Sport activity in patients with cardiomyopathies: a review.
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
17
5
2023
pubmed:
15
5
2023
entrez:
15
5
2023
Statut:
ppublish
Résumé
Exercise has undisputable benefits and is an important therapy component for most cardiovascular diseases, with a proven role in reducing mortality. On the contrary, exercise may paradoxically trigger sudden cardiac arrest in patients with cardiomyopathies requiring refrain from competitive sports participation. The 2020 European guidelines for patients with cardiovascular disease provided indication for sports participation for patients with cardiac conditions, including cardiomyopathies. Although in some cases, the knowledge of the natural history of the disease and the risk of death during intensive exercise is more robust, in others, the evidence is scarce. Therefore, recommendations are not available for all possible scenarios with several uncertainties. In addition, many patients aspire to continue competitive sports or practise recreational activities after a diagnosis of cardiomyopathy. These aspects generate concern for the physician, who should make complex decisions, and confronts the request to design specific exercise programmes without specific indications. This article will review the available evidence on the sports-related risk of sudden cardiac death or cardiovascular events and the progression of the disease in cardiomyopathies.
Identifiants
pubmed: 37186562
doi: 10.2459/JCM.0000000000001470
pii: 01244665-202305002-00004
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e116-e127Informations de copyright
Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.
Références
Pelliccia A, Fagard R, Bjørnstad HH, et al. 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 My. Eur Heart J 2005; 26:1422–1445.
Comitato Organizzativo Cardiologico per l’idoneitá allo Sport (COCIS), Protocolli cardiologici per il giudizio di idoneitá allo sport agonistico 5th ed. Roma: Casa Editrice Scientifica Nazionale 2017; 1–121.
Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021; 42:17–96.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes. Circulation 2009; 119:1085–1092.
Andreassen K, Dejgaard LA, Lie Ø, et al. Exercise training during childhood and adolescence is associated with favorable diastolic function in hypertrophic cardiomyopathy. Int J Cardiol 2022; 364:65–71.
Sheikh N, Papadakis M, Schnell F, et al. Clinical profile of athletes with hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 2015; 8:e003454.
Dejgaard LA, Haland TF, Lie OH, et al. Vigorous exercise in patients with hypertrophic cardiomyopathy. Int J Cardiol 2018; 250:157–163.
Klempfner R, Kamerman T, Schwammenthal E, et al. Efficacy of exercise training in symptomatic patients with hypertrophic cardiomyopathy: results of a structured exercise training program in a cardiac rehabilitation center. Eur J Prev Cardiol 2015; 22:13–19.
Saberi S, Wheeler M, Bragg-Gresham J, et al. Effect of moderate-intensity exercise training on peak oxygen consumption in patients with hypertrophic cardiomyopathy: a randomized clinical trial. JAMA 2017; 317:1349–1357.
Kwon S, Lee HJ, Han K Do, et al. Association of physical activity with all-cause and cardiovascular mortality in 7666 adults with hypertrophic cardiomyopathy (HCM): more physical activity is better. Br J Sports Med 2021; 55:1034–1040.
Limongelli G, Monda E, D’Aponte A, et al. Combined effect of Mediterranean diet and aerobic exercise on weight loss and clinical status in obese symptomatic patients with hypertrophic cardiomyopathy. Heart Fail Clin 2021; 17:303–313.
Sweeting J, Ingles J, Timperio A, Patterson J, Ball K, Semsarian C. Physical activity in hypertrophic cardiomyopathy: prevalence of inactivity and perceived barriers. Open Hear 2016; 3:e000484.
Finocchiaro G, Magavern E, Sinagra G, et al. Impact of demographic features, lifestyle, and comorbidities on the clinical expression of hypertrophic cardiomyopathy. J Am Heart Assoc 2017; 6:
Snir AW, Connelly KA, Goodman JM, Dorian D, Dorian P. Exercise in hypertrophic cardiomyopathy: restrict or rethink. Am J Physiol Hear Circ Physiol 2021; 320:H2101–H2111.
Cavigli L, Olivotto I, Fattirolli F, et al. Prescribing, dosing and titrating exercise in patients with hypertrophic cardiomyopathy for prevention of comorbidities: ready for prime time. Eur J Prev Cardiol 2021; 28:1093–1099.
Pelliccia A, Caselli S, Pelliccia M, et al. Clinical outcomes in adult athletes with hypertrophic cardiomyopathy: a 7-year follow-up study. Br J Sports Med 2020; 54:1008–1012.
Basu J, Finocchiaro G, Jayakumar S, et al. Impact of exercise on outcomes and phenotypic expression in athletes with nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 2022; 80:1498–1500.
Pelliccia A, Borrazzo C, Caselli S, et al. Neither athletic training nor detraining affects LV hypertrophy in adult, low-risk patients with HCM. Cardiovasc Imaging 2022; 15:170–171.
Corrado D, Basso C, Judge DP. Arrhythmogenic cardiomyopathy. Circ Res 2017; 121:785–802.
