Aspects of myocardial heterogeneity in assessment its remodeling

The influence of sports activity on the cardiovascular system is accompanied by physiological adaptation of the organism. Intense physical activity, far exceeding the body’s capabilities, can lead to structural changes or remodeling of the athlete’s myocardium. The review is devoted to the study of myocardial heterogeneity and is aimed at attracting attention of physicians, physiologists, biologists, researchers and developers of ECG computer analysis programs to prognostically significant indicators. Based on the mechanisms of electrical heterogeneity of the ventricular myocardium, the review considers the results of clinical studies by Russian and foreign specialists. The high predictive capabilities of indicators for the detection of fatal and non-fatal cardiovascular events and sudden cardiac death are discussed. It was found that the speed indicators of the electrical activity of the heart are the earliest marker of cardiac arrhythmias and conduction disorders. Risk factors - arterial hypertension, smoking, hypercholesterolemia and overweight - are associated with a decrease in the rate of electrical activity of the heart and an increase in myocardial heterogeneity. The data presented allow us to conclude that myocardial electrical heterogeneity is a prognostically significant indicator for the detection of fatal and non-fatal cardiovascular events; it is widely discussed in foreign literature, but is not used by domestic specialists.