Key result
Exercise-induced VEBs affect ~15% of athletes and link to greater cardiac remodeling and functional capacity.
Why the study?
Ventricular ectopic beats are frequently observed in athletes, but their clinical significance remains debated.
Are exercise-induced ventricular ectopic beats associated with exercise-induced cardiac remodeling and functional capacity in elite athletes?
Are exercise-induced ventricular ectopic beats associated with exercise-induced cardiac remodeling and functional capacity in elite athletes?
Common exercise-induced ventricular ectopic beats in elite athletes appear to be a benign expression of physiological cardiac remodeling and superior exercise performance, whereas uncommon VEBs lack this association.
Answers are grounded in this paper and cite their sources.
Supports benign view of common VEBs in athletes; challenges prior concerns but leaves open need for longitudinal confirmation.
BACKGROUND: Ventricular ectopic beats (VEBs) are frequently observed in athletes, but their clinical significance remains debated. We aimed to assess the prevalence, pattern of exercise-induced VEBs, and their association with exercise-induced cardiac remodeling (EICR) in elite athletes. METHODS: We analyzed a large cohort of Olympic athletes who underwent comprehensive preparticipation screening, including exercise-electrocardiography test and echocardiography. VEB morphology was classified as common (left bundle branch block, with inferior axis, and fascicular) or uncommon, including polymorphic. RESULTS: We enrolled 2525 athletes (mean age, 25.7±5.2 years; 45.1% female); 14.8% of athletes had exercise-induced VEBs, more frequently males (16.7% versus 12.4%; P =0.002), with no differences between sport disciplines ( P =0.295). The VEB pattern was defined in 283 (ie, 76%), including 135 (48%) common and 148 (52%) uncommon, including polymorphic. Prevalence of common VEBs increased proportionally with the functional capacity (as W/kg), ranging from 16.3.% in I quartile to 40% in IV quartile ( P <0.0001), while no differences existed in those with uncommon VEBs ( P =0.140). Moreover, athletes with common VEBs showed a greater EICR, including a larger right ventricle (with wider right ventricular outflow tract; P =0.014; right ventricular end-diastolic area; P =0.016) and left ventricle (greater left ventricular mass indexed; P =0.037; a higher prevalence of eccentric remodeling; P =0.019). On the contrary, no relationship with cardiac remodeling or exercise capacity was seen in athletes with uncommon VEBs and in those without VEBs. CONCLUSIONS: Exercise-induced common VEBs in athletes seem to be associated with EICR and superior exercise performance and may represent a benign phenomenon, expression of the pathophysiologic consequences of EICR. Instead, uncommon VEBs were not related to the extent of EICR or the level of exercise performance, suggesting a nonphysiological nature.
No takes yet. Share an insight, caveat, or question.
Gioia et al. (2025) studied this question. Common exercise-induced ventricular ectopic beats were present in 14.8% of athletes and associated with greater exercise-induced cardiac remodeling and functional capacity.
Synapse has enriched 10 related papers. Consider them for comparative context: