Sports Med 47:122–124

    Article  PubMed  Google Scholar 

  17. Elliott P, Andersson B, Arbustini E, Bilinska Z et al. (2008) Classification of the cardiomyopathies: a position statement from the European Society of Cardiology working group on myocardial and pericardial diseases. Eur Heart J 29:270–276

    Article  PubMed  Google Scholar 

  18. Felker GM, Boehmer JP, Hruban RH et al. (2000) Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol 36:227–232

    Article  CAS  PubMed  Google Scholar 

  19. Ferreira V, Piechnik S, Dall’Armellina E et al. (2013) T1 mapping for the diagnosis of acute myocarditis using CMR. Comparison to T2-weighted and late gadolinium enhanced imaging. J Am Coll Cadrdiol Img 6:1048–1058

    Article  Google Scholar 

  20. Friedrich MG, Sechtem U, Schulz-Menger J et al. (2009) Cardiovascular magnetic resonance in myocarditis: a JACC White Paper. J Am Coll Cardiol 53:1475–1487

    Article  PubMed  PubMed Central  Google Scholar 

  21. Frustaci A, Priori SG, Pieroni M et al. (2005) Cardiac histological substrate in patients with clinical phenotype of Brugada syndrome. Circulation 112(24): 3680–3687

    Article  PubMed  Google Scholar 

  22. Gao X, Peng L, Zeng Q, Wu ZK (2009) Autonomic nervous function and arrhythmias in patients with acute viral myocarditis during a 6-month follow-up period. Cardiology 113:66–71

    Article  PubMed  Google Scholar 

  23. Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen R, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011) 2011 ACCF/AHA Guideline for the diagnosis and treatment of hypertrophic cardiomyopathy. J Am Coll Cardiol 58: e212–e260

    Article  CAS  PubMed  Google Scholar 

  24. Hauer RN, Cox MG, Groeneweg JA (2012) Impact of new electrocardiographic criteria in arrhythmogenic cardiomyopathy. Front Physiol 3:352

    Article  PubMed  PubMed Central  Google Scholar 

  25. Heidbüchel H, Hoogsteen J, Fagard R et al. (2003) High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J 24:1473–1480

    Article  PubMed  Google Scholar 

  26. Heidbüchel H, Prior DL, La Gerche A (2012) Ventricular arrhythmias associated with long-term endurance sports: what is the evidence? Br J Sports Med 46 Suppl 1:i44–50

    Article  PubMed  Google Scholar 

  27. Ho CY (2012) Hypertrophic Cardiomyopathy in 2012. Circulation 125:1432–1438

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hufnagel G, Pankuweit S, Richter A, Schönian U, Maisch B (2000) The European Study of Epidemiology and Treatment of Cardiac Inflammatory Diseases (ESETCID): first epidemiological results. Herz 25:279–285

    Article  CAS  PubMed  Google Scholar 

  29. Ilback NG, Fohlman J, Friman G (1989) Exercise in coxsackie B3 myocarditis: effects on heart lymphocyte subpopulations and the inflammatory reaction. Am Heart J 117:1298–1302

    Article  CAS  PubMed  Google Scholar 

  30. Kindermann W, Dickhuth HH, Niess A, Röcker K, Urhausen A (2007) Sportkardiologie, 2. Aufl. Steinkopff, Darmstadt

    Google Scholar 

  31. Kindermann I, Barth C, Mahfoud F et al. (2012) Update on myocarditis. J Am Coll Cardiol 59:779–792

    Article  PubMed  Google Scholar 

  32. Kirchhof P, Fabritz L, Zwiener M et al. (2006) Age- and training-dependent development of arrhythmogenic right ventricular cardiomyopathy in heterozygous plakoglobin-deficient mice. Circulation 114:1799–1806

    Article  PubMed  Google Scholar 

  33. Kirklin JW, Ellis FH Jr. (1961) Surgical relief of diffuse subvalvular aortic stenosis. Circulation 24:739–742

    Article  CAS  PubMed  Google Scholar 

  34. Kühl U, Pauschinger M, Noutsias M et al. (2005) High prevalence of viral genomes and multiple viral infections in the myocardium of adults with »idiopathic« left ventricular dysfunction. Circulation 111:887–893

    Article  PubMed  Google Scholar 

  35. Kühl C, Luedde M, Langer C, Frey N (2013) Aktuelle Diagnostik und Therapie hypertrophischer Kardiomyopathien. Dtsch Med Wochenschr 138:583–588

    Article  PubMed  Google Scholar 

  36. Kuhn H, Lawrenz T, Lieder F (2008) Survival after transcoronary ablation of septal hypertrophy in hypertrophic obstructive cardiomyopathy (TASH): a 10 year experience. Clin Res Cardiol 97:234–243

    Article  PubMed  Google Scholar 

  37. La Gerche A, Burns, Mooney D et al. (2012) Exerciseinduced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 33: 998–1006

