Screening of Potential Cardiac Involvement in Competitive Athletes Recovering From COVID-19: An Expert Consensus Statement
Autor: | Phelan, Dermot, Kim, Jonathan H., Elliott, Michael D., Wasfy, Meagan M., Cremer, Paul, Johri, Amer M., Emery, Mike, Sengupta, Partho P., Sharma, Sanjay, Martinez, Matthew W., La Gerche, Andre |
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Rok vydání: | 2020 |
Předmět: |
Competitive Behavior
Consensus Heart Diseases Computed Tomography Angiography SARS–CoV-2 severe acute respiratory syndrome coronavirus 2 POCUS point-of-care ultrasound Coronary Angiography Multimodal Imaging Risk Assessment PET positron emission tomography State-of-the-Art Paper hs-cTn high-sensitivity cardiac troponin PCR polymerase chain reaction Predictive Value of Tests Risk Factors COVID-19 coronavirus disease–19 EF ejection fraction EICR exercise-induced cardiac remodeling Humans myocardial injury return-to-play LGE late gadolinium enhancement CV cardiovascular CCTA coronary computed tomography angiography COVID-19 multi-modality imaging PPE pre-participation physical evaluation Prognosis CMR cardiac magnetic resonance imaging Magnetic Resonance Imaging Return to Sport RV right ventricle LV left ventricle Cardiorespiratory Fitness TTE transthoracic echocardiography Athletes Echocardiography GLS global longitudinal strain ECG electrocardiogram athlete myocarditis RTP return-to-play Tomography Emission-Computed |
Zdroj: | Jacc. Cardiovascular Imaging |
ISSN: | 1876-7591 |
Popis: | As our understanding of the complications of coronavirus disease–2019 (COVID-19) evolve, sub-clinical cardiac pathology such as myocarditis, pericarditis and right ventricular dysfunction in the absence of significant clinical symptoms represents a concern. The potential implications of these findings in athletes are significant given the concern that exercise, during the acute phase of viral myocarditis, may exacerbate myocardial injury and precipitate malignant ventricular arrhythmias. Such concerns have led to the development and publication of expert consensus documents aimed at providing guidance for the evaluation of athletes after contracting COVID-19 in order to permit safe return-to-play. Cardiac imaging is at the center of these evaluations. This review seeks to evaluate the current evidence regarding COVID-19associated cardiovascular disease and how multi-modality imaging may be useful in the screening and clinical evaluation of athletes with suspected cardiovascular complications of infection. Guidance is provided with diagnostic “red flags” that raise the suspicion of pathology. Specific emphasis is placed on the unique challenges posed in distinguishing athletic cardiac remodeling from sub-clinical cardiac disease. The strengths and limitations of different imaging modalities are discussed and an approach to return-to-play decision making for athletes’ post COVID-19, as informed by multi-modality imaging, is provided. Highlights: • COVID-19 may cause potential long-term cardiopulmonary complications in athletes, raising concern regarding return to play (RTP). • Exercise induced cardiac remodeling may be misinterpreted as COVID-19 related cardiac injury. • We discuss the strengths and limitations of relevant imaging modalities and an approach to RTP decision making. • Registry data of cardiac testing and outcomes in athletes after COVID-19 is needed to guide future screening strategies. |
Databáze: | OpenAIRE |
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