Assessment of sports activity in patients diagnosed with familial cardiopathies

Abstract

Background: Sports activity was associated with an increased risk of sudden cardiac death (SCD) in adolescents and young adults with undiagnosed cardiomyopathies or channelopathies. It is estimated that one in 1000 athletes may be affected. The present study sought to determine the percentage of patients diagnosed with familial cardiopathies that do physical exercise regularly, their clinical characteristics, and follow-up through a specialized consultation. Methods: A prospective observational study was designed. 1128 consecutive patients (age 49±19, 418 (37%) women) from 765 families that satisfied diagnostic criteria for cardiomyopathy or channelopathy were included. Age of diagnosis, clinical characteristics, and electrocardiographic and echocardiographic parameters were collected. Rate of events was determined in both groups: SCD; resuscitated sudden cardiac death (RSCD); and implantable cardioverter defibrillator (ICD) discharge. Results: 85 athletes (7,5%) were identified. The mean age at diagnosis was significantly lower in the group of patients that practiced sports (31,5±15 years vs 45,6±20 years; p<0,001). Among patients diagnosed with hypertrophic cardiomyopathy, athletes group presented a lower thickness of ventricular septum (median 15mm, range 14 to 20mm vs 19mm, range 16 to 22mm; p=0,001). Left ventricular ejection fraction (LVEF) in patients diagnosed with idiopathic dilated cardiomyopathy was higher in the group of athletes (mean 51,1±5,6% vs 35,4±13,6%; p<0,001). Four patients that practiced sports routinely had events: 3 SCD and one RSCD; while in the group of non-athlete patients, 64 of them presented events: 23 SCD, 26 RSCD, and 15 ICD discharges. There were no significant differences in the development of events between the two groups. Conclusions: A significant proportion of patients with familial cardiopathies practice sport regularly. Diagnosis of heart disease was earlier in the group of athletes. In this group, the thickness of ventricular septum among patients with hypertrophic cardiomyopathy was lower and patients with idiopathic dilated cardiomyopathy had higher LVEF than in the group of non-athletes. There were no differences between both groups in the development of events. Further studies are required to understand the relationship between sport and the development of adverse events in patients diagnosed with familial cardiopathies.