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The ESC Textbook of Sports Cardiology最新文献

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Resuscitation on the field: basic and advanced life support and automatic external defibrillators 现场复苏:基本和高级生命支持和自动体外除颤器
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0044
M. Link, M. Estes
{"title":"Resuscitation on the field: basic and advanced life support and automatic external defibrillators","authors":"M. Link, M. Estes","doi":"10.1093/MED/9780198779742.003.0044","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0044","url":null,"abstract":"Resuscitation on the playing field is at least as important as screening in the prevention of death. Even if a screening strategy is largely effective, individuals will suffer sudden cardiac arrests. Timely recognition of a cardiac arrest with rapid implementation of cardiopulmonary resuscitation (CPR) and deployment and use of automated external defibrillators (AEDs) will save lives. Basic life support, including CPR and AED use, should be a requirement for all those involved in sports, including athletes. An emergency action plan is important in order to render advanced cardiac life support and arrange for transport to medical centres.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121249316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronary computed tomography 冠状动脉计算机断层扫描
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0017
S. Möhlenkamp
{"title":"Coronary computed tomography","authors":"S. Möhlenkamp","doi":"10.1093/MED/9780198779742.003.0017","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0017","url":null,"abstract":"Coronary computed tomography (CCT) allows high resolution imaging of coronary atherosclerosis, coronary artery stenosis, and other coronary pathology or anomaly, such as abnormal origin of coronary arteries or myocardial bridging. Coronary artery calcium (CAC) imaging to quantify calcified plaque or CT angiography (CTA) to detect calcified, mixed, or non-calcified plaque may help to improve risk stratification and exclusion of coronary artery disease, especially in master athletes with present or past cardiovascular risk factors or athletes with atypical chest pain. Initial data suggest that the extent of subclinical atherosclerosis may be underestimated in athletes and that an increased atherosclerosis burden is associated with impaired prognosis. Careful risk–benefit assessment of radiation exposure, contrast agent, and costs of the test is necessary, particularly for asymptomatic athletes with risk factors and young athletes.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131480558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Myocarditis in athletes 运动员心肌炎
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0023
M. Halle, M. Schindler
{"title":"Myocarditis in athletes","authors":"M. Halle, M. Schindler","doi":"10.1093/MED/9780198779742.003.0023","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0023","url":null,"abstract":"Myocardial involvement during viral infection is underestimated (∼5%). Most infections are not perceived and resolve spontaneously. Symptoms may be non-specific, but include new onset of angina in a young athlete, chest pain, increased resting and exercise heart rate, increased dyspnoea, palpitations, syncope, and impairment of exercise capacity. Physical examination, ECG, and echocardiography are the primary diagnostic tools, whereas serology has a low sensitivity and is not generally recommended. Cardiac magnetic resonance should be performed in all athletes with suspected myocarditis, which typically reveals late gadolinium enhancement (LGE) with a patchy pattern. Patients without LGE and with ejection function >60% have a good prognosis. Endomyocardial biopsy should only be performed if there is severe impairment of myocardial function. A detailed clinical work-up should be performed for re-evaluation after 3 and 6 months. Eligibility to participate in sport can be given after 3 months for perimyocarditis and 6 months for myocarditis, if clinical examination is normal.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125087104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ambulatory (24-hour Holter monitoring, event recorders) and signal-averaged ECG for arrhythmia registration in the athlete’s heart 动态(24小时动态心电图监测，事件记录仪)和信号平均ECG用于记录运动员心脏心律失常
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0012
M. Sareban, J. Niebauer
