engleski

Athlete's heart – physiologycal or pathological left ventricular hypertrophy?

Sportsko srce označava funkcionalne i morfološke promjene kardiovaskularnog sustava kao odgovor na ponavljani, stimulirani poticaj fizičkog opterećenja, s temeljnom značajkom hipertrofije lijeve klijetke (HLK) kao prilagodbom na česti fizički napor. Iako je pojam uveo još 1889. godine švedski liječnik S. Henschen, sportsko srce je pored postojećih znanja još uvijek nedovoljno znanstveno istraženo područje, osobito u njegovom odnosu prema zdravlju. U raspravi o važnosti razlikovanja fiziološke i patološke HLK, pažnja nam se usmjerava u hipertrofijsku kardiomiopatiju kao najvažniji razlog iznenadne smrti u sportaša (oko 44%). Metode kardiovaskularnog probira sportaša radi otkrivanja takvih kardiovaskularnih abnormalnosti koje mogu predisponirati srčanu smrt izazvanu športskom aktivnosti pokazale su se uspješnim, a suvremene slikovne metode u kardiologiji, u prvom redu ehokardiografija, mogu značajno doprinjeti u razlikovanju fiziološke hipertrofije lijeve klijetke od navedenog patološkog stanja. Da li je športsko srce fiziološka pojava? Zbog čega je remodeling miokarda u sportu koristna pojava, a u bolesti štetna? Zašto nam je potrebna diferencijacija između fiziološke i patološke HLK? Koje su glavne razlike između navedenih stanja? Koji su najbolji ehokardiografski kriteriji za razlikovanje fiziološke i patološke HLK pitanj asu podložna različitim tumačenjima, a čijem konačnom odgovoru ovaj pregledni rad želi dati doprinos. Athlete’s heart means the functional and morphological changes in the cardiovascular system in response to repeated, stimuli exercises, with fundamental characteristics of left ventricular hypertrophy (LVH) as an adaptation of a common physical effort. Although the concept is introduced 1889th the Swedish physician S. Henschen, Athlete’s heart is in addition to existing knowledge is still insufficient scientifically researched area, especially in its relation to health. Discussing the reason why do we need to differentiate between physiological and pathological LVH, it is well demonstrated now that hypertrophic cardiomyopathy is the most important cause of SCD in athletes (of 44%). Methods for cardiovascular screening of athletes for the detection of this cardiovascular abnormality as that might predispose cardiac death due to sports activities have proven to be successful, and modern imaging methods in cardiology, mainly echocardiography, can significantly contribute to the differentiation of physiological left ventricular hypertrophy of these condition. Is the athlete’s heart a physiological condition? Why is the remodeling of myocardium useful in sport phenomenon and harmful in diseases? Why do we need differentiation between physiologic and pathologic LVH? Which are the main differences between these states? Which are the best echocardiography criteria for differencing physiological from pathological LVH? These issues are subject to different interpretations and whose ultimate answer this brief review can contribute.

athlete's heart ; left ventricular hyperthrophy

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