Vigorous Physical Exercise can Lead to Spongy Appearance of the Heart

High-intensity exercises can trigger a series of physiological changes in the body, including the heart. Professional athletes' hearts adapt to training in a number of ways, including by increasing the number of structures known as trabeculae in the inside of the heart. While this process, termed as hypertrabeculation, is harmless in athletes, it is also a pathological trait of noncompaction cardiomyopathy, a hereditary disease, which can lead to sudden cardiac death. The findings of the study are published in The Journal of the American College of Cardiology. Centro Nacional de Investigaciones Cardiovasculares (CNIC) Scientists have used cardiac magnetic resonance technology to assess exercise-related hypertrabeculation in a general, non-athlete population. The results of the research have significant practical indications as misdiagnosis of noncompaction cardiomyopathy in people who exercise regularly (whether amateurs or professional athletes) can trigger medical recommendations to stop physical exercise unnecessarily," revealed Valentín Fuster, CNIC General Director.

The study forms part of the PESA-CNIC-SANTANDER study, whose principal investigator is Dr. Valentín Fuster. The 700 participants of the study are followed up for analyzing the development, reversibility, and clinical implications of heart adaptation to exercise.

"It is essential to distinguish this benign adaptation to exercise from noncompaction cardiomyopathy, a condition with a genetic component that can have severe outcomes, including thromboembolism, arrhythmias, heart failure, and sudden cardiac death," stated Dr. Borja Ibáñez.

"The walls of the heart in noncompaction cardiomyopathy become thinner, and the usually compact cardiac muscle is replaced by the spongy form, in direct contact with the interior of the ventricles," added Dr. Ibañez.

The problem is that this condition is often diagnosed in young asymptomatic people, resulting in a medical recommendation to cease the physical activity that might cause sudden cardiac death immediately. But, the presence of trabeculae is not always a sign of non-compacted cardiomyopathy.

Study authorJosé de la Chica explained that "it is crucial to distinguish between the disease and the benign physiological adaptation, both to allow relevant medical intervention to prevent disease progression and to prevent recommending healthy young people to avoid participation in sporting activities needlessly."

Cardiac magnetic resonance technology is used to examine accepted diagnostic criteria for non-compacted cardiomyopathy in the study participants who are not professional athletes and have varying levels of physical activity.

Physical activity was measured objectively using accelerometers, which can allow the researchers to classify a person's physical activity as sedentary, moderate, or vigorous exercise and to register the time spent in each type of activity during the week.

The study revealed that participants who regularly did vigorous exercise during the study had larger hearts with more muscle mass. "These changes are similar to 'athlete's heart' and are considered physiological," reports García-Lunar.

A more unexpected finding was that a third of study participants with a high level of vigorous exercise (both men and women) met the diagnostic criteria for noncompaction cardiomyopathy, even though they were clearly healthy.

The authors finally conclude that cardiac magnetic resonance measures for diagnosing noncompaction cardiomyopathy should not be deciphered in isolation. Rather, imaging results should be placed in the context of other parameters, genetic tests, and the level of exercise. This is crucial even in a population of non-athletes to avoid misdiagnosis of the disease. Misdiagnosis could result in the unnecessary cessation of exercise, with all its associated negative physical and psychological consequences.

Source-Medindia