Detraining among Athletes-Is Withdrawal of Adaptive Cardiovascular Changes a Hint for the Differential Diagnosis of Physically Active People?

Abstract

An athlete's training aims to achieve the highest possible sports results by improving physical dispositions which lead to cardiac adaptive changes. The annual training cycle is divided into periods. The preparatory period begins with gradually increasing training intensity and volume until the competitive period occurs, when the athlete's maximum performance is expected. Finally, the athlete enters a phase of loss of fitness, which is called detraining. Detraining is a time of resting both physically and mentally from the training regime and usually lasts about 4 weeks for endurance athletes. We collected data from much research on athletes' detraining. According to these data, the earliest change after detraining seems to be a decrease in left ventricular wall thickness and left ventricular mass, followed by decreased performance parameters, diastolic diameter of the left ventricle and size of the left atrium. A reversal of adaptive changes affects the left heart chamber first, then the right atrium and, finally, the right ventricle. Training reduction is often proposed as a method of differentiating an athlete's heart from cardiomyopathies. The aim of this study is to consider the diagnostic value of detraining in differentiating athletes' hearts from cardiomyopathies. We suggest that detraining cannot be conclusive in differentiating the disease from adaptive changes. Although a withdrawal of the characteristic morphological, functional and electrocardiographic changes occurs in healthy athletes during detraining, it can also concern individuals with cardiomyopathies due to the lower expression of abnormal features after decreased training loads. Therefore, a quick diagnosis and individual assessments using imaging and genetic tests are essential to recommend a proper type of activity.