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. 2014 Dec;16(12):1337-44.
doi: 10.1002/ejhf.181. Epub 2014 Oct 16.

Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members

Jørg Saberniak  1 , Nina E Hasselberg, Rasmus Borgquist, Pyotr G Platonov, Sebastian I Sarvari, Hans-Jørgen Smith, Margareth Ribe, Anders G Holst, Thor Edvardsen, Kristina H Haugaa
Affiliations

Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members

Jørg Saberniak et al. Eur J Heart Fail. 2014 Dec.

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.

Keywords: Arrhythmogenic cardiomyopathy; Exercise; Heart failure; Myocardial function; Ventricular arrhythmia.

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Figures

Figure 1
Figure 1
Bar charts displaying relationship between the amount of physical activity expressed as quartiles of metabolic equivalents (METs) × minutes/week during a minimum of 6 years and echocardiographic findings in the right ventricle and left ventricle in 110 arrhythmogenic right ventricular cardiomyopathy (ARVC) subjects. There was a significant correlation between increasing activity in quartiles and increased right ventricular outflow tract (RVOT) diameter, increased left ventricular (LV) volumes and reduced function by right ventricular (RV) strain and left ventricular ejection fraction (LVEF) (all P < 0.05). The P-values are from Pearson's bivariate correlation. FAC, fractional area change; LVEDV, left ventricular end-diastolic volume; LVESV, left ventricular end-systolic volume.
Figure 2
Figure 2
Scatter plot and regression line of 54 arrhythmogenic right ventricular cardiomyopathy (ARVC) subjects examined with cardiac magnetic resonance imaging (MRI). The amount of physical activity in metabolic equivalents (METs) × min/week during a minimum of 6 years correlated with reduced right ventricular ejection fraction (RVEF) by MRI.
Figure 3
Figure 3
Kaplan Meier analysis of 110 arrhythmogenic right ventricular cardiomyopathy (ARVC) patients and their mutation-positive family members. Athletes had significantly worse outcome regarding cardiac transplantation (n = 5) compared with non-athletes (Log rank, P < 0.001).
See this image and copyright information in PMC

Comment in

References

    1. Sen-Chowdhry S, Morgan RD, Chambers JC, McKenna WJ. Arrhythmogenic cardiomyopathy: etiology, diagnosis, and treatment. Annu Rev Med. 2010;61:233–253. - PubMed
    1. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081–1093. - PubMed
    1. Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation. 2013;128:2259–2279. - PubMed
    1. James CA, Bhonsale A, Tichnell C, Murray B, Russell SD, Tandri H, Tedford RJ, Judge DP, Calkins H. 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. - PMC - PubMed
    1. 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. - PubMed

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