Kardiyomiyopatiler ve Spor
Özet
Kardiyomiyopatiler (KM), ventriküler miyokardın yapısal ve fonksiyonel anormallikleri olarak tanımlanır ve bu anormallikler, akışı kısıtlayan koroner arter hastalığı veya anormal yükleme koşulları ile açıklanamaz. Pediatrik KM'ler, geniş ve heterojen bir hastalık grubunu temsil eder ve bu hastalıkların kendine özgü zorlukları ile sınırlı tedavi seçenekleri mevcuttur.
Fiziksel aktivitenin sağlığa olan iyi bilinen yararlarına rağmen, pediatrik kardiyoloji, ani kardiyak ölüm ve hastalığın ilerlemesini tetikleme endişesi nedeniyle kardiyomiyopatili çocuklara egzersiz önerirken temkinli davranmaktadır.
Pediatrik KM'lerde güvenli ve etkili egzersiz biçimlerinin anlaşılması ve desteklenmesi konusunda artan bir ilgi söz konusudur. Bu derlemenin amacı, KM'li çocuklarda egzersiz ve spora katılımın güvenliği ile yararları hakkında güncel literatürü özetlemek ve bu hastaları uygun şekilde yönlendirmektir.
Referanslar
Allen HD, Driscoll DJ, Shaddy RE, Feltes TF. Moss & Adams' heart disease in infants, children, and adolescents: including the fetus and young adult: Lippincott Williams & Wilkins; 2013.
Lipshultz SE, Law YM, Asante-Korang A, Austin ED, Dipchand AI, Everitt MD, et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association. 2019;140(1):e9-e68.
Kumar S, Kelly AS, editors. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clinic Proceedings; 2017: Elsevier.
Monda E, Rubino M, Lioncino M, Di Fraia F, Pacileo R, Verrillo F, et al. Hypertrophic cardiomyopathy in children: pathophysiology, diagnosis, and treatment of non-sarcomeric causes. 2021;9:94.
Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 2020;76(25):e159-e240.
Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito PJNEJoM. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. 1991;324(5):295-301.
Basavarajaiah S, Boraita A, Whyte G, Wilson M, Carby L, Shah A, et al. Ethnic differences in left ventricular remodeling in highly-trained athletes: relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. 2008;51(23):2256-62.
Basavarajaiah S, Wilson M, Whyte G, Shah A, McKenna W, Sharma SJJotACoC. Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening. 2008;51(10):1033-9.
Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. 2011;32(18):2304-13.
Pelliccia A, Caselli S, Sharma S, Basso C, Bax JJ, Corrado D, et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete’s heart. 2018;39(21):1949-69.
Patel AR, Kramer CMJJCI. Role of cardiac magnetic resonance in the diagnosis and prognosis of nonischemic cardiomyopathy. 2017;10(10 Part A):1180-93.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FOJC. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. 2009;119(8):1085-92.
Finocchiaro G, Papadakis M, Robertus J-L, Dhutia H, Steriotis AK, Tome M, et al. Etiology of sudden death in sports: insights from a United Kingdom regional registry. 2016;67(18):2108-15.
Weissler-Snir A, Allan K, Cunningham K, Connelly KA, Lee DS, Spears DA, et al. Hypertrophic cardiomyopathy–related sudden cardiac death in young people in Ontario. 2019;140(21):1706-16.
Saberi S, Wheeler M, Bragg-Gresham J, Hornsby W, Agarwal PP, Attili A, et al. Effect of moderate-intensity exercise training on peak oxygen consumption in patients with hypertrophic cardiomyopathy: a randomized clinical trial. 2017;317(13):1349-57.
Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, et al. 2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC). 2023;44(37):3503-626.
Reineck E, Rolston B, Bragg-Gresham JL, Salberg L, Baty L, Kumar S, et al. Physical activity and other health behaviors in adults with hypertrophic cardiomyopathy. 2013;111(7):1034-9.
Magrì D, Santolamazza CJAotATS. Cardiopulmonary exercise test in hypertrophic cardiomyopathy. 2017;14(Supplement 1):S102-S9.
