Athlete's Heart

The Role of Cardiac MRI in the Diagnosis and Risk Stratification of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM), the most common genetic cardiomyopathy, is present in one in 500 of the general population and is caused by over 1,400 mutations in at least 11 genes encoding the cardiac sarcomere.1–4 Although the majority of patients with HCM remain asymptomatic with near-normal longevity, a small, but important, subset of patients are at increased risk for a wide range of clinical outcomes including development of advanced heart failure symptoms, atrial and ventricular arrhythmias, thromboembolic events, and even sudden death.5–8

Arrhythmogenic Cardiomyopathy: Electrical and Structural Phenotypes

Arrhythmogenic cardiomyopathy (ACM) is usually referred to as arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D).1A first historical description was made in 1736, whereas its first modern description dates back to 1982.2 Initially, ACM was thought to be an embryological malformation.3 Yet in recent years it became evident that the pathophysiology of an ongoing genetically determined myocardial atrophy did not fit the theory of a congenital myocardial aplasia.

Sudden Cardiac Death in Athletes

The evidence supporting the beneficial effects of physical activity on health is compelling. Regular exercise reduces cardiovascular mortality by 35 % and all-cause mortality by 33 %1 and confers an average of 7 years greater longevity.2 Most professional athletes, however, undertake doses of exercise that far exceed those recommended by the current evidence, which has been adopted by national and international health authorities.

Endurance Sport Activity and Risk of Atrial Fibrillation - Epidemiology, Proposed Mechanisms and Management

Although atrial fibrillation (AF) is considered the most common arrhythmia in clinical practice, its prevalence is relatively low in the young and middle-aged, ranging from 0.5 % in men below 40 years to 1 % by 60 years.1,2 Regular exercise is proposed as a powerful tool for the primary and secondary prevention of cardiovascular disease, reducing most of the risk factors that predispose to AF, such as hypertension, diabetes mellitus, coronary artery disease and obesity.3,4 However, there is growing evidence that long-term endurance exercise may incr