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Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition
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Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Epidemiology, Lifestyle, and Cardiovascular Health".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 4459

Special Issue Editors

Dr. Stavros Dimopoulos

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Guest Editor
1. Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, National and Kapodistrian University of Athens, 106 75 Athens, Greece
2. Cardiac Surgery ICU, Onassis Cardiac Surgery Center, 176 74 Athens, Greece
Interests: exercise training; rehabilitation; cardiopulmonary exercise testing; critical illness; heart failure; pulmonary hypertension; cardiac surgery; extracorporeal membrane oxygenation (ECMO)
Special Issues, Collections and Topics in MDPI journals
Dr. Christos Kourek

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Guest Editor
Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece
Interests: heart failure; endothelial progenitor cells; endothelium; myocardial infarction; revascularization; cardiopulmonary resuscitation; myocarditis; cardiopulmonary exercise testing; exercise training; rehabilitation
Special Issues, Collections and Topics in MDPI journals
Dr. Eleftherios Karatzanos

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Guest Editor
Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, National and Kapodistrian University of Athens, 106 75 Athens, Greece
Interests: heart failure; endothelial progenitor cells; cardiopulmonary exercise testing; exercise training; rehabilitation; acute exercise; neuromuscular electrical stimulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue of the Journal of Cardiovascular Development and Disease focuses on sports cardiology, and specifically on exercise recommendations and eligibility criteria for sports participation in competitive athletes with cardiovascular disease and for exercise training programmes in subjects with known or previously undiagnosed cardiovascular disease. Over the last several decades, increasing numbers of people across the world are being diagnosed with coronary artery heart syndromes, heart failure, valvular heart disease, peripheral vascular disease, congenital heart disease, aortopathies and cardiomyopathies, while others face lethal arrhythmias and sudden cardiac death due to misdiagnosis or underdiagnosis. New diagnostic methods have contributed to the early diagnosis and risk stratification of cardiovascular disease. Regular physical activity, including structured exercise training programmes, is an important component of treatment strategies for stable cardiovascular disease, and is associated with favourable outcomes including improved quality of life and reduced cardiovascular and all-cause mortality. The process from the diagnosis of cardiovascular disease until patients’ participation in exercise training programmes is of paramount importance to achieve optimal outcomes. However, this is a complex procedure, including a multidisciplinary approach and several stages such as screening, diagnosis, risk stratification, shared decision making with physicians and secondary prevention and treatment through exercise protocols, defining the appropriate duration and intensity individualized for each patient.

We are pleased to invite authors to submit original research articles, recommendation articles, and reviews covering all aspects of sports cardiology, from diagnosis to clinical management. In order to evaluate and organize the content of the Special Issue, please let us know the preliminary title of your paper, the type of paper that you plan to submit (research article, review or case report) and any other additional information that would be useful. All manuscripts of original research that fit the scope of this Special Issue are welcome. For reviews, direct co-operation between the authors and the Guest Editors would be useful to avoid thematic overlaps.

Participation in this Special Issue through the submission of a manuscript could be an excellent opportunity for primary researchers to enrich their CV, for doctoral or post-doctoral trainees to gain experience in writing reviews in Sports Cardiology and for institutions to present their original research in a high-quality journal.

Dr. Stavros Dimopoulos
Dr. Christos Kourek
Dr. Eleftherios Karatzanos
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly 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 2700 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
  • cardiovascular risk factors
  • diabetes mellitus
  • arterial hypertension
  • obesity
  • diagnosis
  • chronic coronary syndromes
  • coronary artery bypass graft surgery
  • heart failure
  • valvular heart disease
  • pulmonary hypertension
  • congenital heart disease
  • cardiomyopathies
  • ventricular assist devices
  • sudden cardiac death
  • exercise training
  • rehabilitation
  • risk stratification

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Related Special Issue

Published Papers (6 papers)

