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Diagnostics
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Diagnostic Challenges in Sports Cardiology—2nd Edition
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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 July 2026 | Viewed by 3086

Special Issue Editor

Prof. Dr. Łukasz A. Małek

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Guest Editor
Faculty of Rehabilitation, University of Physical Education, Marymoncka 34, 00-968 Warsaw, Poland
Interests: cardiomyopathies; cardiac MRI; sports cardiology; preventive cardiology
Special Issues, Collections and Topics in MDPI journals

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sports cardiology
  • MRI
  • echocardiography
  • heart rate

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Published Papers (2 papers)

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Research

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15 pages, 4788 KB  
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
Cited by 2 | Viewed by 1106
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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Review

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12 pages, 1081 KB  
Review
Pectus Excavatum—A Frequent but Often Neglected Entity in Sports Cardiology
by Łukasz Małek, Anna Lemańska and Mateusz Śpiewak
Diagnostics 2025, 15(23), 2956; https://doi.org/10.3390/diagnostics15232956 - 21 Nov 2025
Cited by 1 | Viewed by 1486
Abstract
Pectus excavatum (PE) is the most frequent chest wall deformity, representing 65–95% of all cases, with an estimated prevalence of up to 1 in 300 births. Despite its frequency, it remains underrecognized in sports cardiology. PE results from sternal depression and narrowing of [...] Read more.
Pectus excavatum (PE) is the most frequent chest wall deformity, representing 65–95% of all cases, with an estimated prevalence of up to 1 in 300 births. Despite its frequency, it remains underrecognized in sports cardiology. PE results from sternal depression and narrowing of the anterior chest, which may lead to cardiac compression, impaired diastolic filling, and reduced stroke volume during exercise. Consequently, athletes with PE often present with cardiovascular symptoms such as exercise-induced dyspnoea, chest pain, palpitations, presyncope, or reduced physical fitness. Electrocardiographic changes, including right bundle branch block, axis deviation, atrial enlargement, T-wave inversion, QS complexes or Brugada phenocopies, are frequent and may mimic serious cardiovascular conditions, complicating pre-participation screening. Furthermore, PE is associated with potentially high-risk conditions including mitral valve prolapse, ventricular arrhythmias, and connective tissue disorders such as Marfan syndrome, which carry implications for sports eligibility and safety. Assessment of athletes with PE requires multimodal imaging (echocardiography, computed tomography, magnetic resonance), cardiopulmonary exercise testing, and exclusion of concomitant cardiovascular disease. Treatment strategies range from conservative approaches (physiotherapy, vacuum bell therapy) to surgical correction, most commonly with the Nuss procedure, which can improve cardiac function, exercise capacity, and quality of life. Management should involve shared decision making between clinicians, athletes, and families, weighing potential risks against athletic aspirations. Awareness of PE in sports cardiology is crucial, as it not only influences differential diagnosis and screening outcomes but also impacts career decisions and the psychological well-being of athletes. Full article
(This article belongs to the Special Issue Diagnostic Challenges in Sports Cardiology—2nd Edition)
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