Myocardial work index as a marker for physiologic cardiac remodeling in elite endurance athletes.

Introduction: Endurance athletes are expected to present a cardiac remodeling characterized by eccentric hypertrophy. Differentiation from underlying cardiomyopathy mimicking a similar cardiac remodeling may be challenging. Myocardial work indexes (MWI) have been shown to be useful in distinguishing between physiological adaption and pathological changes in the athletes' heart.

Predominant atrial remodeling in elite endurance athletes: a rare and un-investigated type of athlete's heart?

Although athlete's heart is typically characterized by balanced enlargement of all cardiac chambers, previous investigations have placed relatively little focus on specific characteristics of atrial remodeling. The aim of our study is to describe cardiac remodeling in a cohort of elite endurance athletes, with a specific focus on atrial remodeling. Endurance athletes with unremarkable cardiovascular pre-participation screening test results underwent thorough multidisciplinary cardiovascular evaluation, which included transthoracic echocardiography.

A novel insight into the athlete's heart: Hemodynamic forces evaluation by cardiovascular magnetic resonance.

Background: Hemodynamic forces (HDFs) data on elite athletes are scarce. Thus, we aimed to assemble HDFs on a large cohort of Olympic athletes.

Methods: Three hundred and twenty Olympic athletes and 42 sedentary individuals with normal cardiovascular evaluation voluntarily underwent CMR without contrast administration.

Perspectives on artificial intelligence in medical publishing: a survey of medical journal editors.

Artificial intelligence (AI) has been increasingly integrated into medical publishing, hopefully improving efficiency and accuracy, but serious concerns persist regarding ethical implications, authorship attribution, and content reliability. We aimed at understanding the perspectives of editors of medical journals on AI. A structured online questionnaire was developed and distributed to Editors-in-Chief of medical journals worldwide.

Cardiopulmonary Exercise Testing in Elite Athletes: Rethinking Sports Classification.

: ESC sports classification in 2020, based on cardiac morphological adaptations, may not fully reflect also the variations in functional parameters of athletes. This study aims to characterize CPET-derived physiological parameters in elite athletes according to the ESC classification and evaluate whether this morphological classification also corresponds to a functional categorization. : Elite athletes underwent pre-participation screening before the 2023 European Games and 2024 Olympic Games.

Isolated non-ischemic left ventricular scar in athletes: scientific and clinical rationale behind the 2023 Recommendations of the Italian Sports Cardiology Guidelines (COCIS).

Isolated non-ischemic left ventricular scar (NLVS) refers to the presence of significant late gadolinium enhancement (LGE) with subepicardial/midmyocardial distribution detected through cardiac magnetic resonance (CMR) in the absence of other features of a specific disease and excluding the junctional spotty pattern that is not pathological. This nosographic entity is relatively recent, emerging with the widespread clinical use of CMR. The NLVS has recently been associated with cardiac arrest in sports.

Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study.

Athletes engaged in dynamic sports experience a shortened red blood cell (RBC) lifespan and accelerated turnover due to RBC destruction. This accelerated RBC turnover might have a positive impact on exercise performance by increasing the number of young red blood cells with a high oxygen-carrying capacity. However, accelerated turnover might also be a result of intravascular haemolysis caused by RBC destruction during exercise, impairing RBC function and oxygen transport.

The spectrum of eccentric left ventricular hypertrophy in endurance sports disciplines.

Endurance sports disciplines largely differ in terms of specific training and event modalities, likely resulting in diverse morpho-functional cardiac changes. Our study aims to assess elite athletes engaged in different endurance disciplines and describe cardiac remodelling in each. We enrolled 282 Olympic athletes (58.

Correlation between myocardial work indices and main echocardiographic and cardiopulmonary exercise stress test parameters in Olympic endurance athletes.

Introduction: Myocardial works indices (MWI) are new echocardiographic parameters that innovatively assess left ventricular function. Although recent studies show correlation between these indices and traditional morpho-functional echocardiographic (TTE) and cardiopulmonary test (CPET) parameters in general population and in different pathologic conditions, data on athletes remains scarce. Aim of our study is to investigate a relationship between MWI and main TTE and CPET parameters in a large cohort of endurance athletes.

Differences Between Olympic and National Athletes: Training and Experience Are the Keys to Success.

Objective: Olympic athletes (OAs) represent a unique subset of highly trained subjects achieving extraordinary performance. Differences between OAs and elite/national athletes (EAs), defined as athletes not qualified for the Olympics, are not investigated.

Design: Therefore, we compared OAs with EAs enrolling 1472 athletes (63.