Sobierajski F, Storey K, Bird M, Anthony S, Pol S, Pidborochynski T, et al. Use of Photovoice to Explore Pediatric Patients with Hypertrophic Cardiomyopathy and their Parents' Perceptions of a Heart‐Healthy Lifestyle. 2022;11(7):e023572.
Norrish G, Ding T, Field E, Ziółkowska L, Olivotto I, Limongelli G, et al. Development of a novel risk prediction model for sudden cardiac death in childhood hypertrophic cardiomyopathy (HCM Risk-Kids). 2019;4(9):918-27.
Wittlieb-Weber CA, Cohen MS, McBride MG, Paridon SM, Morrow R, Wasserman M, et al. Elevated left ventricular outflow tract velocities on exercise stress echocardiography may be a normal physiologic response in healthy youth. 2013;26(12):1372-8.
Edelson JB, Stanley HM, Min J, Burstein DS, Lane-Fall M, O’Malley S, et al. Cardiopulmonary exercise testing in pediatric patients with hypertrophic cardiomyopathy. 2022;1(4):100107.
Conway J, Min S, Villa C, Weintraub RG, Nakano S, Godown J, et al. The Prevalence and Association of Exercise Test Abnormalities With Sudden Cardiac Death and Transplant-Free Survival in Childhood Hypertrophic Cardiomyopathy. 2023;147(9):718-27.
Dejgaard LA, Haland TF, Lie OH, Ribe M, Bjune T, Leren IS, et al. Vigorous exercise in patients with hypertrophic cardiomyopathy. 2018;250:157-63.
Burstein DS, Gaynor JW, Griffis H, Ritter A, Connor MJO, Rossano JW, et al. Genetic variant burden and adverse outcomes in pediatric cardiomyopathy. 2021;89(6):1470-6.
Etheridge SP, Saarel EV, Martinez MWJHR. Exercise participation and shared decision-making in patients with inherited channelopathies and cardiomyopathies. 2018;15(6):915-20.
Wasserstrum Y, Barbarova I, Lotan D, Kuperstein R, Shechter M, Freimark D, et al. Efficacy and safety of exercise rehabilitation in patients with hypertrophic cardiomyopathy. 2019;74(5):466-72.
Lee TM, Hsu DT, Kantor P, Towbin JA, Ware SM, Colan SD, et al. Pediatric cardiomyopathies. 2017;121(7):855-73.
Chen CK, Manlhiot C, Russell JL, Kantor PF, McCrindle BW, Conway JJT. The utility of cardiopulmonary exercise testing for the prediction of outcomes in ambulatory children with dilated cardiomyopathy. 2017;101(10):2455-60.
Giardini A, Fenton M, Andrews RE, Derrick G, Burch MJC. Peak oxygen uptake correlates with survival without clinical deterioration in ambulatory children with dilated cardiomyopathy. 2011;124(16):1713-8.
Wittekind SG, Gerdes Y, Mays W, Chin C, Jefferies JLJTHIJ. Cardiac rehabilitation improves cardiometabolic health in young patients with nonischemic dilated cardiomyopathy. 2018;45(1):27-30.
McBride MG, Binder TJ, Paridon SMJJoCR, Prevention. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report. 2007;27(4):219-22.
Gewillig M, Mertens L, Moerman P, Dumoulin MJEhj. Idiopathic restrictive cardiomyopathy in childhood: A diastolic disorder characterized by delayed relaxation. 1996;17(9):1413-20.
Corrado D, Link MS, Calkins HJNEjom. Arrhythmogenic right ventricular cardiomyopathy. 2017;376(1):61-72.
Corrado D, Basso C, Thiene G, McKenna WJ, Davies MJ, Fontaliran F, et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. 1997;30(6):1512-20.
Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene GJJotACoC. Does sports activity enhance the risk of sudden death in adolescents and young adults? 2003;42(11):1959-63.
Thiene G, Nava A, Corrado D, Rossi L, Pennelli NJNEJoM. Right ventricular cardiomyopathy and sudden death in young people. 1988;318(3):129-33.
