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Abstract：
Intense and regular physical exercise is responsible for various cardiac changes (electrical, structural and functional) that represent physiological adaptation to exercise training. This remodeling, commonly referred to as \'athlete\'s heart\', can overlap with several pathological entities, in which sudden cardiac death may be the first clinical presentation. Although pre-competitive screening can identify athletes with life-threatening cardiovascular abnormalities, there are no widely used standardized pre-participation programs and those currently implemented are controversial. Data from personal and family history, features of physical examination and changes in the 12-lead electrocardiogram can raise the suspicion of cardiac disease and lead to early detection of entities such as hypertrophic cardiomyopathy. However, interpreting the electrocardiogram is often challenging, because some changes are considered physiological in athletes. Thus, clinical decision-making in such cases can prove difficult: missing a condition associated with an increased risk of life-threatening events, or conversely, mislabeling an athlete with a disease that leads to unnecessary disqualification, are both situations to avoid. This paper provides an up-to-date review of the physiological cardiac effects of exercise training and highlights key points that should be taken into consideration in the assessment of young competitive athletes.
摘要：
激烈和有规律的体育锻炼是各种心脏变化的原因(电，结构和功能)，代表对运动训练的生理适应。这种重塑，通常被称为“运动员的心脏”，可以与几个病理实体重叠，其中心源性猝死可能是第一个临床表现。尽管赛前筛查可以识别患有危及生命的心血管异常的运动员，没有广泛使用的标准化参与前计划，目前实施的计划存在争议。来自个人和家族史的数据，体格检查的特征和12导联心电图的变化可能会增加对心脏病的怀疑，并导致对肥厚型心肌病等实体的早期发现。然而,解释心电图通常很有挑战性，因为有些变化被认为是运动员的生理变化。因此，在这种情况下，临床决策可能很困难：错过与危及生命事件风险增加相关的条件，或者相反，给运动员贴上错误的标签，导致不必要的取消资格，这两种情况都需要避免。本文提供了运动训练对生理心脏影响的最新综述，并强调了在评估年轻竞技运动员时应考虑的关键点。
