2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease

Pelliccia, Antonio; Sharma, Sanjay; Gati, Sabiha; Bäck, Maria; Börjesson, Mats; Caselli, Stefano; Collet, Jean‐Philippe; Corrado, Domenico; Drezner, Jonathan A.; Halle, Martin; Hansen, Dominique; Heidbüchel, Hein; Myers, Jonathan; Niebauer, Josef; Papadakis, Michael; Piepoli, Massimo F; Prescott, E; Roos‐Hesselink, Jolien W.; Stuart, Graham; Taylor, Rod S; Thompson, Paul D; Tiberi, Monica; Vanhees, Luc; Wilhelm, Matthias

doi:10.1016/j.rec.2021.05.003

Cited by 26 publications

(53 citation statements)

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“…Moderate PA in all individuals with cardiovascular disease, after appropriate risk stratification, is recommended as a central component of therapy and is associated with reduced anxiety, hospital readmission, and cardiovascular and all-cause mortality ( 37 ). However, it is yet difficult to place these recommendations in SCAD patients since predicting which patients could have recurrent SCAD is not possible.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is yet difficult to place these recommendations in SCAD patients since predicting which patients could have recurrent SCAD is not possible. Recently, the 2020 European Society of Cardiology guidelines on sports cardiology and exercise in patients with cardiovascular disease ( 37 ) recommend management of SCAD patients based on individual assessment. Resumption of leisure-time activities or competitive sports was suggested in patients under conservative management (i.e., without revascularization) who remain symptom-free, without evident inducible myocardial ischemia or with complete healing on computed tomography.…”

Section: Discussionmentioning

confidence: 99%

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Physical Activity and Exercise Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry

Chacin-Suarez

Bonikowske

Medina‐Inojosa

et al. 2021

Front. Cardiovasc. Med.

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Objective: The objective of the study was to assess the physical activity (PA) and exercise patterns among participants in a large multinational spontaneous coronary artery dissection (SCAD) registry. Patients and Methods: Participants with SCAD enrolled from March 2011 to November 2019 completed surveys including details regarding PA and exercise habits prior to SCAD, and PA counseling received from their provider after SCAD. Demographics and clinical characteristics were collected by electronic record review. Exercise prescribed to patients after SCAD was categorized according to exercise components: type, intensity, frequency, time/session, and extreme environmental conditions.Results: We included 950 participants; mean ± age was 46.8 ± 9.5 years old at the time of first SCAD; most (96.3%) were women and (77.0%) attended ≥1 cardiac rehabilitation session. Hyperlipidemia (34.3%), hypertension (32.8%), and elevated body weight (overweight = 27.0%; obesity = 20.0%) were the most common comorbidities. Prior to SCAD, 48.5% performed aerobic exercise ≥3 times/week, and only 32.0% performed strength-building exercise regularly. PA counseling details after SCAD in 299/950 participants showed that most (93.3%) patients received some form of counseling including exercise prescription (EXP), non-specific recommendations, and discouraged from any exercise. Limits regarding exercise type and intensity were the most common advice among participants who received EXP.Conclusion: Insights from our study suggest that only 48% of the patients performed some aerobic exercise three or more times per week, and 32.0% performed strength-building exercises, which suggest that most of them may not be as active as assumed. Furthermore, 70% of the SCAD patients have ≥1 cardiovascular risk factors. We suggest guiding patients based on individual assessment, taking into consideration baseline PA habits, treatment, and risk factors. SCAD-tailored PA guidelines are needed for optimal EXP without compromising patient safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Physical Activity and Exercise Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry

Chacin-Suarez

Bonikowske

Medina‐Inojosa

et al. 2021

Front. Cardiovasc. Med.

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“…Current ESC guidelines recommend a more flexible approach regarding the avoidance of physical activity, reflecting a tendency to adapt prescription to the individual [88]. It has been clearly stated that patients with a definitive (EMB-based) or a probable (clinician-based) diagnosis of myocarditis are discouraged from participating in both competitive and leisure sports if active inflammation is present.…”

Section: Physical Activitymentioning

confidence: 99%

“…Table 6. Recommended tests for the follow-up assessment of patients with myocarditis (based on [88,89]).…”

Section: Physical Activitymentioning

confidence: 99%

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Personalized Management of Myocarditis and Inflammatory Cardiomyopathy in Clinical Practice

Tymińska

Ozierański

Skwarek

et al. 2022

JPM

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Myocarditis is an inflammatory heart disease induced by infectious and non-infectious causes frequently triggering immune-mediated pathologic mechanisms leading to myocardial damage and dysfunction. In approximately half of the patients, acute myocarditis resolves spontaneously while in the remaining cases, it may evolve into serious complications including inflammatory cardiomyopathy, arrhythmias, death, or heart transplantation. Due to the large variability in clinical presentation, unpredictable course of the disease, and lack of established causative treatment, myocarditis represents a challenging diagnosis in modern cardiology. Moreover, an increase in the incidence of myocarditis and inflammatory cardiomyopathy has been observed in recent years. However, there is a growing potential of available non-invasive diagnostic methods (biomarkers, serum anti-heart autoantibodies (AHA), microRNAs, speckle tracking echocardiography, cardiac magnetic resonance T1 and T2 tissue mapping, positron emission tomography), which may refine the diagnostic workup and/or noninvasive follow-up. Personalized management should include the use of endomyocardial biopsy and AHA, which may allow the etiopathogenetic subsets of myocarditis (infectious, non-infectious, and/or immune-mediated) to be distinguished and implementation of disease-specific therapies. In this review, we summarize current knowledge on myocarditis and inflammatory cardiomyopathy, and outline some practical diagnostic, therapeutic, and follow-up algorithms to facilitate comprehensive individualized management of these patients.

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Vigorous physical activity and atrial fibrillation in healthy individuals: What is the correct approach?

Margolis,

Cohen,

Roguin

2024

Clinical Cardiology

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Sport activity compared to sedentary life is associated with improved wellbeing and risk reduction in many different health conditions including atrial fibrillation (AF). Vigorous physical activity is associated with increased AF risk. We describe four individuals, who regularly perform endurance sport activity and developed AF. We discuss the changes occurring in the heart of endurance athletes and the possible etiology for AF, as well as currently available treatment options in this seemingly healthy population. Although the etiology of AF in the general population differs from the one in the usually younger endurance sport activity population, the treatment options are similar. There are several factors unique to those involved in vigorous physical activity that can influence their management. Despite a lack of evidence, endurance athletes with AF have traditionally been advised to “de‐training,” to reduce both the amount and intensity of exercise. Some of the current offered treatment options (beta‐blockers, class III antiarrhythmic) have a varied range of adverse effect, hindering them unattractive for these individuals. Depending on risk stratification tools, anticoagulation may be indicated. Some suggest an intermittent dosing therapy, while others recommend following current guidelines. AF ablation is recommended in exercising individuals with recurrent, symptomatic AF and/or in those who do not want drug therapy, given its impact on athletic performance, AF treatment decisions should be individualized for those engaging vigorous physical activity, while considering the potential risks, the urgency of returning to training, and the will and expectations of the patient.

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2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease

Cited by 26 publications

References 0 publications

Physical Activity and Exercise Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry

Physical Activity and Exercise Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry

Personalized Management of Myocarditis and Inflammatory Cardiomyopathy in Clinical Practice

Vigorous physical activity and atrial fibrillation in healthy individuals: What is the correct approach?

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