| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.56 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Não é de agora que se discute o impacto da atividade física no sistema cardiovascular
do Homem.
Investigações preliminares no final da década de 1890 e início de 1900
documentaram um aumento das dimensões cardíacas em atletas profissionais sem
evidência precedente de doença cardíaca. Tais achados foram aprimoradamente analisados
ao longo do último século e continuam a intrigar a comunidade científica, apesar de estar já
bem estabelecido que a prática regular e prolongada de exercício físico resulta em alterações
significativas na estrutura e função do miocárdio.
Este processo adaptativo, designado como remodelação cardíaca induzida pelo
exercício físico (RCIE), mais vulgarmente conhecido pelo termo Coração de Atleta, engloba
um conjunto de modificações cardíacas estruturais, incluindo uma hipertrofia ventricular
esquerda com geometria específica do tipo de desporto (excêntrica vs concêntrica),
variações nas funções sistólica e diastólica bem como uma reestruturação elétrica com
tradução eletrocardiográfica.
A crescente popularidade e interesse pelo exercício físico recreativo e atividades
desportivas competitivas levou a um aumento progressivo destes achados na prática clínica
de rotina, tornando-se crucial distinguir claramente uma resposta cardiovascular
adaptativa de outras alterações patológicas observadas em cardiomiopatias hereditárias ou
adquiridas.
Esta dissertação pretende, essencialmente, reunir informação sobre as alterações
consideradas benignas ou patológicas em atletas, de forma a compreender o significado
clínico das mesmas, e explorar os mecanismos adotados pela American Heart Association
e pela European Society of Cardiology na avaliação médica de indivíduos envolvidos no
desporto de competição, minimizando assim o risco de morte súbita cardíaca associado à
prática desportiva.
The effects of physical activity on human beings have been extensively researched for some time now. Initial studies in the late 1890's and early 1900's documented an increase in cardiac size in professional athletes with no previous record of cardiovascular disease. Such findings have been analyzed extensively over the last century and continue to puzzle the medical community, despite the fact that it is now well established that a regular and long-term practice of physical exercise results in significant structural and functional changes to the myocardium. This process, named exercise-induced cardiac remodeling (EICR), more commonly known as Athlete's Heart, entails a number of structural cardiac modifications, including left ventricular hypertrophy with a sport-specific geometry (eccentric vs. concentric), systolic and diastolic dysfunctions, and electrical remodeling of the heart (detectable through electrocardiographic testing). The rising popularity and interest in recreational exercise and competitive athletic pursuits has led to a progressive increase in these findings in routine care, making it crucial to clearly distinguish an adaptive cardiovascular response from other pathological variations found in hereditary or acquired cardiomyopathies. The aim of this thesis is the gathering of information on the abnormalities found in athletes that are deemed benign or pathological, in order to understand their clinical significance, and to explore the mechanisms adopted by the American Heart Association and the European Society of Cardiology in the evaluation prior to competitions of individuals involved in competitive sports, thus minimizing the risk of sudden cardiac death associated with the practice of sports.
The effects of physical activity on human beings have been extensively researched for some time now. Initial studies in the late 1890's and early 1900's documented an increase in cardiac size in professional athletes with no previous record of cardiovascular disease. Such findings have been analyzed extensively over the last century and continue to puzzle the medical community, despite the fact that it is now well established that a regular and long-term practice of physical exercise results in significant structural and functional changes to the myocardium. This process, named exercise-induced cardiac remodeling (EICR), more commonly known as Athlete's Heart, entails a number of structural cardiac modifications, including left ventricular hypertrophy with a sport-specific geometry (eccentric vs. concentric), systolic and diastolic dysfunctions, and electrical remodeling of the heart (detectable through electrocardiographic testing). The rising popularity and interest in recreational exercise and competitive athletic pursuits has led to a progressive increase in these findings in routine care, making it crucial to clearly distinguish an adaptive cardiovascular response from other pathological variations found in hereditary or acquired cardiomyopathies. The aim of this thesis is the gathering of information on the abnormalities found in athletes that are deemed benign or pathological, in order to understand their clinical significance, and to explore the mechanisms adopted by the American Heart Association and the European Society of Cardiology in the evaluation prior to competitions of individuals involved in competitive sports, thus minimizing the risk of sudden cardiac death associated with the practice of sports.
Description
Keywords
Cardiomiopatias Coração de Atleta Exercício Físico Morte Súbita Cardíaca Remodelação Cardíaca