Cited by 326Cardiovascular Effects of ExerciseCardiomyopathy and Myosin StudiesCardiac electrophysiology and arrhythmias

Nonischemic Left Ventricular Scar as a Substrate of Life-Threatening Ventricular Arrhythmias and Sudden Cardiac Death in Competitive Athletes

Open access
Zorzi, Alessandro, Perazzolo Marra, Martina, Rigato, Ilaria, De Lazzari, Manuel, Susana, Angela, Niero, Alice, Pilichou, Kalliopi, Migliore, Federico +14 more·2016·Circulation: Arrhythmia and Electrophysiology

Abstract

Background—: The clinical profile and arrhythmic outcome of competitive athletes with isolated nonischemic left ventricular (LV) scar as evidenced by contrast-enhanced cardiac magnetic resonance remain to be elucidated. Methods and Results—: We compared 35 athletes (80% men, age: 14–48 years) with ventricular arrhythmias and isolated LV subepicardial/midmyocardial late gadolinium enhancement (LGE) on contrast-enhanced cardiac magnetic resonance (group A) with 38 athletes with ventricular arrhythmias and no LGE (group B) and 40 healthy control athletes (group C). A stria LGE pattern with subepicardial/midmyocardial distribution, mostly involving the lateral LV wall, was found in 27 (77%) of group A versus 0 controls (group C; P <0.001), whereas a spotty pattern of LGE localized at the junction of the right ventricle to the septum was respectively observed in 11 (31%) versus 10 (25%; P =0.52). All athletes with stria pattern showed ventricular arrhythmias with a predominant right bundle branch block morphology, 13 of 27 (48%) showed ECG repolarization abnormalities, and 5 of 27 (19%) showed echocardiographic hypokinesis of the lateral LV wall. The majority of athletes with no or spotty LGE pattern had ventricular arrhythmias with a predominant left bundle branch block morphology and no ECG or echocardiographic abnormalities. During a follow-up of 38±25 months, 6 of 27 (22%) athletes with stria pattern experienced malignant arrhythmic events such as appropriate implantable cardiac defibrillator shock (n=4), sustained ventricular tachycardia (n=1), or sudden death (n=1), compared with none of athletes with no or LGE spotty pattern and controls. Conclusions—: Isolated nonischemic LV LGE with a stria pattern may be associated with life-threatening arrhythmias and sudden death in the athlete. Because of its subepicardial/midmyocardial location, LV scar is often not detected by echocardiography.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/circep.116.004229

Cites

52 of 52 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Zorzi et al found that athletes who presented with ventricular arrhythmia and were subsequently found to have nonischemic lateral left ventricular wall fibrosis on cardiovascular magnetic resonance were more likely to experience malignant arrhythmic events than those without fibrosis.

    “Zorzi et al8 found athletes who presented with ventricular arrhythmia and were subsequently found to have nonischemic lateral LV wall fibrosis on CMR were more likely to experience malignant arrhythmic events than those without fibrosis.”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Zorzi, A., Perazzolo Marra, M., Rigato, I., De Lazzari, M., Susana, A., Niero, A., Pilichou, K., Migliore, F., Rizzo, S., Giorgi, B., De Conti, G., Sarto, P., Serratosa, L., Patrizi, G., De Maria, E., Pelliccia, A., Basso, C., Schiavon, M., Bauce, B., Iliceto, S., Thiene, G., & Corrado, D.
Affiliations
  • University of Padua (IT)
  • From the Department of Cardiac, Thoracic, and Vascular Sciences (A.Z., M.P.M., I.R., M.D.L., A.S., A.N., K.P., F.M., S.R., C.B., B.B., S.I., G.T., D.C.) and Division of Radiology, Department of Medicine (B.G.), University of Padova, Padova, Italy; Department of Radiology, Azienda Ospedaliera di Padova, Padova, Italy (G.D.C.); Center for Sports Medicine, Treviso, Italy (P.S.); Unidad de Cardiologica del Deporte, Hospital Universitario Quiron, Madrid, Spain (L.S.); U.O. Cardiologia, Ospedale B...
Corresponding author
Zorzi, Alessandro
Venue
Circulation: Arrhythmia and Electrophysiology
Published
2016-07
Volume
9
Issue
7
ISSN
  • 1941-3084 (ISSN-L)
  • 1941-3149
OpenAlex
W2464247829
Cited by
326
References
52
Citations by year
2026: 21 · 2025: 28 · 2024: 44 · 2023: 47 · 2022: 32 · 2021: 44 · 2020: 50 · 2019: 27 · 2018: 20 · 2017: 12 · 2016: 1
FWCI
16.47
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Circulation Arrhythmia and Electrophysiology (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc-nd)
Funders
  • Università degli Studi di Padova (CPDA133979/13)
  • Regione del Veneto
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
late gadolinium enhancement, sudden cardiac death, ventricular arrhythmias, competitive athletes, right bundle branch block, left bundle branch block, implantable cardioverter-defibrillator shocks, sustained ventricular tachycardia, repolarization abnormalities, cardiac magnetic resonance
MeSH terms
Adolescent, Adult, Cicatrix, Contrast Media, Female, Humans, Magnetic Resonance Imaging, Male, Meglumine, Middle Aged, Organometallic Compounds, Case-Control Studies, Death, Sudden, Cardiac, Tachycardia, Ventricular, Athletes

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review