Diagnostic Challenges in Sports Cardiology—2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 534

Special Issue Editor

Special Issue Information

Dear Colleagues,

When assessing professional or amateur athletes, sports cardiologists are often faced with the problem of differential diagnosis between physiological adaptation to intensive training and suspicion of heart disease. Both false positive and false negative findings may lead to detrimental consequences for the athletes. Recent studies have proposed several algorithms which are helpful in the cardiological assessment of athletes at screening and those with suspicion of a cardiac condition. However, there is limited knowledge on specific groups of athletes, including adolescents, women, veteran or late start athletes, athletes of different ethnic backgrounds, or athletes with disabilities. There is also a paucity of prospective data on athletes with known cardiovascular conditions which would be helpful in decision making for continued sports eligibility. Finally, diagnostic efficacy in sports cardiology may be improved by application of new imaging techniques, biomarkers, and other promising testing methods. All research related to the described area, including systematic reviews, original research, or short communications on important clinical findings as well as comprehensive case reports are highly welcomed for submission.

Prof. Dr. Łukasz A. Małek
Guest Editor

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Keywords

  • sports cardiology
  • MRI
  • echocardiography
  • heart rate

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Published Papers (1 paper)

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Research

15 pages, 4788 KiB  
Article
Long-Term Follow-Up of Professional Soccer Players: The Analyses of Left and Right Heart Morphology and Function by Conventional, Three-Dimensional, and Deformation Analyses
by Joscha Kandels, Michael Metze, Stephan Stöbe, Lisa Do, Maximilian Nicolas Möbius-Winkler, Marios Antoniadis, Andreas Hagendorff and Robert Percy Marshall
Diagnostics 2025, 15(14), 1745; https://doi.org/10.3390/diagnostics15141745 - 9 Jul 2025
Viewed by 316
Abstract
Background: Transthoracic echocardiography (TTE) is the primary imaging modality to assess cardiac morphology and function. In athletes, distinguishing physiological adaptations from pathological changes is essential. This study aimed to evaluate long-term cardiac structural and functional changes in professional soccer players. Methods: This retrospective [...] Read more.
Background: Transthoracic echocardiography (TTE) is the primary imaging modality to assess cardiac morphology and function. In athletes, distinguishing physiological adaptations from pathological changes is essential. This study aimed to evaluate long-term cardiac structural and functional changes in professional soccer players. Methods: This retrospective study included 20 healthy male professional soccer players (mean age 21.2 ± 3.4 years) from the German first division, examined annually from 2016 to 2024 (mean follow-up 5.6 ± 2.0 years). TTE parameters associated with the “athlete’s heart” were assessed, including left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVSD), relative wall thickness (RWT), indexed LV mass (LVMi), and left atrial volume index (LAVi), along with 3D-derived LV and RV volumes. Advanced deformation imaging included global longitudinal strain (GLS), right ventricular strain (RVS), and left/right atrial reservoir strain (LASr and RASr, respectively). Baseline and final follow-up values were compared. Results: No significant changes were observed over time in conventional or advanced echocardiographic parameters (e.g., LVEDD: 54.5 ± 3.1 mm vs. 54.6 ± 3.9 mm; p = 0.868; GLS: −18.7% ± 2.2% vs. −18.4% ± 1.9%; p = 0.670). Ventricular volumes and strain values also remained stable throughout follow-up. Conclusions: Over a mean follow-up of more than five years, professional soccer players showed stable cardiac morphology and function without evidence of pathological remodeling. These findings support the concept that long-term high-level training in mixed-discipline sports leads to balanced, physiological cardiac adaptation. Full article
(This article belongs to the Special Issue Diagnostic Challenges in Sports Cardiology—2nd Edition)
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