Isolated left ventricular non compaction as possible cause of athletic training suspension: a preliminary study on screened athletes.

AIM: The aim of this paper was to determine the prevalence of isolated left ventricular noncomapction (ILVNC) in a sample of 150 athletes send by sports doctors to the Valmontone Hospital's Cardiology Division in a span of about three years, with particular interest in non-compacted segments evaluation. The prevention of cardiovascular complications occurring during sporting activity requires detection of pathologies most often clinically latent but whose first presentation can be sudden cardiac death. In Italy, the pre-participation screening program comprises family history and personal cardiac history, clinical examination and electrocardiography. Subjects with abnormalities are further investigated by stress test, echocardiography and laboratory investigations, and those with significant abnormalities are disqualified from sports training and competition. ILVNC results in multiple trabeculations in the left ventricular myocardium and it is postulated to be caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. This cardiomyopathy should be considered one of the structural cardiac abnormalities responsible for sudden cardiac death. METHODS: There were 150 athletes seen in the Cardiology Division from 2007 to 2010 for an echocardiographic evaluation in order to clarify the nature of physical examination and/or electrocardiogram abnormalities. Echocardiographic diagnosis of ILVNC was based on criteria published by Jenni et al., and by Stölberger et al. RESULTS: Twenty-four of the 150 tested resulted positive for ILVNC (16.0%). This high prevalence is justified because it was a population originally selected because of electrocardiographic abnormalities. CONCLUSION: We believe that in case of unspecific ECG findings, it would be useful to perform echocardiographic examination in order to highlight structural defects. We also believe that it is very important to contemplate ILVNC between the causes of sudden death in young competitive athletes.

ACP1 genetic polymorphism and coronary artery disease: an association study.

OBJECTIVES: Assuming an immune component in the pathogenesis of atherosclerosis, we have investigated a possible association between coronary artery disease (CAD) and the acid phosphatase locus 1 (ACP1) genetic polymorphism, which has previously been found to be associated with immune disorders. METHODS: 226 subjects admitted to the hospital for CAD, 358 consecutive newborn infants, 279 adult subjects with type 2 diabetes without CAD and 137 adults without diabetes and without CAD from the Caucasian population of Rome were studied. The ACP1 genotype was determined by DNA analysis. Statistical analyses were performed using the SPSS package. RESULTS: CAD females showed an excess of ACP1 *A/*C and *B/*C genotypes and a deficiency of ACP1 *B/*B genotype compared to controls, while CAD males did not show significant differences. Among diabetic women the proportion of *C allele carriers was much greater in those with CAD than in those without CAD. This difference was much less evident in nondiabetic women. CONCLUSION: ACP1 may be involved in susceptibility to CAD. Since ACP1 has been found to be associated with immunological diseases, our observation reinforces the notion of an immune component in the pathogenesis of atherosclerosis.