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- Title
Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members.
- Authors
Saberniak, Jørg; Hasselberg, Nina E.; Borgquist, Rasmus; Platonov, Pyotr G; Sarvari, Sebastian I.; Smith, Hans‐Jørgen; Ribe, Margareth; Holst, Anders G.; Edvardsen, Thor; Haugaa, Kristina H.
- Abstract
Aims Exercise increases risk of ventricular arrhythmia in subjects with arrhythmogenic right ventricular cardiomyopathy ( ARVC). We aimed to investigate the impact of exercise on myocardial function in ARVC subjects. Methods and Results We included 110 subjects (age 42 ± 17 years), 65 ARVC patients and 45 mutation-positive family members. Athletes were defined as subjects with ≥4 h vigorous exercise/week [≥1440 metabolic equivalents ( METs × minutes/week)] during a minimum of 6 years. Athlete definition was fulfilled in 37/110 (34%) subjects. We assessed right ventricular ( RV) and left ventricular ( LV) myocardial function by echocardiography, and by magnetic resonance imaging ( MRI). The RV function by RV fractional area change ( FAC), RV global longitudinal strain ( GLS) by echocardiography, and RV ejection fraction ( EF) by MRI was reduced in athletes compared with non-athletes ( FAC 34 ± 9% vs. 40 ± 11%, RVGLS -18.3 ± 6.1% vs. -22.0 ± 4.8%, RVEF 32 ± 8% vs. 43 ± 10%, all P < 0.01). LV function by LVEF and LVGLS was reduced in athletes compared with non-athletes ( LVEF by echocardiography 50 ± 10% vs. 57 ± 5%, LVEF by MRI 46 ± 6% vs. 53 ± 8%, and LVGLS -16.7 ± 4.2% vs. -19.4 ± 2.9%, all P < 0.01). The METs × minutes/week correlated with reduced RV and LV function by echocardiography and MRI (all P < 0.01). The LVEF by MRI was also reduced in subgroups of athlete index patients (46 ± 7% vs. 54 ± 10%, P = 0.02) and in athlete family members (47 ± 3% vs. 52 ± 6%, P < 0.05). Conclusion Athletes showed reduced biventricular function compared with non-athletes in ARVC patients and in mutation-positive family members. The amount and intensity of exercise activity was associated with impaired LV and RV function. Exercise may aggravate and accelerate myocardial dysfunction in ARVC.
- Subjects
PHYSICAL activity; VENTRICULAR arrhythmia; EXERCISE physiology; HEART failure; ECHOCARDIOGRAPHY; MAGNETIC resonance imaging; DIAGNOSIS; DISEASE risk factors
- Publication
European Journal of Heart Failure, 2014, Vol 16, Issue 12, p1337
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1002/ejhf.181