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Segreti A, Celeski M, Monticelli LM, Perillo A, Crispino SP, Di Gioia G, Cammalleri V, Fossati C, Mega S, Papalia R, Pigozzi F, Ussia GP, Grigioni F. Mitral and Tricuspid Valve Disease in Athletes. J Clin Med 2023; 12:jcm12103562. [PMID: 37240669 DOI: 10.3390/jcm12103562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Observing mitral or tricuspid valve disease in an athlete raises many considerations for the clinician. Initially, the etiology must be clarified, with causes differing depending on whether the athlete is young or a master. Notably, vigorous training in competitive athletes leads to a constellation of structural and functional adaptations involving cardiac chambers and atrioventricular valve systems. In addition, a proper evaluation of the athlete with valve disease is necessary to evaluate the eligibility for competitive sports and identify those requiring more follow-up. Indeed, some valve pathologies are associated with an increased risk of severe arrhythmias and potentially sudden cardiac death. Traditional and advanced imaging modalities help clarify clinical doubts, allowing essential information about the athlete's physiology and differentiating between primary valve diseases from those secondary to training-related cardiac adaptations. Remarkably, another application of multimodality imaging is evaluating athletes with valve diseases during exercise to reproduce the sport setting and better characterize the etiology and valve defect mechanism. This review aims to analyze the possible causes of atrioventricular valve diseases in athletes, focusing primarily on imaging applications in diagnosis and risk stratification.
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Affiliation(s)
- Andrea Segreti
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, 00135 Roma, Italy
| | - Mihail Celeski
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Luigi Maria Monticelli
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Alfonso Perillo
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Simone Pasquale Crispino
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Giuseppe Di Gioia
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, 00135 Roma, Italy
- Institute of Sports Medicine, Sport and Health, National Italian Olympic Committee, Largo Piero Gabrielli, 00197 Roma, Italy
| | - Valeria Cammalleri
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, 00135 Roma, Italy
| | - Simona Mega
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Rocco Papalia
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Roma, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis, 00135 Roma, Italy
| | - Gian Paolo Ussia
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
| | - Francesco Grigioni
- Unit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128 Roma, Italy
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Kahyaoglu M, Guney M, Deniz D, Kilic E. Right ventricle early inflow-outflow index may inform about the severity of pneumonia in patients with COVID-19. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:7-13. [PMID: 34709656 PMCID: PMC8657520 DOI: 10.1002/jcu.23066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Echocardiography is generally used in our daily practice to detect cardiovascular complications in COVID-19 patients and for etiological research in the case of worsened clinical status. Many echocardiographic parameters have been the subject of investigation in previous studies on COVID-19. Recently, the right ventricle early inflow-outflow (RVEIO) index has been identified as a possible and indirect marker of the severity of tricuspid regurgitation and right ventricular dysfunction in pulmonary embolism. In this study, we aimed to investigate the relationship between the severity of pneumonia in COVID-19 patients and the RVEIO index. METHODS A total of 54 patients diagnosed with COVID-19 pneumonia were enrolled in this study. Our study population was separated into two groups as severe pneumonia and nonsevere pneumonia based on computed tomography imaging. RESULTS Saturation O2 , C-reactive protein, D-dimer, deceleration time, tricuspid annular plane systolic excursion, tricuspid lateral annular systolic velocity, and RVEIO index values were found to be significantly different between severe and nonsevere pneumonia groups. The result of the multivariate logistic regression test revealed that saturation O2, D-dimer, Sm, and RVEIO index were the independent predictive parameters for severe pneumonia. Receiver operating characteristic curve analysis demonstrated that RVEIO index >4.2 predicted severe pneumonia with 77% sensitivity and 79% specificity. CONCLUSION The RVEIO index can be used as a bedside, noninvasive, easily accessible, and useful marker to identify the COVID-19 patient group with widespread pneumonia and, therefore high risk of complications, morbidity, and mortality.