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Research

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15 pages, 706 KiB  
Article
Autonomic Nervous System Control in Male and Female Elite Soccer Players: Importance of Different Training Routines and Perceived Stress
by Gianluigi Oggionni, Eleonora Pagani, Jacopo Rizzardini, Margherita Rigillo, Luca Giovanelli, Mara Malacarne, Nuno Loureiro, Júlia Machado Ribeiro, Piero Volpi, Massimo Pagani and Daniela Lucini
J. Cardiovasc. Dev. Dis. 2025, 12(4), 150; https://doi.org/10.3390/jcdd12040150 - 10 Apr 2025
Viewed by 281
Abstract
The assessment of cardiac autonomic regulation (CAR) with non-invasive techniques, such as heart rate variability (HRV), might be of practical interest in elite sports, considering its importance in determining training. We studied 117 soccer players (74 male and 43 female) from three First [...] Read more.
The assessment of cardiac autonomic regulation (CAR) with non-invasive techniques, such as heart rate variability (HRV), might be of practical interest in elite sports, considering its importance in determining training. We studied 117 soccer players (74 male and 43 female) from three First Division European soccer teams. We used a ranked Autonomic Nervous System Index (ANSI, resulting from the combination of multivariate statistical methodologies applied to HRV-derived indices) to assess CAR. We hypothesized that ANSI might differentiate playing positions, considering goalkeepers, defenders, midfielders, and forwards. We also assessed the perception of somatic symptoms and stress. We observed in male athletes that ANSI was significantly greater in males as compared to females (p < 0.001), being higher in midfielders and defenders (p = 0.035), who usually sustain the greatest external load. Interestingly, this result was not observed in female athletes, who, instead, reported a significantly higher perception of somatic symptoms (p = 0.018) and stress (p = 0.049), the latter being particularly high in midfielders and forwards (p = 0.045). This approach might represent a convenient model to study the effects of long-term physical exercise on CAR in soccer, even to unveil possible differences due to sex, different playing positions characterized by distinct exercise routines, or stress perception. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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9 pages, 1614 KiB  
Article
Does Long-Term Sport Practice Facilitate the Development of Idiopathic Bradycardia Requiring Early Pacemaker Implantation During the Course of Life?
by Sergei Bondarev, Leonardo Brotto, Francesca Graziano, Alberto Cipriani, Domenico Corrado and Alessandro Zorzi
J. Cardiovasc. Dev. Dis. 2025, 12(3), 102; https://doi.org/10.3390/jcdd12030102 - 15 Mar 2025
Viewed by 394
Abstract
Background: Sinus bradycardia and first-/second-degree atrioventricular (AV) block in athletes are traditionally considered secondary to increased vagal tone and therefore reversible. However, recent studies have suggested that they may persist even after the cessation of physical activity, and combined with the effects [...] Read more.
Background: Sinus bradycardia and first-/second-degree atrioventricular (AV) block in athletes are traditionally considered secondary to increased vagal tone and therefore reversible. However, recent studies have suggested that they may persist even after the cessation of physical activity, and combined with the effects of aging, lead to the earlier onset of clinically significant bradyarrhythmias. Methods: We evaluated the correlation between lifetime sport practice and the age of the onset of premature (≤70 years old) idiopathic sinoatrial node or AV node dysfunction requiring pacemaker (PM) implantation. Results: Of the 1316 patients followed up with at our PM clinic in 2024, we included 79 (6%) who received a PM when they were ≤70 years old for bradyarrhythmias in the absence of secondary causes. Nineteen (24%) had engaged in at least 6 h of sports/week for ≥20 years and were classified as former athletes. For comparison, former athletes who received a PM for idiopathic bradycardia at >70 years old were 6% (p < 0.001). In the group ≤70 years old, the average age of PM implantation was 62.8 years in non-athletes versus 57.9 years in former athletes (p = 0.03). The main reason for PM implantation was AV block in both subgroups. Among former athletes, the correlation between the lifetime volume of sports activity and the age of PM implantation reached borderline statistical significance (p = 0.08). Echocardiography at the time of implant did not reveal significant differences between former athletes and non-athletes. Conclusions: In a cohort of patients who received a PM for bradyarrhythmia before the age of 70 years old in the absence of secondary causes, former athletes were implanted on average ≈5 years before non-athletes. This may suggest a contributing role of cumulative sports activity volume in the development of idiopathic sinus/AV node dysfunction. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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13 pages, 1311 KiB  
Article
Rate of Perceived Exertion Based on Repetitions in Reserve Versus Percentage of One-Repetition Maximum for Resistance Training Prescription in Cardiac Rehabilitation: A Pilot Study
by Alessandro Gismondi, Ferdinando Iellamo, Giuseppe Caminiti, Barbara Sposato, Emanuele Gregorace, Valentino D’Antoni, Deborah Di Biasio, Sara Vadalà, Alessio Franchini, Annalisa Mancuso, Valentina Morsella and Maurizio Volterrani
J. Cardiovasc. Dev. Dis. 2025, 12(1), 8; https://doi.org/10.3390/jcdd12010008 - 27 Dec 2024
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Abstract
The aims of this study were to assess the efficacy of the rate of perceived exertion (RPE) scale based on the number of repetitions in reserve (RIR) before exhaustion for the prescription of resistance training in cardiac rehabilitation and to compare it to [...] Read more.
The aims of this study were to assess the efficacy of the rate of perceived exertion (RPE) scale based on the number of repetitions in reserve (RIR) before exhaustion for the prescription of resistance training in cardiac rehabilitation and to compare it to the percentage of estimated one-repetition maximum (1RM) prescription method. Sixteen male patients (age 60 ± 8) with history of coronary artery disease were randomly assigned to two resistance training rehabilitation protocols lasting nine weeks and consisting of three sessions per week, with the same exercise selection, number of sets and repetitions, and rest periods, but different load prescription method (RPE vs. %1RM). Patients’ strength was evaluated pre- and post-intervention. Patients in the RPE group showed significant increases in strength across all the exercises of the protocol (leg press 24.25 ± 17.07 kg; chest press 7.25 ± 3.41 kg; seated row 13.88 ± 7.57 kg; leg extension 14.24 ± 4.53 kg; shoulder press 5.75 ± 4.06 kg; lat pulldown 7.50 ± 4.66 kg). Post-intervention between-group analysis showed no differences in strength gains (leg press p = 0.955; chest press p = 0.965; seated row p = 0.763; leg extension p = 0.565; shoulder press p = 0.868; lat pulldown p = 0.780) and trivial effect sizes (ES) for one prescription method over the other (leg press ES = −0.03; chest press ES = 0.00; seated row ES = 0.10; leg extension ES = −0.29; shoulder press ES = 0.18; lat pulldown ES = 0.05). RPE based on RIR seems to be an effective prescription method for resistance training in cardiac rehabilitation, showing similar efficacy to the standardized practice of percentage of 1RM. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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Review