Recommendations for cardiac screening and emergency action planning in youth football: a FIFA consensus statement.

Sudden cardiac death is the leading medical cause of death among football players. Determining the optimal cardiac screening, the use of carefully selected medical assessments to detect underlying cardiovascular conditions associated with sudden cardiac arrest/death, is a desired objective of the Fédération Internationale de Football Association (FIFA) for football players of all ages. To date, cardiac screening recommendations in football have primarily focused on adult competitive players.

Correlation between workload-indexed blood pressure response to exercise (SBP/MET slope) and clinical and echocardiographic parameters among normotensive Olympic athletes.

Introduction: The workload-indexed systolic blood pressure response to exercise (SBP/MET slope) has been proposed as a novel parameter for evaluating abnormal blood pressure response to exercise (ABPR) and its potential risks. Aim of our study was to assess the association between SBP/MET slope and clinical and cardiac dimensional parameters in normotensive athletes.

Methods: A cohort of 292 normotensive Olympic athletes (155 male, 53.

Pre-participation Cardiovascular Evaluation for Paris 2024 Olympic Games in Elite Athletes: The Italian Experience.

Introduction: Olympic athletes represent a special subset of the athletic population and deserve a specialized medical approach. In view of the 2024 Paris Olympic Games, we developed and implemented a comprehensive medical protocol including (other than the standard screening with ECG, physical and history) cardiopulmonary exercise test, echocardiography and full blood and urine tests.

Aim: Our aim was to assess the prevalence and type of cardiovascular abnormalities in athletes candidate to Paris 2024 Olympic Games, after implementation of this Olympic medical program.

Subcutaneous Implantable Defibrillators in Young Patients: Arrhythmias, Complications, and Physical Activity.

Background: The safety of subcutaneous implantable cardioverter defibrillator (S-ICD) recipients who lead active lifestyles and engage in recreational sports is unknown. We aimed to evaluate the association between lifestyle and recreational sports and the occurrence of arrhythmia- and device-related complications, appropriate and inappropriate shocks in S-ICD recipients.

Methods: We assessed a cohort of young-adult (15-65 years) S-ICD patients, evaluated their physical activity with IPAQ (International Physical Activity Questionnaire), and assessed the association between lifestyle and recreational sports on S-ICD safety and shocks.

Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology.

This American Heart Association/American College of Cardiology scientific statement on clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities or diseases is organized into 11 distinct sections focused on sports-specific topics or disease processes that are relevant when considering the potential risks of adverse cardiovascular events, including sudden cardiac arrest, during competitive sports participation. Task forces comprising international experts in sports cardiology and the respective topics covered were assigned to each section and prepared specific clinical considerations tables for practitioners to reference. Comprehensive literature review and an emphasis on shared decision-making were integral in the writing of all clinical considerations presented.

Cardiac Magnetic Resonance Feature-Tracking in Olympic Athletes: a myocardial deformation analysis.

Background: Athlete's heart induces extreme cardiovascular remodelling, generating challenges for the differential diagnosis with early stages of cardiomyopathies. Advanced cardiac function analysis could be helpful, but data on healthy athletes and the impact of sports disciplines are lacking.

Aim: To describe myocardial deformation by cardiac magnetic resonance (CMR) in a cohort of Olympic athletes and to evaluate possible differences based on sports disciplines and sex.

Clinical and CT Features, Clinical Management, and Decision on Sport Eligibility of Professional Athletes with Congenital Coronary Anomalies: A Case Series Study.

Background: Congenital coronary artery anomalies (CAAs) are a significant cause of sudden cardiac death and a key factor in determining athletes' eligibility for competitive sports. Their prevalence varies with diagnostic modalities and may present as asymptomatic or with life-threatening ischemic or arrhythmic events. This case series highlights the diverse manifestations of CAAs and the clinical approaches used to determine sports eligibility.

Influence of Persistently Elevated LDL Values on Carotid Intima Media Thickness in Elite Athletes.

Introduction: Carotid IMT is a recognized marker for early atherosclerotic changes and a predictor of future CV events. Previous studies showed 11% increased risk of myocardial infarction with each 0.1 mm incremental increase of carotid IMT.

Abnormal blood pressure response to exercise and ventricular arrhythmias: a suspicious association in athletes.

Introduction: Abnormal blood pressure response to exercise (ABPR) in athletes is considered a risk for incident hypertension, conferring a higher cardiovascular risk profile. We sought to describe the clinical cardiovascular features of athletes with ABPR and, moreover, the relationship of ABPR with occurrence of exercise-induced ventricular ectopic beats (VEBs).

Methods And Results: We enrolled 1460 elite athletes (56.