Alessio Gasperetti1, Antonio Dello Russo2, Mattia Busana3, Mariantonietta Dessanai4, Francesca Pizzamiglio4, Ardan Muammer Saguner5, Anneline S J M Te Riele6, Elena Sommariva4, Giulia Vettor4, Laurens Bosman6, Firat Duru5, Paolo Zeppilli7, Luigi Di Biase8, Andrea Natale9, Claudio Tondo10, Michela Casella4. 1. Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland. Electronic address: alessio.gasperetti93@gmail.com. 2. Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Ospedali Riuniti," Ancona, Italy. 3. Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany. 4. Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, Milan, Italy. 5. Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland. 6. Department of Heart and Lungs, Division of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands. 7. Istituto di Cardiologia, Università Cattolica del Sacro Cuore Rome, Rome, Italy; Istituto di Medicina Dello Sport, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. 8. Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. 9. Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas. 10. Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Science and Community Health, University of Milan, Milan, Italy.
Abstract
BACKGROUND: Disease progression and ventricular arrhythmias (VAs) in arrhythmogenic right ventricular cardiomyopathy (ARVC) are correlated with physical exercise, and clinical detraining and avoidance of competitive sport practice are suggested for ARVC patients. An algorithm assessing primary arrhythmic risk in ARVC patients was recently developed by Cadrin-Tourigny et al. Data regarding its transferability to athletes are lacking. OBJECTIVE: The purpose of this study was to assess the reliability of the Cadrin-Tourigny risk prediction algorithm in a cohort of athletes with ARVC and to describe the impact of clinical detraining on disease progression. METHODS: All athletes undergoing clinical detraining after ARVC diagnosis at our institution were enrolled. Baseline and follow-up clinical characteristics and data on VA events occurring during follow-up were collected. The Cadrin-Tourigny algorithm was used to calculate the a priori predicted VA risk, which was compared with the observed outcomes. RESULTS: Twenty-five athletes (age 36.1 ± 14.0 years; 80% male) with definite ARVC who were undergoing clinical detraining were enrolled. Over median (interquartile range) follow-up of 5.3 (3.2-6.6) years, a reduction in premature ventricular complex (PVC) burden (P = .001) was assessed, and 10 VA events (40%) were recorded. The a priori algorithm-predicted risk seemed to fit with the observed cohort arrhythmic risk [mean observed-predicted risk difference over 5 years -0.85% (interquartile range -4.8% to +3.1%); P = .85]. At 1-year follow-up, 11 patients (44%) had an improved stress ECG response, and no significant changes in right ventricular ejection fraction were observed. CONCLUSION: Clinical detraining is associated with PVC burden reduction in athletes with ARVC. The novel risk prediction algorithm does not seem to require any correction for its application to ARVC athletes.
BACKGROUND: Disease progression and ventricular arrhythmias (VAs) in arrhythmogenic right ventricular cardiomyopathy (ARVC) are correlated with physical exercise, and clinical detraining and avoidance of competitive sport practice are suggested for ARVCpatients. An algorithm assessing primary arrhythmic risk in ARVCpatients was recently developed by Cadrin-Tourigny et al. Data regarding its transferability to athletes are lacking. OBJECTIVE: The purpose of this study was to assess the reliability of the Cadrin-Tourigny risk prediction algorithm in a cohort of athletes with ARVC and to describe the impact of clinical detraining on disease progression. METHODS: All athletes undergoing clinical detraining after ARVC diagnosis at our institution were enrolled. Baseline and follow-up clinical characteristics and data on VA events occurring during follow-up were collected. The Cadrin-Tourigny algorithm was used to calculate the a priori predicted VA risk, which was compared with the observed outcomes. RESULTS: Twenty-five athletes (age 36.1 ± 14.0 years; 80% male) with definite ARVC who were undergoing clinical detraining were enrolled. Over median (interquartile range) follow-up of 5.3 (3.2-6.6) years, a reduction in premature ventricular complex (PVC) burden (P = .001) was assessed, and 10 VA events (40%) were recorded. The a priori algorithm-predicted risk seemed to fit with the observed cohort arrhythmic risk [mean observed-predicted risk difference over 5 years -0.85% (interquartile range -4.8% to +3.1%); P = .85]. At 1-year follow-up, 11 patients (44%) had an improved stress ECG response, and no significant changes in right ventricular ejection fraction were observed. CONCLUSION: Clinical detraining is associated with PVC burden reduction in athletes with ARVC. The novel risk prediction algorithm does not seem to require any correction for its application to ARVC athletes.
Authors: Sarah Costa; Kristina Koch; Alessio Gasperetti; Deniz Akdis; Corinna Brunckhorst; Guan Fu; Felix C Tanner; Frank Ruschitzka; Firat Duru; Ardan M Saguner Journal: J Clin Med Date: 2022-02-22 Impact factor: 4.241
Authors: Paloma Jordà; Laurens P Bosman; Alessio Gasperetti; Andrea Mazzanti; Jean Baptiste Gourraud; Brianna Davies; Tanja Charlotte Frederiksen; Zoraida Moreno Weidmann; Andrea Di Marco; Jason D Roberts; Ciorsti MacIntyre; Colette Seifer; Antoine Delinière; Wael Alqarawi; Deni Kukavica; Damien Minois; Alessandro Trancuccio; Marine Arnaud; Mattia Targetti; Annamaria Martino; Giada Oliviero; Daniel C Pipilas; Corrado Carbucicchio; Paolo Compagnucci; Antonio Dello Russo; Iacopo Olivotto; Leonardo Calò; Steven A Lubitz; Michael J Cutler; Philippe Chevalier; Elena Arbelo; Silvia Giuliana Priori; Jeffrey S Healey; Hugh Calkins; Michela Casella; Henrik Kjærulf Jensen; Claudio Tondo; Rafik Tadros; Cynthia A James; Andrew D Krahn; Julia Cadrin-Tourigny Journal: Eur Heart J Date: 2022-08-21 Impact factor: 35.855
Authors: Alexandros Protonotarios; Riccardo Bariani; Chiara Cappelletto; Menelaos Pavlou; Alba García-García; Alberto Cipriani; Ioannis Protonotarios; Adrian Rivas; Regitze Wittenberg; Maddalena Graziosi; Zafeirenia Xylouri; José M Larrañaga-Moreira; Antonio de Luca; Rudy Celeghin; Kalliopi Pilichou; Athanasios Bakalakos; Luis Rocha Lopes; Konstantinos Savvatis; Davide Stolfo; Matteo Dal Ferro; Marco Merlo; Cristina Basso; Javier Limeres Freire; Jose F Rodriguez-Palomares; Toru Kubo; Tomas Ripoll-Vera; Roberto Barriales-Villa; Loizos Antoniades; Jens Mogensen; Pablo Garcia-Pavia; Karim Wahbi; Elena Biagini; Aris Anastasakis; Adalena Tsatsopoulou; Esther Zorio; Juan R Gimeno; Jose Manuel Garcia-Pinilla; Petros Syrris; Gianfranco Sinagra; Barbara Bauce; Perry M Elliott Journal: Eur Heart J Date: 2022-08-21 Impact factor: 35.855
Authors: Marco Fogante; Giacomo Agliata; Maria Chiara Basile; Paolo Compagnucci; Giovanni Volpato; Umberto Falanga; Giulia Stronati; Federico Guerra; Davide Vignale; Antonio Esposito; Antonio Dello Russo; Michela Casella; Andrea Giovagnoni Journal: Medicina (Kaunas) Date: 2021-05-07 Impact factor: 2.430