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19 pages, 615 KiB  
Review
Narrative Review of High-Intensity Interval Training: Positive Impacts on Cardiovascular Health and Disease Prevention
by Jae-Myun Ko, Wi-Young So and Sung-Eun Park
J. Cardiovasc. Dev. Dis. 2025, 12(4), 158; https://doi.org/10.3390/jcdd12040158 - 17 Apr 2025
Viewed by 369
Abstract
Background: High-intensity interval training (HIIT) has gained recognition for its positive impacts on cardiovascular (CV) health, metabolic outcomes, mental health, and quality of life (QoL). This narrative review aims to comprehensively evaluate the efficacy of HIIT in enhancing CV health and preventing CV [...] Read more.
Background: High-intensity interval training (HIIT) has gained recognition for its positive impacts on cardiovascular (CV) health, metabolic outcomes, mental health, and quality of life (QoL). This narrative review aims to comprehensively evaluate the efficacy of HIIT in enhancing CV health and preventing CV disease (CVD). Methods: A comprehensive search of PubMed identified 257 articles, of which 39 studies met predefined inclusion and exclusion criteria for quality assessment. Key metrics evaluated included blood pressure, vascular function, lipid profiles, body composition, and CRF. Results: HIIT significantly improved vascular function, evidenced by reductions in systolic and diastolic blood pressure and enhanced flow-mediated dilation. Improvements in cardiac function were observed through increased cardiac output and heart rate variability. Additionally, HIIT positively influenced lipid profiles, decreasing low-density lipoprotein and triglycerides while increasing high-density lipoprotein. Significant reductions in body fat and improvements in VO2peak were noted, contributing to enhanced CRF. HIIT also positively impacted mental health and QoL, reducing anxiety and depressive symptoms. Importantly, HIIT was safely and effectively applied to high-risk populations—individuals with obesity, metabolic syndrome, CVD, and cancer survivors—with a low incidence of adverse effects. Conclusions: This review highlights HIIT as an effective and safe exercise modality for improving CV health, metabolic indicators, mental health, and QoL. Future research should focus on developing tailored HIIT protocols to optimize adherence and efficacy across diverse populations, considering variations in age, sex, health status, and underlying medical conditions. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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14 pages, 3489 KiB  
Review
Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
by Carolina Miguel Gonçalves, Adriana Vazão, Mariana Carvalho, Margarida Cabral, André Martins, Mónica Amado, Joana Pereira, Fátima Saraiva, Hélia Martins and Hélder Dores
J. Cardiovasc. Dev. Dis. 2025, 12(3), 94; https://doi.org/10.3390/jcdd12030094 - 6 Mar 2025
Viewed by 580
Abstract
Background: Despite the multiple benefits of exercise for health, exercise in the presence of arrhythmic disorders can trigger adverse clinical events, including sudden cardiac death (SCD). The aim of this narrative review is to summarize the most recent recommendations regarding physical activity and [...] Read more.
Background: Despite the multiple benefits of exercise for health, exercise in the presence of arrhythmic disorders can trigger adverse clinical events, including sudden cardiac death (SCD). The aim of this narrative review is to summarize the most recent recommendations regarding physical activity and exercise in individuals with Brugada Syndrome (BrS). Methods: An advanced literature search was performed on the Pubmed and clinicaltrials.gov databases and published articles/clinical trials registered until September 2024 were analyzed. The final analysis included 33 articles. Results: Despite initial reports suggesting a higher risk of SCD in BrS, the risk is not as high as expected, and there is no evidence that exercise is an independent predictor. Therefore, scientific recommendations have become less restrictive. However, consensus on risk scores is lacking, making the evaluation of BrS a real challenge. The most recent recommendations emphasize individual evaluation, risk stratification, shared decision-making, and general preventive measures, allowing asymptomatic BrS patients as well as genotype positive/phenotype negative patients to participate in competitive sports, excluding sports under extreme conditions. Regarding patients with an implantable cardioverter defibrillator, both leisure and competitive sports may be considered in asymptomatic patients, avoiding contact sports. Conclusions: Research on the relationship between exercise and cardiovascular disease is evolving, but evidence-based recommendations for sports in BrS patients are scarce and further studies are needed. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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Other

