Recommendations for Competitive Sports Participation in Athletes With Cardiovascular Disease: A Consensus Document From the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology

Pelliccia, Antonio; Fagard, Robert; Bjøornstad, H.H.

doi:10.1016/j.accreview.2005.10.013

Cited by 177 publications

(352 citation statements)

References 88 publications

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“…The 36th Bethesda Conference of the American College of Cardiology (ACC) published in 2005 provides eligibility recommendations for competitive athletes with cardiovascular abnormalities in the USA [10], and a parallel document was created by the European Society of Cardiology (ESC) [11]. Consensus documents from the USA [12] and Europe [13] provide recommendations for recreational sports participation for patients with genetic cardiovascular diseases.…”

Section: Published Guidelines For Sports Participation In Individualsmentioning

confidence: 99%

Exercise in Hypertrophic Cardiomyopathy

Day

2009

J. of Cardiovasc. Trans. Res.

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The risk of sudden cardiac death (SCD) associated with vigorous athletic competition in individuals with hypertrophic cardiomyopathy (HCM) is well documented, and is the basis for recommended exclusion from competitive sports independent of other risk factors. Although SCD risk with recreational exercise is less well defined, published guidelines for participation in recreational sports, based on a consensus of expert opinion, offer a valuable framework for counseling patients. Exercise stress testing is an important diagnostic and prognostic tool in the evaluation of HCM patients, providing an objective measure of functional capacity, physiologic hemodynamic responses to stress, presence of ischemia, and provocable left ventricular outflow tract obstruction. The value of cardiopulmonary exercise testing in HCM is less well studied than in the heart failure population, but can be used to set a safe target for exercise intensity as part of an individualized exercise prescription. The long-term effects of exercise on HCM pathophysiology are largely theoretical at this stage. Potential harmful effects of fatiguing exercise include prolonged contractile dysfunction resulting from microvascular ischemia and energetic compromise. Conversely, several animal studies have shown that voluntary exercise prevents or reverses many pathologic features of HCM, including those related to apoptosis and energetics. Substantial evidence for health-promoting benefits of exercise in the general population, in addition to promising safety and efficacy data in patients with chronic heart failure, emphasizes the need to attain a reasonable balance between potential risks and benefits of aerobic fitness in individuals with HCM.

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Section: Published Guidelines For Sports Participation In Individualsmentioning

confidence: 99%

Exercise in Hypertrophic Cardiomyopathy

Day

2009

J. of Cardiovasc. Trans. Res.

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“…The European Society of Cardiology also recommends restriction from competitive sports for genotype-positive phenotype-negative individuals. 10 …”

Section: Hypertrophic Cardiomyopathymentioning

confidence: 97%

“…Detection of cardiovascular disorders responsible for syncope has an impact on eligibility for competitive sports activity because of the increased exercise-related risk. 10 …”

Section: Introductionmentioning

confidence: 97%

Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes

et al. 2015

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“…Nach Abklingen der Symptomatik, jedoch frühestens 6 Monate nach Beginn der Myokarditis ist vor Wiederbeginn der sportlichen Aktivität eine genaue klinische Untersuchung, in vielen Fällen inklusive Kontroll-EMB, erforderlich [11,29]. Eine Zulassung zum Wettkampfsport ist dann wieder möglich, wenn sich die linksventrikuläre Funktion erholt hat und relevante Arrhythmien nicht mehr nachweisbar sind [11,30].…”

Section: Behandlungunclassified

Myokarditis als Ursache des plötzlichen Herztodes bei Sportlern

Frick

Pachinger²,

Pölzl

2009

Herz

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Myocarditis is the reason for sudden cardiac death in 5-22% of athletes < 35 years of age. Actually, parvovirus B19 and human herpes virus 6 are the most important pathogens. Clinical presentation of myocarditis is heterogeneous, with all courses between asymptomatic and fulminant reported. Especially in athletes it is important to take subtle discomforts seriously and initiate further evaluation. Electrocardiogram, laboratory parameters, serologic markers, and echocardiography are helpful in diagnosis of myocarditis, but are not specific. Magnetic resonance imaging (MRI) of the heart has become an important tool in the evaluation of patients with myocarditis and allows noninvasive appraisal of myocardial inflammation using late enhancement. However, MRI is not able to assess viral persistence. Therefore, endomyocardial biopsy (EMB) remains the gold standard in diagnosis of myocarditis. When considering EMB in these athletes one should not ignore spontaneous healing in 50% of patients with myocarditis. Contrariwise, specific therapy (e.g., immunosuppression, interferon, immunoglobulins) for myocarditis is only feasible after getting results of EMB. When myocarditis is verified, athletes have to withdraw from sport for at least 6 months. Before restarting physical activity, a detailed examination is necessary and most of the patients will undergo another EMB. For prevention of myocarditis and sudden cardiac death it is recommended to stop elite sport for 4 weeks after an unspecific infection. Whether moderate sport can be started earlier is unclear.

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Cited by 177 publications

References 88 publications

Exercise in Hypertrophic Cardiomyopathy

Exercise in Hypertrophic Cardiomyopathy

Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes

Myokarditis als Ursache des plötzlichen Herztodes bei Sportlern

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