Kirchhof P, Fabritz L, Zwiener M, Witt H, Schäfers M, Zellerhoff S, et al. Age-and training-dependent development of arrhythmogenic right ventricular cardiomyopathy in heterozygous plakoglobin-deficient mice. 2006;114(17):1799-806.
Saberniak J, Hasselberg NE, Borgquist R, Platonov PG, Sarvari SI, Smith HJ, et al. Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members. 2014;16(12):1337-44.
Ruwald A-C, Marcus F, Estes III NM, Link M, McNitt S, Polonsky B, et al. Association of competitive and recreational sport participation with cardiac events in patients with arrhythmogenic right ventricular cardiomyopathy: results from the North American multidisciplinary study of arrhythmogenic right ventricular cardiomyopathy. 2015;36(27):1735-43.
Zorzi A, Pelliccia A, Corrado DJNHJ. Inherited cardiomyopathies and sports participation. 2018;26:154-65.
Hoedemaekers YM, Caliskan K, Michels M, Frohn-Mulder I, van der Smagt JJ, Phefferkorn JE, et al. The importance of genetic counseling, DNA diagnostics, and cardiologic family screening in left ventricular noncompaction cardiomyopathy. 2010;3(3):232-9.
Probst S, Oechslin E, Schuler P, Greutmann M, Boyé P, Knirsch W, et al. Sarcomere gene mutations in isolated left ventricular noncompaction cardiomyopathy do not predict clinical phenotype. 2011;4(4):367-74.
Gati S, Papadakis M, Papamichael ND, Zaidi A, Sheikh N, Reed M, et al. Reversible de novo left ventricular trabeculations in pregnant women: implications for the diagnosis of left ventricular noncompaction in low-risk populations. 2014;130(6):475-83.
Gati S, Papadakis M, Van Niekerk N, Reed M, Yeghen T, Sharma SJIjoc. Increased left ventricular trabeculation in individuals with sickle cell anaemia: physiology or pathology? 2013;168(2):1658-60.
Gati S, Chandra N, Bennett RL, Reed M, Kervio G, Panoulas VF, et al. Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes? 2013;99(6):401-8.
Caselli S, Jost CHA, Jenni R, Pelliccia AJTAjoc. Left ventricular noncompaction diagnosis and management relevant to pre-participation screening of athletes. 2015;116(5):801-8.
Maron BJ, Udelson JE, Bonow RO, Nishimura RA, Ackerman MJ, Estes III NM, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientific statement from the American Heart Association and American College of Cardiology. 2015;132(22):e273-e80.
Referanslar
Allen HD, Driscoll DJ, Shaddy RE, Feltes TF. Moss & Adams' heart disease in infants, children, and adolescents: including the fetus and young adult: Lippincott Williams & Wilkins; 2013.
Lipshultz SE, Law YM, Asante-Korang A, Austin ED, Dipchand AI, Everitt MD, et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association. 2019;140(1):e9-e68.
Kumar S, Kelly AS, editors. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clinic Proceedings; 2017: Elsevier.
Monda E, Rubino M, Lioncino M, Di Fraia F, Pacileo R, Verrillo F, et al. Hypertrophic cardiomyopathy in children: pathophysiology, diagnosis, and treatment of non-sarcomeric causes. 2021;9:94.
Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. 2020;76(25):e159-e240.
Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito PJNEJoM. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. 1991;324(5):295-301.
Basavarajaiah S, Boraita A, Whyte G, Wilson M, Carby L, Shah A, et al. Ethnic differences in left ventricular remodeling in highly-trained athletes: relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. 2008;51(23):2256-62.
Basavarajaiah S, Wilson M, Whyte G, Shah A, McKenna W, Sharma SJJotACoC. Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening. 2008;51(10):1033-9.
Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. 2011;32(18):2304-13.
Pelliccia A, Caselli S, Sharma S, Basso C, Bax JJ, Corrado D, et al. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete’s heart. 2018;39(21):1949-69.
