Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie?
Identifieur interne : 002884 ( Ncbi/Merge ); précédent : 002883; suivant : 002885Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie?
Auteurs : Frédéric Schnell [Belgique] ; Guido Claessen [Belgique] ; André La Gerche [Australie] ; Jan Bogaert [Belgique] ; Pierre-Axel Lentz [France] ; Piet Claus [Belgique] ; Philippe Mabo [France] ; François Carré [France] ; Hein Heidbuchel [Belgique]Source :
- British journal of sports medicine [ 1473-0480 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte, Angiographie par résonance magnétique, Diagnostic précoce, Femelle, Fonction ventriculaire gauche (physiologie), Gadolinium, Humains, Jeune adulte, Myocardite (anatomopathologie), Myocardite (physiopathologie), Mâle, Produits de contraste, Remodelage ventriculaire (physiologie), Sports (physiologie), Syndrome de Brugada (anatomopathologie), Syndrome de Brugada (physiopathologie), Troubles du rythme cardiaque (diagnostic), Troubles du rythme cardiaque (physiopathologie), Électrocardiographie.
- MESH :
- anatomopathologie : Myocardite, Syndrome de Brugada.
- diagnostic : Troubles du rythme cardiaque.
- physiologie : Fonction ventriculaire gauche, Remodelage ventriculaire, Sports.
- physiopathologie : Myocardite, Syndrome de Brugada, Troubles du rythme cardiaque.
- Adulte, Angiographie par résonance magnétique, Diagnostic précoce, Femelle, Gadolinium, Humains, Jeune adulte, Mâle, Produits de contraste, Électrocardiographie.
English descriptors
- KwdEn :
- Adult, Arrhythmias, Cardiac (diagnosis), Arrhythmias, Cardiac (physiopathology), Brugada Syndrome (pathology), Brugada Syndrome (physiopathology), Contrast Media, Early Diagnosis, Electrocardiography, Female, Gadolinium, Humans, Magnetic Resonance Angiography, Male, Myocarditis (pathology), Myocarditis (physiopathology), Sports (physiology), Ventricular Function, Left (physiology), Ventricular Remodeling (physiology), Young Adult.
- MESH :
- chemical : Contrast Media, Gadolinium.
- diagnosis : Arrhythmias, Cardiac.
- pathology : Brugada Syndrome, Myocarditis.
- physiology : Sports, Ventricular Function, Left, Ventricular Remodeling.
- physiopathology : Arrhythmias, Cardiac, Brugada Syndrome, Myocarditis.
- Adult, Early Diagnosis, Electrocardiography, Female, Humans, Magnetic Resonance Angiography, Male, Young Adult.
Abstract
Subepicardial delayed gadolinium enhancement (DGE) patches without underlying cardiomyopathy is poorly understood. It is often reported as the result of prior silent myocarditis. Its prognostic relevance in asymptomatic athletes is unknown; therefore, medical clearance for competitive sports participation is debated. This case series aims to relate this pattern of DGE in athletes to outcome.
DOI: 10.1136/bjsports-2014-094546
PubMed: 26224114
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pubmed:26224114Le document en format XML
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Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Claessen, Guido" sort="Claessen, Guido" uniqKey="Claessen G" first="Guido" last="Claessen">Guido Claessen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="La Gerche, Andre" sort="La Gerche, Andre" uniqKey="La Gerche A" first="André" last="La Gerche">André La Gerche</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.</nlm:affiliation><country 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uniqKey="Mabo P" first="Philippe" last="Mabo">Philippe Mabo</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, University Hospital Pontchaillou, Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Cardiology, University Hospital Pontchaillou, Rennes</wicri:regionArea><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Carre, Francois" sort="Carre, Francois" uniqKey="Carre F" first="François" last="Carré">François Carré</name><affiliation wicri:level="3"><nlm:affiliation>Department of Sport Medicine, University Hospital Pontchaillou, Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Sport Medicine, University Hospital Pontchaillou, Rennes</wicri:regionArea><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Heidbuchel, Hein" sort="Heidbuchel, Hein" uniqKey="Heidbuchel H" first="Hein" last="Heidbuchel">Hein Heidbuchel</name><affiliation wicri:level="1"><nlm:affiliation>Hasselt University and Heart Center, Jessa Hospital, Hasselt, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Hasselt University and Heart Center, Jessa Hospital, Hasselt</wicri:regionArea><wicri:noRegion>Hasselt</wicri:noRegion></affiliation></author></analytic><series><title level="j">British journal of sports medicine</title><idno type="eISSN">1473-0480</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Arrhythmias, Cardiac (diagnosis)</term><term>Arrhythmias, Cardiac (physiopathology)</term><term>Brugada Syndrome (pathology)</term><term>Brugada Syndrome (physiopathology)</term><term>Contrast Media</term><term>Early Diagnosis</term><term>Electrocardiography</term><term>Female</term><term>Gadolinium</term><term>Humans</term><term>Magnetic Resonance Angiography</term><term>Male</term><term>Myocarditis (pathology)</term><term>Myocarditis (physiopathology)</term><term>Sports (physiology)</term><term>Ventricular Function, Left (physiology)</term><term>Ventricular Remodeling (physiology)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Angiographie par résonance magnétique</term><term>Diagnostic précoce</term><term>Femelle</term><term>Fonction ventriculaire gauche (physiologie)</term><term>Gadolinium</term><term>Humains</term><term>Jeune adulte</term><term>Myocardite (anatomopathologie)</term><term>Myocardite (physiopathologie)</term><term>Mâle</term><term>Produits de contraste</term><term>Remodelage ventriculaire (physiologie)</term><term>Sports (physiologie)</term><term>Syndrome de Brugada (anatomopathologie)</term><term>Syndrome de Brugada (physiopathologie)</term><term>Troubles du rythme cardiaque (diagnostic)</term><term>Troubles du rythme cardiaque (physiopathologie)</term><term>Électrocardiographie</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Contrast Media</term><term>Gadolinium</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Myocardite</term><term>Syndrome de Brugada</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Arrhythmias, Cardiac</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Troubles du rythme cardiaque</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brugada Syndrome</term><term>Myocarditis</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Fonction ventriculaire gauche</term><term>Remodelage ventriculaire</term><term>Sports</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Sports</term><term>Ventricular Function, Left</term><term>Ventricular Remodeling</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Myocardite</term><term>Syndrome de Brugada</term><term>Troubles du rythme cardiaque</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Brugada Syndrome</term><term>Myocarditis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Early Diagnosis</term><term>Electrocardiography</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Angiography</term><term>Male</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Angiographie par résonance magnétique</term><term>Diagnostic précoce</term><term>Femelle</term><term>Gadolinium</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Produits de contraste</term><term>Électrocardiographie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subepicardial delayed gadolinium enhancement (DGE) patches without underlying cardiomyopathy is poorly understood. It is often reported as the result of prior silent myocarditis. Its prognostic relevance in asymptomatic athletes is unknown; therefore, medical clearance for competitive sports participation is debated. This case series aims to relate this pattern of DGE in athletes to outcome.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26224114</PMID><DateCreated><Year>2016</Year><Month>01</Month><Day>05</Day></DateCreated><DateCompleted><Year>2016</Year><Month>09</Month><Day>26</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1473-0480</ISSN><JournalIssue CitedMedium="Internet"><Volume>50</Volume><Issue>2</Issue><PubDate><Year>2016</Year><Month>Jan</Month></PubDate></JournalIssue><Title>British journal of sports medicine</Title><ISOAbbreviation>Br J Sports Med</ISOAbbreviation></Journal><ArticleTitle>Subepicardial delayed gadolinium enhancement in asymptomatic athletes: let sleeping dogs lie?</ArticleTitle><Pagination><MedlinePgn>111-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bjsports-2014-094546</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Subepicardial delayed gadolinium enhancement (DGE) patches without underlying cardiomyopathy is poorly understood. It is often reported as the result of prior silent myocarditis. Its prognostic relevance in asymptomatic athletes is unknown; therefore, medical clearance for competitive sports participation is debated. This case series aims to relate this pattern of DGE in athletes to outcome.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We report on seven young asymptomatic athletes with isolated subepicardial DGE detected during workup of abnormalities on their regular screening examination, that is, pathological T-wave inversions on ECG (n=4) or ventricular arrhythmias on exercise test (n=3). All underwent a comprehensive initial investigation in order to assess left ventricular (LV) function at rest and exercise (exercise cardiac MRI and/or exercise echocardiography) and occurrence of arrhythmias (exercise test, 24 h-ECG Holter, electrophysiological study). All underwent a careful follow-up with biannual evaluation.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">All athletes had extensive subepicardial DGE (12.0±4.8% of LV mass), predominantly in the lateral wall. Three athletes had non-sustained ventricular arrhythmias, whereas two of them had LV ejection fraction <50% at rest with no contractile reserve at exercise. During a follow-up of 3.0±1.5 years in the four remaining athletes, two had symptomatic ventricular tachycardia and one demonstrated progressive LV dysfunction. Hence, six of seven athletes had to be excluded from competitive sports participation.