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10 pages, 435 KiB  
Systematic Review
Benefits from Implementing Low- to High-Intensity Inspiratory Muscle Training in Patients Undergoing Cardiac Surgery: A Systematic Review
by Aphrodite Evangelodimou, Irini Patsaki, Alexandros Andrikopoulos, Foteini Chatzivasiloglou and Stavros Dimopoulos
J. Cardiovasc. Dev. Dis. 2024, 11(12), 380; https://doi.org/10.3390/jcdd11120380 - 27 Nov 2024
Viewed by 1321
Abstract
Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has [...] Read more.
Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has been found to be beneficial in improving respiratory muscle function in critically ill patients and patients with heart failure. The purpose of this review is to present the results of implementing inspiratory muscle training (IMT) programs in patients before and/or after cardiac surgery. The PubMed, Embase and Science Direct databases were searched from January 2012 to August 2023. In the present review, randomized controlled clinical trials (RCTs), clinical trials and quasi-experimental studies conducted in adult patients pre and/or post cardiac surgery were included. Fifteen studies were considered eligible for inclusion in the review. The results revealed that the IMT programs varied in intensity, repetitions, and duration in all included studies. Most studies implemented the IMT after the surgery. Statistical significance between groups was noted in Maximal Inspiratory Pressure and the 6-Minute Walk Distance Test. Preoperative and postoperative programs could improve inspiratory muscle strength, pulmonary function, and functional capacity as well as decrease the length of hospital stay in patients undergoing cardiac surgery. No clear evidence emerged favoring low or higher IMT intensities. The combination of IMT with other forms of exercise might be beneficial in patients undergoing cardiac surgery. However, further RCTs are required to provide confirming evidence. Full article
(This article belongs to the Special Issue Sports Cardiology: From Diagnosis to Clinical Management, 2nd Edition)
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