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'Trabeculations of the athlete's heart'

A marker of physiological adaptation or a cardiomyopathy phenotype'

The authors:St George’s university of London, UK:
Dr Sabiha Gati, Cardiac Imaging Fellow
Dr Michael Papadakis, Lecturer in cardiology
Prof Sanjay Sharma, Professor of clinical cardiology
on behalf of the EACPR Sports Cardiology Section.

Sports Cardiology


The case:

A 23-year-old Afro-Caribbean football player underwent pre-participation cardiovascular screening. He exercised for 12 hours per week. He did not report any sinister cardiac symptoms.  He was not on any regular medications and there was no family history of premature sudden cardiac death or cardiomyopathy. Clinical examination was normal. The 12-lead ECG and echocardiogram is presented below (see accompanying videos).

 

 

 

 

 

 

Conclusion

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References

For further reading:
[*1] Comparison of systolic and diastolic criteria for isolated lv noncompaction in cmr.
Stacey RB, Andersen MM, St Clair M, Hundley WG, Thohan V.
JACC Cardiovasc Imaging. 2013;6:931-940

[2*] Left ventricular non-compaction: Insights from cardiovascular magnetic resonance imaging.
Petersen SE, Selvanayagam JB, Wiesmann F, Robson MD, Francis JM, Anderson RH, Watkins H, Neubauer S.
J Am Coll Cardiol. 2005;46:101-105
[*3] Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction.
Jacquier A, Thuny F, Jop B, Giorgi R, Cohen F, Gaubert JY, Vidal V, Bartoli JM, Habib G, Moulin G.
Eur Heart J. 2010;31:1098-1104
[*4] Quantification of left ventricular trabeculae using fractal analysis.
Captur G, Muthurangu V, Cook C, Flett AS, Wilson R, Barison A, Sado DM, Anderson S, McKenna WJ, Mohun TJ, Elliott PM, Moon JC.
J Cardiovasc Magn Reson. 2013;15:36
[*5] Diagnosis of left-ventricular non-compaction in patients with left-ventricular systolic dysfunction: Time for a reappraisal of diagnostic criteria?
Kohli SK, Pantazis AA, Shah JS, Adeyemi B, Jackson G, McKenna WJ, Sharma S, Elliott PM.
Eur Heart J. 2008;29:89-95
[*6]
Increased left ventricular trabeculation in individuals with sickle cell anaemia: Physiology or pathology?
Gati S, Papadakis M, Van Niekerk N, Reed M, Yeghen T, Sharma S.  
Int J Cardiol. 2013;168:1658-1660
[7*] Increased left ventricular trabeculation in highly trained athletes: Do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes?
Gati S, Chandra N, Bennett RL, Reed M, Kervio G, Panoulas VF, Ghani S, Sheikh N, Zaidi A, Wilson M, Papadakis M, Carre F, Sharma S.
Heart. 2013;99:401-408
[*8] Ethnic differences in ventricular hypertrabeculation on cardiac mri in elite football players.
Luijkx T, Cramer MJ, Zaidi A, Rienks R, Senden PJ, Sharma S, van Hellemondt FJ, Buckens CF, Mali WP, Velthuis BK.
Neth Heart J. 2012;20:389-395
[*9] Isolated left ventricular non compaction as possible cause of athletic training suspension: A preliminary study on screened athletes.
Martinoli R, Papetti F, Dofcaci A, Mercurio V, Pirruccio G, Pirelli M, Piccirilli S, Greci G, Lanzillo C, Sansoni I, Saccucci P, Banci M.
J Sports Med Phys Fitness. 2013;53:240-247
[*10] Sports participation in non-compaction cardiomyopathy: A systematic review.
Ganga HV, Thompson PD.
Br J Sports Med. 2013
[*11] Reversible de novo left ventricular trabeculations in pregnant women implications for the diagnosis of left ventricular noncompaction in low-risk populations.
Gati S, Papadakis M, Papamichael N, Zaidi A, Sheikh N, Reed M, Sharma R, Thilaganathan B, Sharma S.
Circulation. 2014
[*12] Left ventricular non-compaction revisited: A distinct phenotype with genetic heterogeneity?
Oechslin E, Jenni R.
Eur Heart J. 2011;32:1446-1456