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Isolated large areas of subepicardial DGE in an asymptomatic athlete are not benign and require a careful evaluation at exercise and a strict follow-up. These findings question whether extreme exercise during silent myocarditis may facilitate fibrosis generation and adverse remodelling.</AbstractText><CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Schnell</LastName><ForeName>Frédéric</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Sport Medicine, University Hospital Pontchaillou, Rennes, France Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Claessen</LastName><ForeName>Guido</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>La Gerche</LastName><ForeName>André</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bogaert</LastName><ForeName>Jan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Radiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lentz</LastName><ForeName>Pierre-Axel</ForeName><Initials>PA</Initials><AffiliationInfo><Affiliation>Department of Radiology, University Hospital Pontchaillou, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Claus</LastName><ForeName>Piet</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Imaging and Dynamics, University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mabo</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Hospital Pontchaillou, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carré</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Sport Medicine, University Hospital Pontchaillou, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heidbuchel</LastName><ForeName>Hein</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Hasselt University and Heart Center, Jessa Hospital, Hasselt, Belgium.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>07</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Br J Sports Med</MedlineTA><NlmUniqueID>0432520</NlmUniqueID><ISSNLinking>0306-3674</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D003287">Contrast Media</NameOfSubstance></Chemical><Chemical><RegistryNumber>AU0V1LM3JT</RegistryNumber><NameOfSubstance UI="D005682">Gadolinium</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C562490">Cardiac Conduction Defect</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="N">Arrhythmias, Cardiac</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053840" MajorTopicYN="N">Brugada Syndrome</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003287" MajorTopicYN="N">Contrast Media</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D042241" MajorTopicYN="N">Early Diagnosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005682" MajorTopicYN="N">Gadolinium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018810" MajorTopicYN="N">Magnetic Resonance Angiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009205" MajorTopicYN="N">Myocarditis</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013177" MajorTopicYN="N">Sports</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020257" MajorTopicYN="N">Ventricular Remodeling</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Athlete</Keyword><Keyword MajorTopicYN="N">Cardiology</Keyword><Keyword MajorTopicYN="N">MRI</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>07</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>7</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>8</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>9</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26224114</ArticleId><ArticleId IdType="pii">bjsports-2014-094546</ArticleId><ArticleId IdType="doi">10.1136/bjsports-2014-094546</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li><li>Belgique</li><li>France</li></country><region><li>Région Bretagne</li></region><settlement><li>Rennes</li></settlement></list><tree><country name="Belgique"><noRegion><name sortKey="Schnell, Frederic" sort="Schnell, Frederic" uniqKey="Schnell F" first="Frédéric" last="Schnell">Frédéric Schnell</name></noRegion><name sortKey="Bogaert, Jan" sort="Bogaert, Jan" uniqKey="Bogaert J" first="Jan" last="Bogaert">Jan Bogaert</name><name sortKey="Claessen, Guido" sort="Claessen, Guido" uniqKey="Claessen G" first="Guido" last="Claessen">Guido Claessen</name><name sortKey="Claus, Piet" sort="Claus, Piet" uniqKey="Claus P" first="Piet" last="Claus">Piet Claus</name><name sortKey="Heidbuchel, Hein" sort="Heidbuchel, Hein" uniqKey="Heidbuchel H" first="Hein" last="Heidbuchel">Hein Heidbuchel</name></country><country name="Australie"><noRegion><name sortKey="La Gerche, Andre" sort="La Gerche, Andre" uniqKey="La Gerche A" first="André" last="La Gerche">André La Gerche</name></noRegion></country><country name="France"><region name="Région Bretagne"><name sortKey="Lentz, Pierre Axel" sort="Lentz, Pierre Axel" uniqKey="Lentz P" first="Pierre-Axel" last="Lentz">Pierre-Axel Lentz</name></region><name sortKey="Carre, Francois" sort="Carre, Francois" uniqKey="Carre F" first="François" last="Carré">François Carré</name><name sortKey="Mabo, Philippe" sort="Mabo, Philippe" uniqKey="Mabo P" first="Philippe" last="Mabo">Philippe Mabo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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