{"title":"Ambulatory (24-hour Holter monitoring, event recorders) and signal-averaged ECG for arrhythmia registration in the athlete’s heart","authors":"M. Sareban, J. Niebauer","doi":"10.1093/MED/9780198779742.003.0012","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0012","url":null,"abstract":"Systematic physical exercise leads to structural, functional, and electrical cardiovascular changes summarized in the term ‘athlete’s heart’. Arrhythmias that are common features in the resting ECG of otherwise healthy athletes may be an expression of the athlete’s heart, but on the other hand may be caused by underlying cardiac pathology, opening up a grey zone of diagnostic uncertainty. Differentiating adaptive changes from pathological cardiac conditions is of great clinical importance because some cardiomyopathies are leading causes of sudden cardiac death in athletes. In addition, there is increasing evidence that excessive endurance training may induce intermittent atrial arrhythmias, which can be hard to detect by resting ECG. Therefore this chapter will highlight 24-hour Holter monitoring, event recorders, and signal-averaged ECGs in the emerging field of ambulatory arrhythmia registration as part of the diagnostic work-up of athlete’s heart.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"224 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121621809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vascular remodelling 血管重塑
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0005
S. Gielen, M. Laughlin, D. Duncker
{"title":"Vascular remodelling","authors":"S. Gielen, M. Laughlin, D. Duncker","doi":"10.1093/med/9780198779742.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0005","url":null,"abstract":"Vascular remodelling plays an important role in the adaptation of the athlete to increased exercise duration and intensity. Endurance exercise improves endothelium-dependent flow-mediated vasodilation and leads to increases in conduit artery lumen diameter after regular exercise, typically in the trained limb. These changes result in a reduced vascular stiffnes. On the contrary strength training (e.g. for weight-lifting) produces increased vascular stiffness and enlarged central vessels (e.g. aortic root diameters), while the diameters of peripheral vessels are unchanged. In the skeletal muscle, endurance training increases capillary density and improves oxygen exchange, thus adding further functional reserves to the aerobic exercise capacity. Aerobic exercise leads to a large increase in cardiac functional reserves, hence myocardial perfusion is increased in line with metabolic demands. In addition to improved endothelium-dependent vasodilation, coronary arterioles also exhibit an increased myogenic tone.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114667320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Cardiac magnetic resonance imaging 心脏磁共振成像
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0016
G. Claessen, A. Gerche
{"title":"Cardiac magnetic resonance imaging","authors":"G. Claessen, A. Gerche","doi":"10.1093/MED/9780198779742.003.0016","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0016","url":null,"abstract":"Cardiac magnetic resonance imaging (CMR) has become an extremely valuable tool in the detection of cardiac pathology because of its accuracy in assessing cardiac structure and function, and its ability to provide tissue characterization. In this chapter we discuss the role of CMR in the evaluation of athletes, in whom it can be challenging to differentiate physiological changes from underlying myocardial pathology. It is fundamental to distinguish athletes undergoing CMR because of concerning symptoms from athletes evaluated for screening purposes with little pre-test probability for disease. We will briefly highlight state-of-the-art imaging sequences and post-processing techniques that are being used to assess cardiac morphology, function, and viability in athletes. Finally, we will discuss CMR findings present in inherited and acquired cardiomyopathies and how to distinguish these from physiological changes observed in highly trained athletes.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122314210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indications for genetic testing in athletes and its application in daily practice 运动员基因检测的适应症及其在日常训练中的应用
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198779742.003.0020
A. Mazzanti, Katherine Underwood, S. Priori
{"title":"Indications for genetic testing in athletes and its application in daily practice","authors":"A. Mazzanti, Katherine Underwood, S. Priori","doi":"10.1093/MED/9780198779742.003.0020","DOIUrl":"https://doi.org/10.1093/MED/9780198779742.003.0020","url":null,"abstract":"Genetic information is fundamental for the management of patients with primary arrhythmia syndromes (e.g. long QT syndrome or catecholaminergic polymorphic ventricular tachycardia) and cardiomyopathies (e.g. arrhythmogenic right ventricular cardiomyopathy or hypertrophic cardiomyopathy) which increase the risk of sudden cardiac death. Importantly, molecular testing can play a pivotal role in establishing a clinical diagnosis of an inherited cardiovascular disease, particularly when the phenotype in unclear and overlaps with the normal adaptations induced in the heart by chronic exercise. However, the decision to undergo genetic testing needs to be justified on a clinical basis and handled by professionals who are capable of framing the results in the correct perspective. In this chapter we will answer the following questions. When should genetic testing be performed in athletes? Which genetic tests should be requested for athletes? What impact should a positive genetic result have on sports eligibility?","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133043037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Supraventricular tachyarrhythmias
