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Effect of Endurance Sport on the Right Heart

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Right Heart Pathology

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Abstract

The right ventricle (RV) responds differently to prolonged exhaustive and competitive exercise, usually with enlargement, than does the left ventricle. Evidence has accumulated indicating that regular intense endurance exercise and sporting can promote electrical and structural remodeling of the RV, leading to fibrosis. This “exercise-induced cardiomyopathy” mimics features observed in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). In addition, exercise-induced impairment in atrial function (atrial remodeling), mostly in the right atrium related to RV systolic dysfunction, has also been suggested which favors the development of atrial arrhythmias. It should be noted that these adverse effects seem to be limited to extreme intensity levels of exercise and not related to recreational or moderate exercise levels. These deleterious effects of heavy endurance exercise on the right heart can be studied by several methods, including standard and newer echocardiographic techniques, stress testing methods, standard ECG, cardiac magnetic resonance imaging, biomarkers, electroanatomical mapping and/or an electrophysiology study, and in specific cases by genetic testing. All these issues are reviewed in this chapter.

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Abbreviations

AF:

Atrial fibrillation

ARVD/C:

Arrhythmogenic right ventricular dysplasia/cardiomyopathy

CMR:

Cardiac magnetic resonance imaging

ECG:

Electrocardiogram

RBBB:

Right bundle branch block

RV:

Right ventric-le (-ular)

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Conflict of Interest

None declared.

Author information

Authors and Affiliations

  1. Third Department of Cardiology, Athens University School of Medicine, Athens, Greece

    Antonis S. Manolis

  2. Patras University School of Medicine, Patras, Greece

    Antonis A. Manolis

Authors
  1. Antonis S. Manolis
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  2. Antonis A. Manolis
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Correspondence to Antonis S. Manolis .

Editor information

Editors and Affiliations

  1. Department of Medicine, Titu Maiorescu University, Bucharest, Romania

    Silviu Ionel Dumitrescu

  2. Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Ion C. Ţintoiu

  3. Department of Surgery, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Malcolm John Underwood

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Manolis, A.S., Manolis, A.A. (2018). Effect of Endurance Sport on the Right Heart. In: Dumitrescu, S., Ţintoiu, I., Underwood, M. (eds) Right Heart Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-73764-5_6

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  • DOI: https://doi.org/10.1007/978-3-319-73764-5_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73763-8

  • Online ISBN: 978-3-319-73764-5

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