Determinants of supraventricular extra beats in elite athletes practicing different sporting disciplines.

Supraventricular extra beats (SVEB) are frequently observed in athletes but data on significance, prognostic role and correlation with cardiac remodeling are contrasting. It is uncertain whether SVEB may indicate the development of more complex arrhythmias and the need for closer monitoring is undetermined. The aim was to assess the prevalence and clinical significance of BESV in Olympic athletes of different sporting disciplines, evaluating potential correlations with cardiac remodeling and clinical features. We enrolled athletes who participated at 2012-2022 Olympic Games, submitted to physical examination, blood tests, echocardiography and exercise tests, categorized into power, skills, endurance and mixed disciplines. We studied 1492 elite athletes: 56% male individuals, mean age 25.8 ± 5.1 years; 29.5% practiced power, 12.3% skills, 21% endurance and 37.2% mixed disciplines. At exercise-stress tests, 6.2% had SVEB, mostly single beats. SVEB were not influenced by anthropometrics or blood test results. They were more common in male individuals (77.4 vs. 54.6%, P < 0.0001) and older athletes (27.1 ± 5.7 vs. 25.7 ± 5.1, P = 0.01). In male athletes with SVEB, higher left atrial volumes were observed (24.2 ± 7.3 vs. 22.2 ± 7.1 ml/m2, P = 0.03). No differences were found in terms of sporting discipline: despite larger left atrial dimensions in aerobic disciplines, SVEB rates were similar in different sporting disciplines (6.1% endurance, 6.3% mixed, 5.2% power and 8.7% skills; P = 0.435). SVEB were more common in older, male athletes and associated with higher left atrial volume (especially in male individuals) regardless of sport practiced. Athletes with greater left atrial volume and SVEB are supposed to have higher risk, in middle age, of developing more complex arrhythmias.

Di Gioia G ，Vespasiano F ，Maestrini V ，Monosilio S ，Segreti A ，Lemme E ，Squeo MR ，Serdoz A ，Pelliccia A ... -  《-》

Sport disciplines and cardiac remodeling in elite university athletes competing in 2017 Taipei Summer Universiade.

Adea JB ，Leonor RML ，Lu CH ，Lin LC ，Wu M ，Lee KT ，Lin YS ，Chang SH ，Hung KC ，Lin FC ，Hsieh IC ，Chu PH ，Wen MS ，Wu VC ，Wang CL ... -  《-》

Atrial remodeling and ectopic burden in recreational athletes: Implications for risk of atrial fibrillation.

Atrial remodeling, vagal tone, and atrial ectopic triggers are suggested to contribute to increased incidence of atrial fibrillation (AF) in endurance athletes. How these parameters change with increased lifetime training hours is debated. Atrial remodeling occurs in proportion to total training history, thus contributing to elevated risk of AF. We recruited 99 recreational endurance athletes, subsequently grouped according to lifetime training hours, to undergo evaluation of atrial size, autonomic modulation, and atrial ectopy. Athletes were grouped by self-reported lifetime training hours: low (<3000 h), medium (3000-6000 h), and high (>6000 h). Left atrial (LA) volume, left ventricular (LV) dimensions, and LV systolic and diastolic function were assessed by echocardiography. We used 48-hour ambulatory electrocardiographic monitoring to determine heart rate, heart rate variability, premature atrial contractions, and premature ventricular contractions. LA volume was significantly greater in the high (+5.1 mL/m2 , 95% CI: 1.3-8.9) and medium (+4.2 mL/m2 , 95% CI: 0.2-8.1) groups, compared with the low group. LA dilation was observed in 19.4%, 12.9%, and 0% of the high, medium, and low groups, respectively (P = 0.05). No differences were observed between groups for measures of LV dimensions or function. Minimum heart rate, parasympathetic tone expressed using heart rate variability indices, and premature atrial contraction and premature ventricular contraction frequencies did not differ between groups. In recreational endurance athletes, increased lifetime training is associated with LA dilation in the absence of increased vagal parameters or atrial ectopy, which may promote incidence of AF in this cohort.

Elliott AD ，Mahajan R ，Linz D ，Stokes M ，Verdicchio CV ，Middeldorp ME ，La Gerche A ，Lau DH ，Sanders P ... -  《-》

Association between FT3 Levels and Exercise-Induced Cardiac Remodeling in Elite Athletes.

Di Gioia G ，Squeo MR ，Lemme E ，Maestrini V ，Monosilio S ，Ferrera A ，Buzzelli L ，Valente D ，Pelliccia A ... -  《Biomedicines》

No evidence of adverse cardiac remodeling in former elite endurance athletes.

The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42 amateur-level ('sub-elite') cyclists or runners, aged 40-70years] and 18 aged-matched controls. A subset of 15 subjects (5 controls, 3 sub-elite and 7 elite athletes) also underwent cardiac magnetic resonance imaging (cMRI). Elite and sub-elite athletes had greater echocardiography-determined left ventricular myocardial mass indexed to body surface area than controls (113±22, 115.2±23.1 and 94.8±21g/m(2), respectively, p=0.008 for group effect), with similar results for left (50.5±4.4, 48.2±4.3 and 46.4±5.2mm, p=0.008) and right (38.6±3.8, 41.1±5.5 and 34.7±4.3mm, p<0.001) ventricular end-diastolic diameter, and cMRI-determined left atrial volume indexed to body surface area (62.7±8.1, 56.4±16.0 and 39.0±14.1ml/m(2), p=0.026). Two athletes showed a non-coronary pattern of small, fibrotic left ventricular patches detected by late gadolinium enhancement. No group effect was noted for biomarkers. Regardless of their competition level at a younger age, veteran endurance athletes showed an overall healthy, non-pathological pattern of cardiac remodeling. Nonetheless, the physiopathology of the ventricular fibrotic patches detected warrants further investigation.

Sanchis-Gomar F ，López-Ramón M ，Alis R ，Garatachea N ，Pareja-Galeano H ，Santos-Lozano A ，Catalán P ，Sansoni V ，Perego S ，Lombardi G ，Löllgen H ，Bueno H ，Serrano-Ostáriz E ，Lucia A ... -  《-》