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0031
M. Wilhelm
{"title":"Supraventricular tachyarrhythmias","authors":"M. Wilhelm","doi":"10.1093/med/9780198779742.003.0031","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0031","url":null,"abstract":"Supraventricular tachyarrhythmias (SVTs) include atrial tachycardia (AT), atrioventricular nodal re-entrant tachycardia (AVNRT), atrioventricular re-entrant tachycardia (AVRT), atrial flutter (AFL), and atrial fibrillation (AF).\u0000 The prevalence of SVT does not differ between athletes and the general population. An exception is AF, with a two- to eightfold higher prevalence in athletes, probably due to exercise-induced atrial remodelling. Symptoms of SVTs include palpitations, dizziness, weakness, and rarely syncope, and may impair athletic performance. Except for AF in the presence of an accessory pathway, SVTs are rarely life-threatening. For treatment of AT, AVNRT, AVRT, and AFL catheter ablation is generally preferred over lifelong anti-arrhythmic drug (AAD) therapy because of high rates of resolution. Reduction of training volume and AAD therapy should be attempted in athletes with AF. However, catheter ablation of AF may be the first-line therapy in athletes with severe symptoms. Most athletes with SVT can continue leisure-time activities and competitive sports.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126614861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Incidence of sudden cardiac death in athletes 运动员心源性猝死的发生率
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0033
J. Drezner, K. Harmon
{"title":"Incidence of sudden cardiac death in athletes","authors":"J. Drezner, K. Harmon","doi":"10.1093/med/9780198779742.003.0033","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0033","url":null,"abstract":"Sudden cardiac death (SCD) is the leading cause of fatalities in competitive athletes during sports and exercise. These tragic events often receive intense public attention and stimulate debate regarding the most appropriate prevention strategies. A precise understanding of SCD incidence is needed to guide effective screening programmes and proper emergency preparations at athletic events. However, published estimates of SCD incidence vary widely, and are strongly influenced by the methodology used for case identification (numerator) and calculations of the population at risk (denominator). Studies searching only media reports or catastrophic insurance claims tend to underestimate SCD risk. Few studies with mandatory reporting of SCD are available, leaving significant knowledge gaps in our understanding of SCD in competitive athletes. In general, SCD is more common in males, black athletes, and male basketball players. This chapter reviews the incidence of SCD in athletes and examines differences based on gender, race, sport, and geographic region.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130805173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Protocols of exercise testing in athletes and cardiopulmonary testing: assessment of fitness 运动员运动试验和心肺试验的规程:适应性评估
The ESC Textbook of Sports Cardiology Pub Date : 2019-03-01 DOI: 10.1093/med/9780198779742.003.0010
M. Guazzi, P. Adami
{"title":"Protocols of exercise testing in athletes and cardiopulmonary testing: assessment of fitness","authors":"M. Guazzi, P. Adami","doi":"10.1093/med/9780198779742.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198779742.003.0010","url":null,"abstract":"Exercise and cardiopulmonary exercise testing are essential in the evaluation of the cardiovascular response to exercise. They are clinically used to evaluate the subject’s capacity to tolerate increasing work loads. Throughout the tests electrocardiographic, haemodynamic, and symptomatic responses are monitored to assess ischaemic, hypertensive, and arrhythmic manifestations of disease. Ventilatory expired gas analysis may also be performed, as it provides fundamental information, particularly in patients with congestive heart failure or other exercise-induced limitations.","PeriodicalId":143273,"journal":{"name":"The ESC Textbook of Sports Cardiology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132706312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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