    Article  CAS  PubMed  Google Scholar 

  38. Magnani JW, Danik HJ, Dec GW Jr, DiSalvo TG (2006) Survival in biopsy-proven myocarditis: a long-term retrospective analysis of the histopathologic, clinical, and hemodynamic predictors. Am Heart J 151:463–470

    Article  PubMed  Google Scholar 

  39. Mahrholdt H, Goedecke C, Wagner A et al. (2004) Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation 109:1250–1258

    Article  PubMed  Google Scholar 

  40. Marcus F, Fontaine G, Guirdaudon G et al. (1982) Right ventricular dysplasia: a report of 24 adult cases. Circulation 384–398

    Google Scholar 

  41. Marcus F, Zareba W, Calkins H et al. (2009) Arrhythmogenic right ventricular cardiomyopathy/dysplasia clinical presentation and diagnostic evaluation: results from the North American Multidisciplinary Study. Heart Rhythm 6:984–992

    Article  PubMed  PubMed Central  Google Scholar 

  42. Marcus F, McKenna WJ, Sherrill D et al. (2010) Diagnosis of arrhythmogenic right ventricular cardiomyopathy/ dysplasia : proposed modification of the Task Force criteria. Circulation 121:1533–1541

    Article  PubMed  PubMed Central  Google Scholar 

  43. Maron BJ, Shen WK, Link MS (2000) Efficacy of implantable cardioverter-defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Engl J Med 342:365–373

    Article  CAS  PubMed  Google Scholar 

  44. Maron BJ, Ackerman M, Nishimura R et al. (2005) Task Force 4: HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. JACC 45:1340–1345

    Article  PubMed  Google Scholar 

  45. Maron BJ, Doerer JJ, Haas TS (2009) Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation 119:1085–1092

    Article  PubMed  Google Scholar 

  46. Maron BJ, Braunwald E (2012) Evolution of hypertrophic cardiomyopathy to a contemporary treatable disease. Circulation 126:1640–1644

    Article  PubMed  Google Scholar 

  47. Maron BJ, Maron MS, Sensarian C (2012) Genetics of hypertrophic cardiomyopathy after 20 years. J Am Coll Cardiol 60:705–715

    Article  PubMed  Google Scholar 

  48. McKenna WJ, Thiene G, Nava A et al. (1994) Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group of Myocardial disease of the European Society of Cardiology and of the Scientific Council on cardiomyopathies of the International Society and Federation of Cardiology. Br Heart J 71:215–218

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Moon JC, McKenna WJ, McCrohon JA (2003) Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J Am Coll Cardiol 41:1561–1567

    Article  PubMed  Google Scholar 

  50. Morgera T, Di Lenarda A, Dreas L et al. (1992) Electrocardiography of myocarditis revisited: clinical and prognostic significance of electrocardiographic changes. Am Heart J 124:455–467

    Article  CAS  PubMed  Google Scholar 

  51. Papadakis M, Basavarajaiah S, Rawlins J et al. (2009) Prevalence and significance of T-wave inversions in predominantly Caucasian adolescent athletes. Eur Heart J 30:1728–1735

    Article  PubMed  Google Scholar 

  52. Papadakis M, Carre F, Kervio G et al. (2011) The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J 32:2304–2313

    Article  PubMed  Google Scholar 

  53. Pelliccia A, Fagard R, Bjornstad HH (2005) Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 26:1422–1445

    Article  PubMed  Google Scholar 

  54. Pelliccia A, Corrado D, Bjørnstad HH et al. (2006) Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis. Eur J Cardiovasc Prev Rehabil 13:876–885

    Article  PubMed  Google Scholar 

  55. Pelliccia A, Zipes DP, Maron BJ (2008a) Bethesda Conference 36 and the European Society of Cardiology Consensus Recommendations revisited: a comparison of U.S. and European criteria for eligibility and disqualifications of competitive athletes with cardiovascular abnormalities J Am Coll Cardiol 52:1990–1996

    Google Scholar 

  56. Pelliccia A, Di Paolo FM, Quattrini FM et al. (2008b) Outcomes in athletes with marked ECG repolarization abnormalities. N Engl J Med 358:152–161

    Article  CAS  PubMed  Google Scholar 

  57. Peters S, Trümmel M, Meyners W (2004) Prevalence of right ventricular dysplasia-cardiomyopathy in a nonreferral hospital. Int J Cardiol 97:499–501

    Article  PubMed  Google Scholar 

  58. Reyes MP, Smith FE, Lerner AM (1984) An enterovirusinduced murine model of an acute dilated-type cardiomyopathy. Intervirology 22:146–155

    Article  CAS  PubMed  Google Scholar 

  59. Richardson P, McKenna W, Bristow M et al. (1996) Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 93:841–842

    Article  CAS  PubMed  Google Scholar 

  60. Sen-Chowdhry S, Syrris P, Ward D et al. (2007) Clinical and genetic characterization of families with arrhythmogenic right ventricular dysplasia/cardiomyopathy provides novel insights into patterns of disease expression. Circulation 115:1710-1720