Patel AR, Kramer CMJJCI. Role of cardiac magnetic resonance in the diagnosis and prognosis of nonischemic cardiomyopathy. 2017;10(10 Part A):1180-93.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FOJC. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. 2009;119(8):1085-92.
Finocchiaro G, Papadakis M, Robertus J-L, Dhutia H, Steriotis AK, Tome M, et al. Etiology of sudden death in sports: insights from a United Kingdom regional registry. 2016;67(18):2108-15.
Weissler-Snir A, Allan K, Cunningham K, Connelly KA, Lee DS, Spears DA, et al. Hypertrophic cardiomyopathy–related sudden cardiac death in young people in Ontario. 2019;140(21):1706-16.
Saberi S, Wheeler M, Bragg-Gresham J, Hornsby W, Agarwal PP, Attili A, et al. Effect of moderate-intensity exercise training on peak oxygen consumption in patients with hypertrophic cardiomyopathy: a randomized clinical trial. 2017;317(13):1349-57.
Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, et al. 2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC). 2023;44(37):3503-626.
Reineck E, Rolston B, Bragg-Gresham JL, Salberg L, Baty L, Kumar S, et al. Physical activity and other health behaviors in adults with hypertrophic cardiomyopathy. 2013;111(7):1034-9.
Magrì D, Santolamazza CJAotATS. Cardiopulmonary exercise test in hypertrophic cardiomyopathy. 2017;14(Supplement 1):S102-S9.
Sobierajski F, Storey K, Bird M, Anthony S, Pol S, Pidborochynski T, et al. Use of Photovoice to Explore Pediatric Patients with Hypertrophic Cardiomyopathy and their Parents' Perceptions of a Heart‐Healthy Lifestyle. 2022;11(7):e023572.
Norrish G, Ding T, Field E, Ziółkowska L, Olivotto I, Limongelli G, et al. Development of a novel risk prediction model for sudden cardiac death in childhood hypertrophic cardiomyopathy (HCM Risk-Kids). 2019;4(9):918-27.
Wittlieb-Weber CA, Cohen MS, McBride MG, Paridon SM, Morrow R, Wasserman M, et al. Elevated left ventricular outflow tract velocities on exercise stress echocardiography may be a normal physiologic response in healthy youth. 2013;26(12):1372-8.
Edelson JB, Stanley HM, Min J, Burstein DS, Lane-Fall M, O’Malley S, et al. Cardiopulmonary exercise testing in pediatric patients with hypertrophic cardiomyopathy. 2022;1(4):100107.
Conway J, Min S, Villa C, Weintraub RG, Nakano S, Godown J, et al. The Prevalence and Association of Exercise Test Abnormalities With Sudden Cardiac Death and Transplant-Free Survival in Childhood Hypertrophic Cardiomyopathy. 2023;147(9):718-27.
Dejgaard LA, Haland TF, Lie OH, Ribe M, Bjune T, Leren IS, et al. Vigorous exercise in patients with hypertrophic cardiomyopathy. 2018;250:157-63.
Burstein DS, Gaynor JW, Griffis H, Ritter A, Connor MJO, Rossano JW, et al. Genetic variant burden and adverse outcomes in pediatric cardiomyopathy. 2021;89(6):1470-6.
Etheridge SP, Saarel EV, Martinez MWJHR. Exercise participation and shared decision-making in patients with inherited channelopathies and cardiomyopathies. 2018;15(6):915-20.
Wasserstrum Y, Barbarova I, Lotan D, Kuperstein R, Shechter M, Freimark D, et al. Efficacy and safety of exercise rehabilitation in patients with hypertrophic cardiomyopathy. 2019;74(5):466-72.
Lee TM, Hsu DT, Kantor P, Towbin JA, Ware SM, Colan SD, et al. Pediatric cardiomyopathies. 2017;121(7):855-73.
Chen CK, Manlhiot C, Russell JL, Kantor PF, McCrindle BW, Conway JJT. The utility of cardiopulmonary exercise testing for the prediction of outcomes in ambulatory children with dilated cardiomyopathy. 2017;101(10):2455-60.
