| Abstract ID |
| 20260024 |
| Category |
| Cartilage |
| Preferable Presentation |
| Both |
| Title |
| THE IMPACT OF PECTUS EXCAVATUM ON SPORTS CARDIOLOGY |
| Author |
|
| Presenter |
| Rustem Hayaliev |
| Abstract |
| Background. Pectus excavatum (PE) is the most frequent chest wall deformity, representing 65-95% of all cases, with an estimated prevalence of up to 1 in 300 births. Despite its frequency, it remains underrecognized in sports cardiology. PE should be systematically considered in pre-participation screening to avoid misdiagnosis and unnecessary disqualification of athletes. Symptoms and signs of PE can mimic other high-risk cardiovascular diseases, while diseases accompanying PE form a life-threatening risk for an athlete in case of severe ventricular arrhythmias or syncope. Finally, pectus excavatum can impair a promising athletic career, which should be considered as early as possible and addressed with means of rehabilitation or surgery in the spirit of shared-decision making. Patients with HI >4.5 or CI above 30% may become candidates for surgery if PE is accompanied by symptoms, objective cardiac compression, significant arrhythmia, or syncope/presyncope. The aim of this study was to assess cardiac function before and during temporary sternal elevation using the non-invasive vacuum bell (VB) device on young sportsmen with PE. Methods: During the period 2024-2025, 567 male athletes from the federations of athletics, weightlifting, swimming, boxing and cycling underwent routine medical examinations. Funnel-shaped deformity of mild to moderate severity was found in 11 (1.94%) athletes. 10 of them gave voluntary consent and participated in an in-depth study of the cardiovascular system (with HI = 3-4.0 or CI = 15-30%). Patients underwent cardiac magnetic resonance imaging (CMRI) before and during the application of the VB. Steady-state free precession sequences were used for the evaluation of biventricular volume and function. Phase contrast sequences measured the aortic and pulmonary flow to calculate stroke index (SI). A control group of healthy individuals was assessed in the same way. Results: In total, 10 patients with PE (mean age 18±4.6 years) and 10 healthy athletes (mean age 19±6.2 years) underwent CMR before and during VB application. Before intervention, baseline cardiac volumes and function were similar between the groups, with patient-values in the low-to-normal range. Following VB application, PE patients revealed a 12% increase in biventricular SI. Furthermore, left ventricular end-diastolic volume index (LV EDVI) improved by 9% and right ventricular ejection fraction (RV EF) increased by 6%. These findings were not mirrored in the healthy individuals. A significant correlation between the improvement of heart parameters and the baseline Haller index in patients with PE was found only in 2 patients with grade 2 deformity (18% increase in biventricular SI, p<0.05). However, there is no doubt that with an increase in the sample of more than 100 people, it can be argued that there is a significant correlation between the degree of the Haller index and an improvement in heart parameters. Conclusions: Non-invasive, momentary correction of PE is associated with an immediate improvement in SI, RV EF and LV EDVI, not observed in controls. The findings suggest that sternal depression in PE patients affects cardiac function. Management should involve shared decision making between clinicians, athletes, and families, weighing potential risks against athletic aspirations. |