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Affiliation(s)
- Muzaffer Kahyaoglu
- Department of CardiologyGaziantep Abdulkadir Yuksel State HospitalGaziantepTurkey
| | - MuratCan Guney
- Department of CardiologyGaziantep Abdulkadir Yuksel State HospitalGaziantepTurkey
| | - Derya Deniz
- Department of Chest DiseasesGaziantep Abdulkadir Yuksel State HospitalGaziantepTurkey
| | - Ertugrul Kilic
- Department of Anaesthesiology and ReanimationGaziantep Abdulkadir Yuksel State HospitalGaziantepTurkey
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Kimura BJ, Mansour CM. The RVEIO and RV function: More, please. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:14-16. [PMID: 35043438 DOI: 10.1002/jcu.23078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 06/14/2023]
Abstract
Early proof of the value of RVEIO is currently limited by acquisition biases in specific patient populations. More research is needed on this potentially important index.
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Affiliation(s)
- Bruce J Kimura
- Department of Medicine, Scripps Mercy Hospital, San Diego, California, USA
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van Buuren F, Gati S, Sharma S, Papadakis M, Adami PE, Niebauer J, Pelliccia A, Rudolph V, Börjesson M, Carre F, Solberg E, Heidbuchel H, Caselli S, Corrado D, Serratosa L, Biffi A, Pressler A, Schmied C, Panhuyzen-Goedkoop NM, Rasmussen HK, La Gerche A, Faber L, Bogunovic N, D'Ascenzi F, Mellwig KP. Athletes with valvular heart disease and competitive sports: a position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2021; 28:1569-1578. [PMID: 33846742 DOI: 10.1093/eurjpc/zwab058] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 12/18/2022]
Abstract
This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precaution to ensure a high level of safety for all affected individuals. Valvular heart disease is usually an age-related degenerative process, predominantly affecting individuals in their fifth decade and onwards. However, there is an increasing group of younger individuals with valvular defects. The diagnosis of cardiac disorders during routine cardiac examination often raises questions about on-going participation in competitive sport with a high dynamic or static component and the level of permissible physical effort during recreational exercise. Although the natural history of several valvular diseases has been reported in the general population, little is known about the potential influence of chronic intensive physical activity on valve function, left ventricular remodelling pulmonary artery pressure, and risk of arrhythmia. Due to the sparsity of data on the effects of exercise on VHD, the present document is largely based on clinical experience and expert opinion.
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Affiliation(s)
- Frank van Buuren
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.,Catholic Hospital Southwestfalia, St. Martinus Hospital Olpe, Germany
| | - Sabiha Gati
- National Heart and Lung Institute, Imperial College, London, UK.,Department of Cardiology, Royal Brompton Hospital, London, SW3 6NP, UK
| | - Sanjay Sharma
- Cardiovascular Clinical Academic Group, St. George's, University of London, UK
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St. George's, University of London, UK
| | - Paolo Emilio Adami
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Antonio Pelliccia
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Volker Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Mats Börjesson
- Department of Molecular and Clinical Medicine, Institute of Medicine; Center for Health and Performance, Gothenburg University.,Department of Medicine, Sahlgrenzska University Hospital/Östra, Gothenburg, Sweden
| | - Francois Carre
- Sport Medicine Department, Rennes University Hospital, LTSI INSERM UMR 1099, France
| | - Erik Solberg
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Hein Heidbuchel
- Antwerp University and University Hospital, Cardiology, Antwerp, Belgium
| | - Stefano Caselli
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland.,Ospedale San Pietro Fatebenefratelli, Rome, Italy
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padova, Italy
| | - Luis Serratosa
- Hospital Universitario Quironsalud Madrid, Spain.,Ripoll y De Prado Sport Clinic, FIFA Medical Centre of Excellence, Madrid, Spain
| | - Alessandro Biffi
- Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich Switzerland
| | - Axel Pressler
- Centre for General, Sports and Preventive Cardiology, Munich, Germany.,Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Germany
| | - Christian Schmied