Thiene G, Nava A, Corrado D, Rossi L, Pennelli N. Right ventricular cardiomyopathy and sudden death in young people. The New England Journal of Medicine 2010; 318:129–133.
Nava A, Bauce B, Basso C, et al. Clinical profile and long-term follow-up of 37 families with arrhythmogenic right ventricular cardiomyopathy. J Am Coll Cardiol 2000; 36:2226–2233.
Elliott PM, Anastasakis A, Asimaki A, et al. Definition and treatment of arrhythmogenic cardiomyopathy: an updated expert panel report. Eur J Heart Fail 2019; 21:955–964.
Bariani R, Rigato I, Cason M, et al. Genetic background and clinical features in arrhythmogenic left ventricular cardiomyopathy: a systematic review. J Clin Med 2022 2022; 11:4313.
Gandjbakhch E, Redheuil A, Pousset F, Charron P, Frank R. Clinical diagnosis, imaging, and genetics of arrhythmogenic right ventricular cardiomyopathy/dysplasia: JACC state-of-the-art review. J Am Coll Cardiol 2018; 72:784–804.
Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a Preparticipation Screening Program. JAMA 2006; 296:1593–1601.
Finocchiaro G, Papadakis M, Robertus JL, et al. Etiology of sudden death in sports: insights from a United Kingdom Regional Registry. J Am Coll Cardiol 2016; 67:2108–2115.
Corrado D, Zorzi A. Sudden death in athletes. Int J Cardiol 2017; 237:67–70.
Zorzi A, Cipriani A, Bariani R, Pilichou K, Corrado D, Bauce B. Role of exercise as a modulating factor in arrhythmogenic cardiomyopathy. Curr Cardiol Rep 2021; 23:57.
Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42:1959–1963.
James CA, Bhonsale A, Tichnell C, et al. Exercise increases age-related penetrance and arrhythmic risk in arrhythmogenic right ventricular dysplasia/cardiomyopathy-associated desmosomal mutation carriers. J Am Coll Cardiol 2013; 62:1290–1297.
Sawant AC, Bhonsale A, te Riele ASJM, et al. Exercise has a disproportionate role in the pathogenesis of arrhythmogenic right ventricular dysplasia/cardiomyopathy in patients without desmosomal mutations. J Am Heart Assoc 2014; 3:
Lie ØH, Dejgaard LA, Saberniak J, et al. Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy. JACC Clin Electrophysiol 2018; 4:744–753.
Ruwald AC, Marcus F, Estes NAM, et al. Association of competitive and recreational sport participation with cardiac events in patients with arrhythmogenic right ventricular cardiomyopathy: results from the North American multidisciplinary study of arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2015; 36:1735–1743.
Ruiz Salas A, Barrera Cordero A, Navarro-Arce I, et al. Impact of dynamic physical exercise on high-risk definite arrhythmogenic right ventricular cardiomyopathy. J Cardiovasc Electrophysiol 2018; 29:1523–1529.
Müssigbrodt A, Czimbalmos C, Stauber A, et al. Effect of exercise on outcome after ventricular tachycardia ablation in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Int J Sports Med 2019; 40:657–662.
Paulin FL, Hodgkinson KA, MacLaughlan S, et al. Exercise and arrhythmic risk in TMEM43 p.S358L arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm 2020; 17:1159–1166.
Saberniak J, Hasselberg NE, Borgquist R, et al. Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members. Eur J Heart Fail 2014; 16:1337–1344.
Leischik R, Dworrak B, Strauss M, et al. Special article: exercise-induced right ventricular injury or arrhythmogenic cardiomyopathy (ACM): the bright side and the dark side of the moon. Prog Cardiovasc Dis 2020; 63:671–681.
Pinto YM, Elliott PM, Arbustini E, et al. Proposal for a revised definition of dilated cardiomyopathy, hypokinetic nondilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases. Eur Heart J 2016; 37:1850–1858.
McNally EM, Mestroni L. Dilated cardiomyopathy. Circ Res 2017; 121:731–748.
Gulati A, Jabbour A, Ismail TF, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA 2013; 309:896–908.
Millar LM, Fanton Z, Finocchiaro G, et al. Differentiation between athlete ’ s heart and dilated cardiomyopathy in athletic individuals. Heart 2020; 106:1059–1065.
Webb-Peploe KM, Chua TP, Harrington D, Henein MY, Gibson DG, Coats AJS. Different response of patients with idiopathic and ischaemic dilated cardiomyopathy to exercise training. Int J Cardiol 2000; 74:215–224.
Stolen KQ, Kemppainen J, Ukkonen H, et al. Exercise training improves biventricular oxidative metabolism and left ventricular efficiency in patients with dilated cardiomyopathy. J Am Coll Cardiol 2003; 41:460–467.
Beer M, Wagner D, Myers J, et al. Effects of exercise training on myocardial energy metabolism and ventricular function assessed by quantitative phosphorus-31 magnetic resonance spectroscopy and magnetic resonance imaging in dilated cardiomyopathy. J Am Coll Cardiol 2008; 51:1883–1891.