Giardini A, Fenton M, Andrews RE, Derrick G, Burch MJC. Peak oxygen uptake correlates with survival without clinical deterioration in ambulatory children with dilated cardiomyopathy. 2011;124(16):1713-8.
Wittekind SG, Gerdes Y, Mays W, Chin C, Jefferies JLJTHIJ. Cardiac rehabilitation improves cardiometabolic health in young patients with nonischemic dilated cardiomyopathy. 2018;45(1):27-30.
McBride MG, Binder TJ, Paridon SMJJoCR, Prevention. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report. 2007;27(4):219-22.
Gewillig M, Mertens L, Moerman P, Dumoulin MJEhj. Idiopathic restrictive cardiomyopathy in childhood: A diastolic disorder characterized by delayed relaxation. 1996;17(9):1413-20.
Corrado D, Link MS, Calkins HJNEjom. Arrhythmogenic right ventricular cardiomyopathy. 2017;376(1):61-72.
Corrado D, Basso C, Thiene G, McKenna WJ, Davies MJ, Fontaliran F, et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. 1997;30(6):1512-20.
Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene GJJotACoC. Does sports activity enhance the risk of sudden death in adolescents and young adults? 2003;42(11):1959-63.
Thiene G, Nava A, Corrado D, Rossi L, Pennelli NJNEJoM. Right ventricular cardiomyopathy and sudden death in young people. 1988;318(3):129-33.
Kirchhof P, Fabritz L, Zwiener M, Witt H, Schäfers M, Zellerhoff S, et al. Age-and training-dependent development of arrhythmogenic right ventricular cardiomyopathy in heterozygous plakoglobin-deficient mice. 2006;114(17):1799-806.
Saberniak J, Hasselberg NE, Borgquist R, Platonov PG, Sarvari SI, Smith HJ, et al. Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members. 2014;16(12):1337-44.
Ruwald A-C, Marcus F, Estes III NM, Link M, McNitt S, Polonsky B, et al. Association of competitive and recreational sport participation with cardiac events in patients with arrhythmogenic right ventricular cardiomyopathy: results from the North American multidisciplinary study of arrhythmogenic right ventricular cardiomyopathy. 2015;36(27):1735-43.
Zorzi A, Pelliccia A, Corrado DJNHJ. Inherited cardiomyopathies and sports participation. 2018;26:154-65.
Hoedemaekers YM, Caliskan K, Michels M, Frohn-Mulder I, van der Smagt JJ, Phefferkorn JE, et al. The importance of genetic counseling, DNA diagnostics, and cardiologic family screening in left ventricular noncompaction cardiomyopathy. 2010;3(3):232-9.
Probst S, Oechslin E, Schuler P, Greutmann M, Boyé P, Knirsch W, et al. Sarcomere gene mutations in isolated left ventricular noncompaction cardiomyopathy do not predict clinical phenotype. 2011;4(4):367-74.
Gati S, Papadakis M, Papamichael ND, Zaidi A, Sheikh N, Reed M, et al. Reversible de novo left ventricular trabeculations in pregnant women: implications for the diagnosis of left ventricular noncompaction in low-risk populations. 2014;130(6):475-83.
Gati S, Papadakis M, Van Niekerk N, Reed M, Yeghen T, Sharma SJIjoc. Increased left ventricular trabeculation in individuals with sickle cell anaemia: physiology or pathology? 2013;168(2):1658-60.
Gati S, Chandra N, Bennett RL, Reed M, Kervio G, Panoulas VF, et al. Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes? 2013;99(6):401-8.
Caselli S, Jost CHA, Jenni R, Pelliccia AJTAjoc. Left ventricular noncompaction diagnosis and management relevant to pre-participation screening of athletes. 2015;116(5):801-8.
Maron BJ, Udelson JE, Bonow RO, Nishimura RA, Ackerman MJ, Estes III NM, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientific statement from the American Heart Association and American College of Cardiology. 2015;132(22):e273-e80.
