Morphological features of heart of athletes with symptoms of connective tissue dysplasia.

Authors

  • O. B. Nekhanevich ДЗ «Дніпропетровська медична академія МОЗ України», Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2015.1.47-51

Keywords:

athletes, connective tissue dysplasia, mitral valve prolapse, myxomatous degeneration

Abstract

Backgraund. The issue of medical monitoring of people with mitral valve prolapse during sports and recreational physical culture is widely discussed in contemporary literature. Mitral valve prolapse occurs with a frequency of 0.5% to 38.0%; it may be a manifestation of diseases with different origin and prognosis. It evidences the requirement of deep analysis and differential diagnosis by specialists to prevent complications in such athletes. Objective. The purpose of the work is to improve medical support of training process in athletes with mitral valve, based on the clinical form of mitral valve prolapse and degree of systemic involvement of connective tissue. Methods. We have examined 246 athletes aged from 7 to 40 years (average age was 16,1±5,9 years), 65.2% - women and 34.8% - men. By using anthropometry and somatoscopy signs of systemic involvement of the musculoskeletal system in dysplastic process were determined. In a state of physiological rest echocardiographic examination was performed by the standard method. As a result of echocardiographic examination athletes with mitral valve prolapse were selected – 58 people. The control group comprised 188 athletes without specified attributes. Results. The most frequent signs of the phenotypic manifestations of systemic involvement of connective tissue in the dysplastic process were dolichostenomelia, hypermobility of joints and flat feet. In the group of athletes with mitral valve prolapse signs of systemic involvement of connective tissue were detected statistically significantly more frequent. In the group with myxomatous degeneration of leaflets mitral valve prolapse was 0.12±0.12 cm, while in the athletes without myxomatous degeneration mitral valve prolapse was – 0.04±0.12 cm, (p=0.03). In individuals with mitral valve prolapse without myxomatous degeneration systemic involvement of connective tissue was maximum, indicating that mitral valve prolapse originates as a small heart defect, accompanying other classified and unclassified dysplastic syndromes, whereas in the group of athletes with mitral valve prolapse and myxomatous degeneration systemic involvement of connective tissue is lower, indicating the original nature of myxomatous mitral valve prolapse. Conclusion. 1. Different clinical forms of mitral valve prolapse require differential approaches of sports doctors in permissions and planning of training loads in sportsmen. 2. Increase in the number of musculoskeletal signs of connective tissue involvement in the dysplastic process may indicate other accompanying classified and unclassified dysplastic syndromes. 3. Increased thickness of mitral valve evidences the original nature of myxomatous mitral valve prolapse with a prognostically unfavorable course.

References

  1. Kryvolap NV. [Dysplastic cardiopathy in football players: characteristics of manifestations depending on age, sex and sports experience]. Sportyvna medycyna. 2014;(1):95-101. Ukrainian.
  2. Mikhailova AV, Smolenskii AV. [Recommendations for supervision of the young athletes with heart connective tissue dysplasia syndrome]. In: [Proceedings of the 9th International scientific conference of young scientists ‘Current issues of sports medicine, therapeutic physical training, physiotherapy and balneology’]. Sochi: Sport-Med; 2010. p. 146-9. Russian.
  3. Bonow RO, Cheitlin MD, Crawford MH, Douglas PS. Task Force 3: valvular heart disease. In: 36th Bethesda Conference: Recommendations for determining eligibility for competition in athletes with cardiovascular abnormalties. J Am Coll Cardiol. 2005 Apr 19;45(8):1334-40. PMID: 15837283.
  4. Kadurina TY, Gorbunova VN. [Connective tissue dysplasia: guideline for physicians]. St Petersburs: ELBY; 2008. 714 p. Russian.
  5. Hayek E, Gring CN, Griffin BP. Mitral valve prolapse. Lancet. 2005 Feb 5-11;365(9458):507-18. PMID: 15705461.
  6. Volosovec OP, Marcenyuk YO. [Abnormal heart rhythm and conduction in children with mitral valve prolapse]. Pediatriya, akusherstvo i ginekologiya. 2004;(3):10-13. Ukrainian.
  7. Malev EG, Reeva SV, Timofeev EV, Zemtsovsky EV. [Modern methods of mitral valve prolapse diagnostics and prevalence assessment in young people]. Russ J Cardiol. 2010;(1):35-41. Russian.
  8. Hepner AD, Ahmadi-Kashani M, Movahed MR. The prevalence of mitral valve prolapse in patients undergoing echocardiography for clinical reason. Int J Cardiol. 2007 Dec 15;123(1):55-7. PMID: 17292985.
  9. Sattur S, Bates S, Movahed MR. Prevalence of mitral valve prolapse and associated valvular regurgitations in healthy teenagers undergoing screening echocardiography. Exp Clin Cardiol. 2010 Spring;15(1):e13-5. PMID: 20664768; PMCID: PMC2907880.
  10. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2006 Aug 1;48(3):e1-148. PMID: 16875962.
  11. Zemtsovskii EV, Malev EG. [Small anomalies of heart and dysplastic phenotypes]. St Petersburs: IVESEP; 2012. 160 p. Russian.
  12. Kadurina TY, Gnusaev SF, Аbbakumova LN, et al. [Heritable and multifactorial disorders of connective tissue in children. Diagnostic algorithms, tactic]. Pediatriia. 2014;93(5):1-40. Russian.
  13. Beighton Р, Grahame R, Bird H. Hypermobility of Joints. New York: Springer; 2012. 204 р.
  14. Kovalenko VM, Lutaj MI, Bratus' VV, Viktorov OP, Voronkov LG, et al., authors; Kovalenko VM, editor. [Guide for cardiology]. Kiev: МОRІОN; 2009. 1368 p. Ukrainian.
  15. Evangelista A, Flachskampf F, Lancellotti P, Badano L, Aguilar R, Monaghan M, et al. European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr. 2008 Jul;9(4):438-48. doi: 10.1093/ejechocard/jen174. PMID: 18579482.
  16. Khalafyan AA. STATISTICA 6: Statisticheskiy analiz dannykh [STATISTICA 6: Statistical analysis of data]. 3rd ed. Moscow: ‘Binom-Press’ Co Ltd; 2007. 512 p. Russian.
  17. Grande-Allen KJ, Borowski AG, Troughton RW, Houghtaling PL, DiPaola NR, Moravec CS, Vesely I, Griffin BP. Apparently normal mitral valves in patients with heart failure demonstrate biochemical and structural derangements: an extracellular matrix and echocardiographic study. J Am Coll Cardiol. 2005 Jan 4;45(1):54-61. PMID: 15629373.

Downloads

How to Cite

Nekhanevich, O. B. (2015). Morphological features of heart of athletes with symptoms of connective tissue dysplasia. Морфологія / Morphologia / Morfologìâ, 9(1), 47–51. https://doi.org/10.26641/1997-9665.2015.1.47-51

Issue

Vol. 9 No. 1 (2015)

Section

Статті

License

Copyright (c) 2018 Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.