Kemps HM, Schep G, de Vries WR, et al. Predicting effects of exercise training in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 2008; 102:1073–1078.
Mehani SHM. Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy. J Adv Res 2013; 4:189–200.
Pelliccia A, Solberg EE, Papadakis M, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2019; 40:19–33.
Holloway CJ, Dass S, Suttie JJ, et al. Exercise training in dilated cardiomyopathy improves rest and stress cardiac function without changes in cardiac high energy phosphate metabolism. Heart 2012; 98:1083–1090.
Oechslin E, Jenni R. Left ventricular noncompaction revisited: a distinct phenotype with genetic heterogeneity? Eur Heart J 2011; 32:1446–1456.
Caselli S, Attenhofer Jost CH, Jenni R, Pelliccia A. Left ventricular noncompaction diagnosis and management relevant to preparticipation screening of athletes. Am J Cardiol 2015; 116:801–808.
Coris EE, Moran BK, De Cuba R, Farrar T, Curtis AB. Left ventricular non-compaction in athletes: to play or not to play. Sport Med 2016; 46:1249–1259.
Gati S, Papadakis M, Papamichael ND, et al. Reversible de novo left ventricular trabeculations in pregnant women. Circulation 2014; 130:475–483.
Caselli S, Ferreira D, Kanawati E, et al. Prominent left ventricular trabeculations in competitive athletes: a proposal for risk stratification and management. Int J Cardiol 2016; 223:590–595.
Gati S, Chandra N, Bennett RL, et al. Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular noncompaction in athletes? Heart 2013; 99:401–408.
de la Chica JA, Gómez-Talavera S, García-Ruiz JM, et al. Association between left ventricular noncompaction and vigorous physical activity. J Am Coll Cardiol 2020; 76:1723–1733.
D’Ascenzi F, Pelliccia A, Natali BM, Bonifazi M, Mondillo S. Exercise-induced left-ventricular hypertrabeculation in athlete's heart. Int J Cardiol 2015; 181:320–322.
Ganga HV, Thompson PD. Sports participation in noncompaction cardiomyopathy: a systematic review. Br J Sports Med 2014; 48:1466–1471.
D'Silva A, Captur G, Bhuva AN, et al. Recreational marathon running does not cause exercise-induced left ventricular hypertrabeculation. Int J Cardiol 2020; 315:67–71.
Woodbridge SP, Aung N, Paiva JM, et al. Physical activity and left ventricular trabeculation in the UK Biobank community-based cohort study. Heart 2019; 105:990–998.
Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 2015; 17:405–424.
Janin A, Januel L, Cazeneuve C, Delinière A, Chevalier P, Millat G. Molecular diagnosis of inherited cardiac diseases in the era of next-generation sequencing: a single center's experience over 5 years. Mol Diagn Ther 2021; 25:373–385.
Gifford CA, Ranade SS, Samarakoon R, et al. Oligogenic inheritance of a human heart disease involving a genetic modifier. Science 2019; 364:865–870.
Fourey D, Care M, Siminovitch KA, et al. Prevalence and clinical implication of double mutations in hypertrophic cardiomyopathy: revisiting the gene-dose effect. Circ Cardiovasc Genet 2017; 10:e001685.
Li L, Bainbridge MN, Tan Y, Willerson JT, Marian AJ. A potential oligogenic etiology of hypertrophic cardiomyopathy: a classic single-gene disorder. Circ Res 2017; 120:1084–1090.
Pourebrahim K, Marian JG, Tan Y, Chang JT, Marian AJ. A combinatorial oligogenic basis for the phenotypic plasticity between late-onset dilated and arrhythmogenic cardiomyopathy in a single family. J Cardiovasc Aging 2021; 1.
Rigato I, Bauce B, Rampazzo A, et al. Compound and digenic heterozygosity predicts lifetime arrhythmic outcome and sudden cardiac death in desmosomal gene-related arrhythmogenic right ventricular cardiomyopathy. Circ Cardiovasc Genet 2013; 6:533–542.
Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy: a clinical practice resource of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2018; 20:899–909.
Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997–4126.
Arbustini E, Behr ER, Carrier L, et al. Interpretation and actionability of genetic variants in cardiomyopathies: a position statement from the European Society of Cardiology Council on cardiovascular genomics. Eur Heart J 2022; 43:1901–1916.
El Mecky J, Johansson L, Plantinga M, et al. Reinterpretation, reclassification, and its downstream effects: challenges for clinical laboratory geneticists. BMC Med Genomics 2019; 12:170.
Whitehill RD, Balaji S, Kelleman M, et al. Exercise recommendations in pediatric HCM: variation and influence of provider characteristics. Pediatr Cardiol 2022; 43:132–141.
Sarto P, Merlo L, Astolfo P, Sarto M, Bedin L, Noventa D. Comprehensive therapeutic program for cardiovascular patients: role of a sports medicine unit in collaboration with local gymnasiums. J Cardiovasc Med (Hagerstown) 2009; 10:27–33.