- Kardiologisches Ambulatorium, Sportmedizin/Sportkardiologie, University Heart Center, Zurich, Switzerland
| | | | | | | | - Lothar Faber
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Nikola Bogunovic
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Klaus Peter Mellwig
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
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5
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Acar E, İzci S, Inanir M, Yılmaz MF, Izgi IA, Kirma C. Right Ventricular Early Inflow‐Outflow Index—A new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism. Echocardiography 2020; 37:223-230. [DOI: 10.1111/echo.14591] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/12/2019] [Accepted: 12/28/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Emrah Acar
- Department of Cardiology Gumushane State Hospital Gumushane Turkey
| | - Servet İzci
- Kartal Koşuyolu Heart And Vascular Disease Research And Training Hospital Istanbul Turkey
| | - Mehmet Inanir
- Department of Cardiology Bolu Abant Izzet Baysal University Bolu Turkey
| | - Mehmet Fatih Yılmaz
- Department of Cardiology Siyami Ersek Research and Training Hospital Istanbul Turkey
| | - Ibrahim Akin Izgi
- Kartal Koşuyolu Heart And Vascular Disease Research And Training Hospital Istanbul Turkey
| | - Cevat Kirma
- Kartal Koşuyolu Heart And Vascular Disease Research And Training Hospital Istanbul Turkey
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Lee CH, Laurence DW, Ross CJ, Kramer KE, Babu AR, Johnson EL, Hsu MC, Aggarwal A, Mir A, Burkhart HM, Towner RA, Baumwart R, Wu Y. Mechanics of the Tricuspid Valve-From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling. Bioengineering (Basel) 2019; 6:E47. [PMID: 31121881 PMCID: PMC6630695 DOI: 10.3390/bioengineering6020047] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022] Open
Abstract
Proper tricuspid valve (TV) function is essential to unidirectional blood flow through the right side of the heart. Alterations to the tricuspid valvular components, such as the TV annulus, may lead to functional tricuspid regurgitation (FTR), where the valve is unable to prevent undesired backflow of blood from the right ventricle into the right atrium during systole. Various treatment options are currently available for FTR; however, research for the tricuspid heart valve, functional tricuspid regurgitation, and the relevant treatment methodologies are limited due to the pervasive expectation among cardiac surgeons and cardiologists that FTR will naturally regress after repair of left-sided heart valve lesions. Recent studies have focused on (i) understanding the function of the TV and the initiation or progression of FTR using both in-vivo and in-vitro methods, (ii) quantifying the biomechanical properties of the tricuspid valve apparatus as well as its surrounding heart tissue, and (iii) performing computational modeling of the TV to provide new insight into its biomechanical and physiological function. This review paper focuses on these advances and summarizes recent research relevant to the TV within the scope of FTR. Moreover, this review also provides future perspectives and extensions critical to enhancing the current understanding of the functioning and remodeling tricuspid valve in both the healthy and pathophysiological states.
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Affiliation(s)
- Chung-Hao Lee
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
- Institute for Biomedical Engineering, Science and Technology (IBEST), The University of Oklahoma, Norman, OK 73019, USA.
| | - Devin W Laurence
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Colton J Ross
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Katherine E Kramer
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Anju R Babu
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
- Department of Biotechnology and Medical Engineering, National Institute of Technology Rourkela, Rourkela, Odisha 769008, India.
| | - Emily L Johnson
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA.
| | - Ming-Chen Hsu
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA.
| | - Ankush Aggarwal
- Glasgow Computational Engineering Centre, School of Engineering, University of Glasgow, Scotland G12 8LT, UK.
| | - Arshid Mir
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Harold M Burkhart
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Rheal A Towner
- Advance Magnetic Resonance Center, MS 60, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Ryan Baumwart
- Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Yi Wu
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
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