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July 18, 2026JACC Case ReportsOpen Access

Elite athletic performance does not exclude early nonischemic cardiomyopathy despite preserved contractile reserve.

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Population

1 adolescent elite athlete with severe left ventricular dilation and electrical instability

Design

Case_report

Key result

Elite athletic performance does not exclude early nonischemic cardiomyopathy, as demonstrated by an adolescent athlete with severe left ventricular dilation and preserved contractile reserve.

Authors

CMCedrick MutebiMCMarius I. ChukwurahMCMerije Toya Chukumerije

Discussion

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Overview

Evaluation for cardiomyopathy remains essential in elite athletes with LV dilation; this case leaves open broader screening and progression questions.

Key Points

  • The aim is to differentiate between normal athletic heart changes and early signs of cardiomyopathy in elite athletes.
  • Case evaluation of an adolescent elite athlete exhibiting severe left ventricular dilation and preserved contractile reserve.
  • Performance measures including maximum oxygen uptake (52.5 mL/kg/min) were assessed without arrhythmias.
  • Discussion on physiologic versus pathologic heart remodeling in athletes.
  • Identified significant left ventricular dilation while maintaining contractile function and high exercise capacity.
  • Noted electrical instability complicating the assessment of athlete's heart versus early cardiomyopathy.
  • Emphasized the necessity for collaborative decision-making in return-to-play evaluations for athletes with ambiguous findings.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
One adolescent elite athlete presenting with severe left ventricular dilation and preserved contractile reserve.

Elite athletic performance does not exclude early nonischemic cardiomyopathy, and return-to-play decisions in gray-zone phenotypes require shared decision-making.

Cite This Study

Mutebi et al. (2026) conducted a case report in Severe left ventricular dilation / early nonischemic cardiomyopathy (n=1). Elite athletic performance does not exclude early nonischemic cardiomyopathy, as demonstrated by an adolescent athlete with severe left ventricular dilation and preserved contractile reserve.

synapsesocial.com/papers/6a5b38f68167787360d24dc9https://doi.org/10.1016/j.jaccas.2026.108866
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