Molecular genetic testing in athletes: Why and when a position statement from the Italian Society of Sports Cardiology. (1st October 2022)

• Record Type: Journal Article
• Authors: Castelletti, Silvia; Zorzi, Alessandro; Ballardini, Enrico; Basso, Cristina; Biffi, Alessandro; Brancati, Francesco; Cavarretta, Elena; Crotti, Lia; Contursi, Maurizio; D'Aleo, Antonio; D'Ascenzi, Flavio; Delise, Pietro; Dello Russo, Antonio; Gazale, Giovanni; Mos, Lucio; Novelli, Valeria; Palamà, Zefferino; Palermi, Stefano; Palmieri, Vincenzo; Patrizi, Giampiero; Pelliccia, Antonio; Pilichou, Kalliopi; Romano, Silvio; Sarto, Patrizio; Schwartz, Peter J.; Tiberi, Monica; Zeppilli, Paolo; Corrado, Domenico; Sciarra, Luigi
• Is Part Of: International journal of cardiology. Volume 364(2022)
• Page Start: 169
• Page End: 177
• Publication Date: 2022-10-01
• Subjects: Cardiomyopathy -- Genetic testing -- Ion channel disease -- Inherited cardiac diseases -- Sports cardiology -- Sudden cardiac death -- Ventricular fibrillation; ACM arrhythmogenic cardiomyopathy -- AF atrial fibrillation -- ALVC Arrhythmogenic left ventricular cardiomyopathy -- AV atrio-ventricular -- BrS Brugada Syndrome -- CVD cardiovascular disease -- CPVT catecholaminergic polymorphic ventricular tachycardia -- DCM dilated cardiomyopathy -- DNA deoxyribonucleic acid -- ECG electrocardiogram -- HCM hypertrophic cardiomyopathy -- LQTS long QT syndrome -- LV left ventricle -- LVNC left ventricular non-compaction -- PRKAG2 regulatory γ2-subunit of the AMP-activated protein kinase -- SCD sudden cardiac death -- TWI T-wave inversion -- VA ventricular arrhythmias -- VUS variant of uncertain significance -- WPW Wolff-Parkinson-White; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.05.071
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Molecular genetic testing is an increasingly available test to support the clinical diagnosis of inherited cardiovascular diseases through identification of pathogenic gene variants and to make a preclinical genetic diagnosis among proband's family members (so-called "cascade family screening"). In athletes, the added value of molecular genetic testing is to assist in discriminating between physiological adaptive changes of the athlete's heart and inherited cardiovascular diseases, in the presence of overlapping phenotypic features such as ECG changes, imaging abnormalities or arrhythmias ("grey zone"). Additional benefits of molecular genetic testing in the athlete include the potential impact on the disease risk stratification and the implications for eligibility to competitive sports. This position statement of the Italian Society of Sports Cardiology aims to guide general sports medical physicians and sports cardiologists on clinical decision as why and when to perform a molecular genetic testing in the athlete, highlighting strengths and weaknesses for each inherited cardiovascular disease at-risk of sudden cardiac death during sport. The importance of early (preclinical) diagnosis to prevent the negative effects of exercise on phenotypic expression, disease progression and worsening of the arrhythmogenic substrate is also addressed. Highlights: Molecular genetic test is an increasingly available test to support the clinical diagnosis of inherited cardiovascular diseases. In athletes, molecular genetic test may assist in discriminating between athlete's heart and inherited cardiovascular diseases. Additional benefits of molecular genetic testing in the athlete include the potential impact on risk stratification and sports recommendations. This position statement aims to guide on clinical decision as why and when to perform a molecular genetic test in the athlete.