How can physiological exercise-induced right ventricular remodeling be differentiated from early arrhythmogenic right ventricular cardiomyopathy (ARVC)?
This review highlights the diagnostic challenge of distinguishing physiological athletic heart adaptations from early arrhythmogenic right ventricular cardiomyopathy to prevent sudden cardiac death.
Intense exercise-induced right ventricular remodeling is a potential adaptation of cardiac function and structure. The features of the remodeling may overlap with those of a very early form of arrhythmogenic right ventricular cardiomyopathy (ARVC): at this early stage, it could be difficult to discriminate ARVC, from exercise-induced cardiac adaptation that may develop in normal individuals. The purpose of this paper is to discuss which exercise-induced remodeling may be a pathological or a physiological finding. A complete evaluation may be required to identify the pathological features of ARVC that would include potential risk of sudden cardiac death during sport or, to avoid the false diagnosis of ARVC. The most recent expert assessment of arrhythmogenic cardiomyopathy focuses on endurance athletes presenting with clinical features indistinguishable from ARVC.
Mascia et al. (Tue,) studied this question.
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