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(Circulation. 2006;114:1633-1644.)
© 2006 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

The Heart of Trained Athletes

Cardiac Remodeling and the Risks of Sports, Including Sudden Death

Barry J. Maron, MD; Antonio Pelliccia, MD

From the Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minn, and the Institute of Sports Medicine and Science, Rome, Italy.

Correspondence to Barry J. Maron, MD, The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 920 East 28th St, Suite 60, Minneapolis, MN 55407. E-mail hcm.maron@mhif.org

Key Words: cardiomyopathy • death, sudden • echocardiography • electrophysiology • exercise • hypertrophy • remodeling

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Young competitive athletes are widely regarded as a special subgroup of healthy individuals with a unique lifestyle who are seemingly invulnerable and often capable of extraordinary physical achievement.^1–3 For more than 100 years, there has been considerable interest in the effects of intense athletic conditioning on the cardiovascular system.^4–27 The advent of echocardiography more than 30 years ago provided a noninvasive quantitative assessment of cardiac remodeling associated with systematic training, and consequently, a vast body of literature has been assembled that is focused on the constellation of alterations known as "athlete’s heart."^4–27

Athlete’s heart is generally regarded as a benign increase in cardiac mass, with specific circulatory and cardiac morphological alterations, that represents a physiological adaptation to systematic training.^1,6–27 However, the clinical profile of athlete’s heart has expanded considerably over the last several years as a result of greater accessibility to large populations of trained athletes studied systematically with echocardiography, ECG, cardiac magnetic resonance, and ambulatory Holter ECG monitoring. As a consequence, there is increasing recognition of the impact that prolonged conditioning has on cardiac remodeling, which may eventually mimic certain pathological conditions with the potential for sudden death or disease progression.

Over the last several years, sudden deaths of trained athletes, usually associated with exercise, have become highly visible events fueled by news media reports and with substantial impact on both the physician and lay communities.^1,28–36 Interest in these tragic events has accelerated owing to their increased recognition; awareness that underlying, clinically identifiable cardiovascular diseases are often responsible; and . . . [Full Text of this Article]

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