Acute myocarditis (AM) in athletes is a frequent source of concern.
Investigate whether the way of practice has an impact on the severity of AM and on the occurrence of long-term adverse events if sport is resumed.
82 athletes (≥2hours of sport per week) who presented an AM were retrospectively included from January 2009 to December 2019. AM was defined by onset of symptoms<1 month and a positive endomyocardial biopsy (Dallas criteria) or a positive CMR (2 or 3 Lake Louise Criteria) associated with an elevation of troponin. The habits of practicing sport before and after AM were collected. Endpoints were severe AM, defined by a left ventricular ejection fraction<50% or the use of inotropic drugs or ventricular assist device, and the occurrence of late (>6 months after acute phase) heart failure, rehospitalization or recurrence.
Mean age was 29±9 years old, 77 (94%) were men, median time of practice was 5.4±3.7hours per week. Sixteen (29.5%) presented a severe AM. Practicing sport>6hours a week (43.8% vs. 16.7% P=0.019) or a Mitchell's Class IIIA sport (37.5% vs. 10.6%; P=0.008) was associated with severe AM. Practicing a Michell's Class IC sport (6.3% vs. 37.9%; P=0.008) was associated with non-severe AM. Median follow-up was 33.8 [16.6–60], 65 (79.3%) patients resumed sport (Fig. 1). In univariate Cox regression analysis, sport resumes (HR 0.97; 95% CI 0.20–4.57, P=0.97), competition (HR 0.76; 95%CI 0.15–3.82; P=0.74) and amount of hours of practice par week (HR 1.15; 95%CI 0.98–1.32; P=0.06) were not associated with the occurrence of late heart failure, rehospitalization or recurrence (Table 1).
In athlete's AM, the way of sport participation (static or dynamic component, practice over 6hours a week) is associated with the presentation's severity. The return to sport after the acute phase does not seem to be associated with the occurrence of adverse events.Le texte complet de cet article est disponible en PDF.