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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">rpcardio</journal-id><journal-title-group><journal-title xml:lang="en">Rational Pharmacotherapy in Cardiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Рациональная Фармакотерапия в Кардиологии</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1819-6446</issn><issn pub-type="epub">2225-3653</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20996/1819-6446-2026-3299</article-id><article-id custom-type="edn" pub-id-type="custom">URYKZI</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-3299</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASE</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЙ СЛУЧАЙ</subject></subj-group></article-categories><title-group><article-title>Left ventricular non-compaction in an athlete: a clinical case with sudden manifestation</article-title><trans-title-group xml:lang="ru"><trans-title>Синдром некомпактного миокарда левого желудочка у спортсмена: клинический случай с внезапной манифестацией</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1243-2471</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аракелянц</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Arakelyants</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аракелянц Амалия Ашотовна </p><p>ул. Трубецкая, д. 8, стр. 2, Москва, 119991 </p></bio><bio xml:lang="en"><p>Amaliia A. Arakelyants </p><p>Trubetskaya str., 8, bld. 2, Moscow, 119048 </p></bio><email xlink:type="simple">arakelyants_a_a@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3748-8180</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Морозова</surname><given-names>Т. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Morozova</surname><given-names>T. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Морозова Татьяна Евгеньевна </p><p>ул. Трубецкая, д. 8, стр. 2, Москва, 119991 </p></bio><bio xml:lang="en"><p>Tatiana E. Morozova </p><p>Trubetskaya str., 8, bld. 2, Moscow, 119048 </p></bio><email xlink:type="simple">zadoya.artyom@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0587-7193</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Задоя</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zadoia</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Задоя Артём Николаевич </p><p>Ломоносовский проспект, д. 27, стр. 1, Москва, 119991</p></bio><bio xml:lang="en"><p>Artem N. Zadoia </p><p>Lomonosovsky Prospekt, 27, bld. 1, Moscow, 119991</p></bio><email xlink:type="simple">zadoya.artyom@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3009-4143</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яснева</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Yasneva</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яснева Анастасия Станиславовна </p><p>Ломоносовский проспект, д. 27, стр. 1, Москва, 119991</p></bio><bio xml:lang="en"><p>Anastasia S. Yasneva </p><p>Lomonosovsky Prospekt, 27, bld. 1, Moscow, 119991</p></bio><email xlink:type="simple">anastasiia.iasnieva@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-3099-968X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Филипенко</surname><given-names>М. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Filipenko</surname><given-names>M. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Филипенко Марина Борисовна </p><p>Ломоносовский проспект, д. 27, стр. 1, Москва, 119991</p></bio><bio xml:lang="en"><p>Marina B. Filipenko </p><p>Lomonosovsky Prospekt, 27, bld. 1, Moscow, 119991</p></bio><email xlink:type="simple">zadoya.artyom@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-0900-2029</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ушерзон</surname><given-names>М. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Usherzon</surname><given-names>M. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ушерзон Майя Борисовна </p><p>Ломоносовский проспект, д. 27, стр. 1, Москва, 119991</p></bio><bio xml:lang="en"><p>Maya B. Usherzon </p><p>Lomonosovsky Prospekt, 27, bld. 1, Moscow, 119991</p></bio><email xlink:type="simple">zadoya.artyom@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2015-4712</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Плисюк</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Plisyuk</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Плисюк Алина Геннадьевна </p><p>Ломоносовский проспект, д. 27, стр. 1, Москва, 119991</p></bio><bio xml:lang="en"><p>Alina G. Plisyuk </p><p>Lomonosovsky Prospekt, 27, bld. 1, Moscow, 119991</p></bio><email xlink:type="simple">apl.cardio@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov First Moscow State Medicine University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Московский государственный университет им. М. В. Ломоносова» Медицинский научно-образовательный институт МГУ (Университетская клиника МГУ)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Lomonosov Moscow State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>17</day><month>06</month><year>2026</year></pub-date><volume>22</volume><issue>2</issue><fpage>204</fpage><lpage>212</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Arakelyants A.A., Morozova T.E., Zadoia A.N., Yasneva A.S., Filipenko M.B., Usherzon M.B., Plisyuk A.G., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Аракелянц А.