MMW - Fortschritte der Medizin

, Volume 156, Issue 13, pp 44–48 | Cite as

Plötzlicher Herztod bei jungen Sportlern

Gefahr rechtzeitig erkennen: Screening-Empfehlungen für Athleten unter 35 Jahren
  • Roman Leischik

Der plötzliche Herztod bei jungen Sportlern (unter 35 Jahren) ist zwar selten, aber immer tragisch. In Anbetracht neuer Daten und neuer diagnostischer Ver­fahren soll das Phänomen hier diskutiert werden. Werden durch intensive sport­liche Betätigung kardiale Strukturen geschädigt?

Keywords - Sudden cardiac death in young athletes. New screening recommendations

Sudden cardiac death triathlon cardiac fatique athletes 


  1. 1.
    American S (2011). „Why Is Swimming the Most Deadly Leg of a Triathlon.“ from Scholar
  2. 2.
    Andersen K, Farahmand B, Ahlbom A, et al. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J 2013Google Scholar
  3. 3.
    Bellavia A, Bottai M, Wolk A, et al. Physical activity and mortality in a prospective cohort of middle-aged and elderly men - a time perspective. Int J Behav Nutr Phys Act 2013; 10: 94PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Benito B, Gay-Jordi G, Serrano-Mollar A, et al. Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation 2011; 123: 13–22PubMedCrossRefGoogle Scholar
  5. 5.
    Biffi A, Delise P, Zeppilli P, et al. Italian cardiological guidelines for sports eligibility in athletes with heart disease: part 2. J Cardiovasc Med (Hagerstown) 2013; 14: 500–515CrossRefGoogle Scholar
  6. 6.
    Blair SN, Kohl HW, Gordon NF, et al. How much physical activity is good for health? Annu Rev Public Health 1992; 13: 99–126PubMedCrossRefGoogle Scholar
  7. 7.
    Bray MS, Hagberg JM, Perusse L, et al. The human gene map for performance and health-related fitness phenotypes: the 2006-2007 update. Med Sci Sports Exerc 2009; 41: 35–73PubMedCrossRefGoogle Scholar
  8. 8.
    Breuckmann F, Mohlenkamp S, Nassenstein K, et al. Myocardial late gadolinium enhancement: prevalence, pattern, and prognostic relevance in marathon runners. Radiology 2009; 251: 50–57PubMedCrossRefGoogle Scholar
  9. 9.
    Burstein B Nattel S Atrial Fibrosis: Mechanisms and Clinical Relevance in Atrial Fibrillation. J Am Coll Cardiol 2008; 51: 802–809PubMedCrossRefGoogle Scholar
  10. 10.
    Calvo N, Brugada J, Sitges M, et al. Atrial fibrillation and atrial flutter in athletes. Br J Sports Med 2012; 46 Suppl 1: i37–43PubMedCrossRefGoogle Scholar
  11. 11.
    Cerrone M Priori SG Genetics of sudden death: focus on inherited channelopathies. Eur Heart J 2011; 32: 2109–2118PubMedCrossRefGoogle Scholar
  12. 12.
    Corrado D, Basso C, Rizzoli G, et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42: 1959–1963PubMedCrossRefGoogle Scholar
  13. 13.
    Corrado D, Migliore F, Basso C, et al. Exercise and the risk of sudden cardiac death. Herz 2006; 31: 553–558PubMedCrossRefGoogle Scholar
  14. 14.
    Corrado D, Schmied C, Basso C, et al. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes? Eur Heart J 2011; 32: 934–944PubMedCrossRefGoogle Scholar
  15. 15.
    Di Meo S Venditti P Mitochondria in exercise- induced oxidative stress. Neurosignals 2001; 10: 125–140CrossRefGoogle Scholar
  16. 16.
    Foxbusiness (2013). „The True Costs of Training for Triathlons.“ from
  17. 17.
    Harris KM, Henry JT, Rohman E, et al. Sudden death during the triathlon. Jama 2010; 303: 1255–1257PubMedCrossRefGoogle Scholar
  18. 18.
    Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39: 1423–1434PubMedCrossRefGoogle Scholar
  19. 19.
    Heidbuchel H La Gerche A The right heart in athletes. Evidence for exercise-induced arrhythmogenic right ventricular cardiomyopathy. Herzschrittmacherther Elektrophysiol 2012; 23: 82–86PubMedGoogle Scholar
  20. 20.
    Herring MP, Sailors MH Bray MS Genetic factors in exercise adoption, adherence and obesity. Obes Rev 2014; 15: 29–39PubMedCrossRefGoogle Scholar
  21. 21.
    Kaplan NM, Deveraux RB Miller HS, Jr. 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 4: systemic hypertension. J Am Coll Cardiol 1994; 24: 885–888PubMedCrossRefGoogle Scholar
  22. 22.
    Knez WL, Coombes JS Jenkins DG Ultraendurance exercise and oxidative damage: implications for cardiovascular health. Sports Med 2006; 36: 429–441PubMedCrossRefGoogle Scholar
  23. 23.
  24. 24.
    La Gerche A Can intense endurance exercise cause myocardial damage and fibrosis? Curr Sports Med Rep 2013; 12: 63–69PubMedCrossRefGoogle Scholar
  25. 25.
    La Gerche A, Baggish AL, Knuuti J, et al. Cardiac imaging and stress testing asymptomatic athletes to identify those at risk of sudden cardiac death. JACC Cardiovasc Imaging 2013; 6: 993–1007PubMedCrossRefGoogle Scholar
  26. 26.
    La Gerche A, Burns AT, Mooney DJ, et al. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J 2012; 33: 998–1006PubMedCrossRefGoogle Scholar
