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Acute myocarditis risk in weightlifting

Summary of a study looking at how the sport a person is performing affects the complication during acute heart inflammation.

Who

82 athletes (5 females, 77 males) who presented to the hospital with acute myocarditis (heart inflammation) aged 29.1±9.4 years with median sports participation of 5.4±3.7 hours per week (France).

acute myocarditisinflammation of the heart often resulting from a viral infection; diagnosed via positive endomyocardial biopsy or a positive cardiac magnetic resonance combined with an elevation in blood troponin.

Design

Retrospective study. Athletes who had acute myocarditis (heart inflammation) were questioned about their sport.

Outcome measures/tests

  • sports activity level before having a heart inflammation (at least 2.5 hours per week for the 6 months before the acute myocarditis):
    • exercisers: 2.5 h of training per week focusing on health
    • recreational athletes: 4 h per week focusing on pleasure, fitness, and competition
    • competitive athletes: 6 h per week focusing on participation in “official” competitions
  • sports activity type via Michell’s classification:
    • I: low <20% of max voluntary contraction
    • II: moderate 20-50% of max voluntary contraction
    • III: high >50% of max voluntary contraction
    • A: low <40% of max O uptake
    • B: moderate 40-70% of max O uptake
    • C: high >70% of max O uptake
  • severity of the heart inflammation:
    • uncomplicated: no complications
    • complicated: left ventricular ejection fraction <50% OR use of dobutamine or noradrenaline OR use of cardiac assistance device
  • return to sport after the heart inflammation

Main results

Acute myocarditis risk in weightlifting - infographic

  • sports activity level:
    • exercisers: 29 (35%)
    • recreational athletes: 39 (47%)
    • competitive athletes: 14 (17%)
  • sports activity type:
    • IC: 26 (35%) (soccer 15 (18%), running 10 (12%))
    • IIB: 14 (17%) (rugby 10 (12%), fitness 2 (4%))
    • IIIA: 13 (16%) (weightlifting 10 (12%))
  • severity:
    • uncomplicated 66 (80%)
    • complicated 16 (20%)
  • risks associated with complications in acute myocarditis:
    • sports participation over 6 hours per week
    • participation the sport classified as IIIA on Mitchell’s classification (e.g., weightlifting)
  • factors associated with uncomplicated acute myocarditis:
    • participation in the sport classified as IC
  • 65 athletes (79%) returned to their sport after a median of 6 months; 35 (43%) returned to sport at the same level as before; 18 (22%) returned to competing.

Take home message

For a clinician & coach
Practicing weightlifting was associated with a risk for complications when experiencing acute myocarditis, as was practicing sports for more than 6 hours per week. Practicing high-intensity endurance sports was associated with uncomplicated acute myocarditis.
For a parent
People who did weightlifting as their sport were at higher risk for complications when experiencing inflammation of the heart. People who did high-intensity endurance sports were more likely to have uncomplicated inflammation of the heart.
For an athlete
People who did weightlifting as their sport were at higher risk for complications when experiencing inflammation of the heart. People who did high-intensity endurance sports were more likely to have uncomplicated inflammation of the heart.

Original article

Bouchau R, Cariou E, Deney A, Belaid S, Itier R, Blanchard V, Fournier P, Duparc A, Galinier M, Carrié D, Lairez O. Sports participation and myocarditis: Influence of sport types on disease severity. IJC Heart & Vasculature. 2021 Dec 1;37:100895.

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