    Article  PubMed  Google Scholar 

  61. Sen-Chowdhry S, Syrris P, Pantazis A et al. (2010) Mutational heterogeneity, modifier genes and environmental influences contribute to phenotypic diversity of arrhythmogenic cardiomyopathy. Circ Cardiovasc Genet 3:323–330

    Article  PubMed  Google Scholar 

  62. Sharma S, Zaidi A (2012) Exercise-induced arrhythmogenic right ventricular cardiomyopathy: fact or fallacy? Eur Heart J 33:938–940

    Article  PubMed  Google Scholar 

  63. Silvano M, Corrado D, Köbe J, Mönnig G, Basso C, Thiene G, Eckardt L (2013) Risk stratification in arrhythmogenic right ventricular cardiomyopathy. Herzschrittmacherther Elektrophysiol 24:202–208

    Article  CAS  PubMed  Google Scholar 

  64. Smith SC, Ladenson JH, Mason JW, Jaffe AS (1997) Elevations of cardiac troponin I are associated with myocarditis : experimental and clinical correlates. Circulation 95:163–168

    Article  CAS  PubMed  Google Scholar 

  65. Tabib A, Loire R, Chalabreysse L et al. (2003) Circumstances of death and gross and microscopic observations in a series of 200 cases of sudden death associated with arrhythmogenic right ventricular cardiomyopathy and/or dysplasia. Circulation 108:3000–3005

    Article  CAS  PubMed  Google Scholar 

  66. Tear D (1958) Asymmetric hypertrophy of the heart in young adults Br Heart J 20:1–8

    Article  Google Scholar 

  67. Urhausen A (2013) Die Echokardiographie in der Sportmedizin. Dtsch Z Sportmed 64:357–361

    Google Scholar 

  68. Wesslen L, Pahlson C, Lindquist O et al. (1996) An increase in sudden unexpected cardiac deaths among young Swedish orienteers during 1979-1992. Eur Heart J 17:902–910

    Article  CAS  PubMed  Google Scholar 

  69. Wilson MG, Sharma S, Carré F, Charron P et al. (2012) Significance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: practical solutions for managing the diagnostic conumdrum. Br J Sports Med 46 Suppl 1:i51–i58

    Article  PubMed  PubMed Central  Google Scholar 

  70. Yilmaz A, Ferreira V, Klingel K et al. (2013) Role of cardiovascular magnetic resonance imaging (CMR) in the diagnosis of acute and chronic myocarditis. Heart Fail Rev 18:747–760

    Article  PubMed  Google Scholar 

  71. Zagrosek A, Wassmuth R, Abdel-Aty H et al. (2008) Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis - a CMR study. J Cardiovasc Magn Reson 10:19

    Article  PubMed  PubMed Central  Google Scholar 

  72. Zipes D, Camm AJ, Borggrefe M et al. (2006) ACC/AHA/ ESC 2006 Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. JACC 48: e247–e346

    Article  PubMed  Google Scholar 

  73. Zorzi A, ElMaghawry M, Rigato I, Cardoso Bianchini F, Crespi Ponta G, Michieli P, Migliore F, Perazzolo Marra M, Bauce B, Basso C, Schiavon M, Thiene G, Iliceto S, Corrado D (2013) Exercise-induced normalization of right precordial negative T waves in arrhythmogenic right ventricular cardiomyopathy. Am J Cardiol 112:411–415

    Article  PubMed  Google Scholar 

  74. Ganga HV, Thompson PD (2014) Sports participation in non-compaction cardiomyopathy: a systematic review. Br J Sports Med 48:1466–1471

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de Cardiologie, Centre Hospitalier de Luxembourg, 4, rue Ernest Barblé, 1210, Luxembourg, Luxemburg

    Dr. Andrei Codreanu, Dr. Charles Delagardelle & Dr. Laurent Groben

  2. Codirector Luxembourg Olympic Medical Center, Centre Hospitalier de Luxembourg-Clinique d’Eich, 78, rue d’Eich, 1460, Luxembourg, Luxemburg

    Prof. Dr. Axel Urhausen (Médecine du Sport et de PréventionClinique du Sport)

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  1. Dr. Andrei Codreanu
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  2. Dr. Charles Delagardelle
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  3. Dr. Laurent Groben
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  4. Prof. Dr. Axel Urhausen
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  1. FA Innere Medizin, Kardiologie, Sportmedizin Universitätsinstitut für präventive und rehabilitative Sportmedizin Forschungsinstitut für molekulare Sport- und Rehabilitationsmedizin Paracelsus Medizinische Privatuniversität Salzburg Institut für Sportmedizin des Landes Salzburg Sportmedizin, Olympiazentrums Salzburg-Rif, 5020, Salzburg, Österreich

    Josef Niebauer

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Codreanu, A., Delagardelle, C., Groben, L., Urhausen, A. (2015). Sport bei Myokarderkrankungen. In: Niebauer, J. (eds) Sportkardiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43711-7_22

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