  27. 27.
    Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification. European Journal of Echocardiography 2006; 7: 79–108PubMedCrossRefGoogle Scholar
  28. 28.
    Leischik R Endurance Sport and Cardiac Injury. Polish Journal of Cardiology, Kardiologia Polska 2014; 72: 311–321CrossRefGoogle Scholar
  29. 29.
    Leischik R (2014). „Ugly duckling or Nosferatu ? - marathon running and cardiovascular function How to screen the athletes?“. from Scholar
  30. 30.
    Leischik R, Dworrak B, Littwitz H, et al. Prognostic significance of exercise stress echocardiography in 3329 outpatients (5-year longitudinal study). Int J Cardiol 2007; 119: 297–305PubMedCrossRefGoogle Scholar
  31. 31.
    Leischik R Littwitz H Slow recovery of the right and left ventricular deformation after conversion from atrial fibrillation American Journal of Sports Science. 2014; Vol. 2.: pp. 13–16Google Scholar
  32. 32.
    Leischik R Spelsberg N Leistungsdiagnostik und echokardiographische Befunde bei Ironman-Triathleten-Gibt es Hinweise für eine myokardiale Schädigung? Journal für Kardiologie-Austrian Journal of Cardiology 2014; 21: 144–152Google Scholar
  33. 33.
    Leischik R, Spelsberg N, Niggemann H, et al. Exercise-induced arterial hypertension - an independent factor for hypertrophy and a ticking clock for cardiac fatigue or atrial fibrillation in athletes? F1000 Research 2014; 3:
  34. 34.
    Marijon E, Tafflet M, Celermajer DS, et al. Sports-related sudden death in the general population. Circulation 2011; 124: 672–681PubMedCrossRefGoogle Scholar
  35. 35.
    Maron BJ Pelliccia A The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 2006; 114: 1633–1644PubMedCrossRefGoogle Scholar
  36. 36.
    Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation. Circulation 2007; 115: 1643–1655PubMedCrossRefGoogle Scholar
  37. 37.
    O’Keefe JH, Harshal RP, Lavie CJ, et al. Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise. Mayo Clin Proc. 2012; 87: 587–595PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Organisation WH (2009). „Global Health Risks.“ Page 17,18,. Retrieved 2009, from Scholar
  39. 39.
    Oxborough D, Birch K, Shave R, et al. „Exercise-induced cardiac fatigue“—a review of the echocardiographic literature. Echocardiography 2010; 27: 1130–1140PubMedCrossRefGoogle Scholar
  40. 40.
    Pattynama PM, Lamb HJ, Van Der Velde EA, et al. Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass. Magn Reson Imaging 1995; 13: 53–63PubMedCrossRefGoogle Scholar
  41. 41.
    Pelliccia A, Fagard R, Bjørnstad HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease A consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 1422–1445PubMedCrossRefGoogle Scholar
  42. 42.
    Rowe WJ A world record marathon runner with silent ischemia without coronary atherosclerosis. Chest 1991; 99: 1306–1308PubMedCrossRefGoogle Scholar
  43. 43.
    Scharhag J, Lollgen H Kindermann W Competitive sports and the heart: benefit or risk? Dtsch Arztebl Int 2013; 110: 14–23; quiz 24; e11-12PubMedCentralPubMedGoogle Scholar
  44. 44.
    Shave R Oxborough D Exercise-induced cardiac injury: evidence from novel imaging techniques and highly sensitive cardiac troponin assays. Prog Cardiovasc Dis 2012; 54: 407–415PubMedCrossRefGoogle Scholar
  45. 45.
    Solberg EE, Gjertsen F, Haugstad E, et al. Sudden death in sports among young adults in Norway. Eur J Cardiovasc Prev Rehabil 2010; 17: 337–341PubMedGoogle Scholar
  46. 46.
    Thiene G, Corrado D, Rigato I, et al. Why and how to support screening strategies to prevent sudden death in athletes. Cell Tissue Res 2012; 348: 315–318PubMedCrossRefGoogle Scholar
  47. 47.
    Thiene G, Nava A, Corrado D, et al. Right ventricular cardiomyopathy and sudden death in young people. N Engl J Med 1988; 318: 129–133PubMedCrossRefGoogle Scholar
  48. 48.
    Traustadottir T, Davies SS, Su Y, et al. Oxidative stress in older adults: effects of physical fitness. Age (Dordr) 2012; 34: 969–982CrossRefGoogle Scholar
  49. 49.
    Wike J Kernan M Sudden cardiac death in the active adult: causes, screening, and preventive strategies. Curr Sports Med Rep 2005; 4: 76–82PubMedCrossRefGoogle Scholar
  50. 50.
    Willems S Sudden cardiac death in young athletes: orienteering on Chlamydia pneumoniae? Eur Heart J 1996; 17: 810–812PubMedCrossRefGoogle Scholar
  51. 51.
    Wilson M, O’hanlon R, Prasad S, et al. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol (1985) 2011; 110: 1622–1626CrossRefGoogle Scholar

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Fakultät für Gesundheit/Humanmedizin, Sektion Prävention, Gesundheitsförderung und Sportmedizin, Abt. KardiologieUniversität Witten/HerdeckeHagenDeutschland

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