А., Морозова Т.Е., Задоя А.Н., Яснева А.С., Филипенко М.Б., Ушерзон М.Б., Плисюк А.Г.</copyright-holder><copyright-holder xml:lang="en">Arakelyants A.A., Morozova T.E., Zadoia A.N., Yasneva A.S., Filipenko M.B., Usherzon M.B., Plisyuk A.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpcardio.online/jour/article/view/3299">https://www.rpcardio.online/jour/article/view/3299</self-uri><abstract><p>Left ventricular non-compaction cardiomyopathy is a rare genetically determined phenomenon associated with impaired myocardial compaction and the risk of developing chronic heart failure, ventricular arrhythmias, and thromboembolism. This report presents the case of a 26-year-old professional boxer, previously considered healthy, who developed edema, progressive dyspnea, and syncope after COVID-19, leading to hospitalisation. Echocardiography revealed chamber dilation, left ventricular wall hypertrabeculation, a noncompacted-to-compacted layer ratio greater than two to one, and a left ventricular ejection fraction of 21 to 28 percent. Contrast-enhanced magnetic resonance imaging confirmed left ventricular noncompaction cardiomyopathy (noncompacted myocardial mass of 23% according to the А. Jacquier et al. criterion) and signs of fibrosis. Treatment was initiated with quadruple therapy for chronic heart failure, diuretics, and rivaroxaban; no thromboembolic events were recorded. On optimal therapy, the left ventricular ejection fraction improved to 44% by November 2025, symptoms significantly regressed, and the patient returned to non-professional training. The case of detecting left ventricular non-compaction syndrome in an athlete is particularly interesting due to the complexity of differentiating between the physiological hypertrophy of an "athlete’s heart" and the excessive trabeculation and non-compaction of the left ventricular myocardium seen in left ventricle non’compaction. Intense training most likely contributed to the functional maladaptation of the left ventricle, and a prior viral infection may have served as a triggering factor in a morphologically altered heart, leading to the subsequent transition to cardiomyopathy against a background of genetic predisposition.</p></abstract><trans-abstract xml:lang="ru"><p>Некомпактный миокард левого желудочка (НМЛЖ) – редкий генетически детерминированный феномен, связанный с нарушением компактизации миокарда и риском развития хронической сердечной недостаточности (ХСН), желудочковых аритмий и тромбоэмболий. Представлен случай 26-летнего профессионального боксера, ранее считавшегося себя здоровым, у которого после перенесённой новой коронавирусной инфекции возникли отеки, прогрессирующая одышка и синкопе с госпитализацией. Эхокардиография выявила дилатацию камер, гипертрабекулярность стенки левого желудочка (ЛЖ), отношение некомпактного/компактного слоев &gt;2 и фракцию выброса ЛЖ (ФВ ЛЖ) 21-28%. Магнитно-резонансная томография (МРТ) с контрастированием подтвердила НМЛЖ (масса некомпактного миокарда 23% по А. Jacquier и соавт.) и признаки фиброза. Назначены квадротерапия ХСН, диуретики и ривароксабан; тромбоэмболических событий не зарегистрировано. На оптимальной терапии ФВ ЛЖ повысилась до 44% к ноябрю 2025 г., симптомы существенно регрессировали, пациент вернулся к любительским тренировкам. Случай выявления синдрома НМЛЖ у спортсмена особенно интересен из-за сложности дифференциации между физиологической гипертрофией «спортивного сердца» и чрезмерной трабекуляцией и некомпактностью миокарда левого желудочка. Интенсивные тренировки, вероятнее всего, способствовали функциональной дезадаптации ЛЖ, а перенесенная вирусная инфекция могла послужить пусковым фактором в морфологически измененном сердце последующего перехода в кардиомиопатию на фоне генетической предрасположенности.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>некомпактный миокард левого желудочка</kwd><kwd>кардиомиопатия</kwd><kwd>хроническая сердечная недостаточность</kwd><kwd>эхокардиография</kwd><kwd>магнитно-резонансная томография</kwd><kwd>дифференциальная диагностика</kwd><kwd>квадротерапия</kwd><kwd>трабекулярность</kwd><kwd>оптимальная медикаментозная терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>left ventricular non-compaction</kwd><kwd>cardiomyopathy</kwd><kwd>chronic heart failure</kwd><kwd>echocardiography</kwd><kwd>magnetic resonance imaging</kwd><kwd>differential diagnosis</kwd><kwd>quadruple therapy</kwd><kwd>trabeculation</kwd><kwd>optimal medical therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Блинова В.В., Богданова Т.М., Семенова В.А. и др. 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