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Advancements in Diagnostic Innovations in Sports Cardiology
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Advancements in Diagnostic Innovations in Sports Cardiology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 25 October 2025 | Viewed by 3260

Special Issue Editors

Dr. Giuseppe Di Gioia

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Guest Editor
1. Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 00197 Roma, Italy
2. Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 00135 Roma, Italy
Interests: athlete’s heart; cardiomyopathies; dyslipidemia; hypertension; heart remodelling
Special Issues, Collections and Topics in MDPI journals
Dr. Maria Rosaria Squeo

E-Mail Website
Guest Editor
Department of Sports Medicine, Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197 Rome, Italy
Interests: athlete’s heart; heart remodeling; athletes; exercise prescription; olympic
Special Issues, Collections and Topics in MDPI journals
Dr. Stefano Palermi

E-Mail Website
Guest Editor
Departmental Faculty of Medicine and Surgery, UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
Interests: sports medicine; sports cardiology; pre-participation screening; sports injury rehabilitation; echocardiography; musculoskeletal ultrasound
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sports cardiology is a rapidly evolving field, driven by the increasing recognition of cardiovascular conditions in athletes. Over the past decade, innovations in diagnostic tools, imaging techniques, and risk stratification strategies have significantly advanced our understanding of cardiovascular health in sports contexts. These breakthroughs are essential in improving the detection, diagnosis, and management of cardiovascular conditions, ultimately enhancing athletic performance and safeguarding the health of athletes.

This Special Issue aims to provide an overview of the latest advancements in sports cardiology diagnostics. From cutting-edge imaging modalities to novel biomarkers and sophisticated risk assessment models, the contributions gathered here highlight the forefront of research that is reshaping clinical practice. As sports cardiology continues to grow, it is crucial that we stay ahead of emerging trends to ensure that athletes receive the most accurate, timely, and personalized care.

The aim of this Special Issue is to highlight advancements in non-invasive imaging, genetic screening, wearable technology, and the integration of artificial intelligence into clinical decision-making.

Dr. Giuseppe Di Gioia
Dr. Maria Rosaria Squeo
Dr. Stefano Palermi
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 Clinical Medicine 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

  • athletes
  • cardiovascular prevention
  • risk factors
  • sport cardiology
  • sudden cardiac death

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Published Papers (3 papers)

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Research

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17 pages, 396 KB  
Article
The Association Between Cardiorespiratory Fitness Directly Assessed by the Cardiopulmonary Stress Test and the Perception of Stress
by Gianluigi Oggionni, Marcello Rizzi, Giuseppina Bernardelli, Mara Malacarne, Massimo Pagani and Daniela Lucini
J. Clin. Med. 2025, 14(19), 7120; https://doi.org/10.3390/jcm14197120 - 9 Oct 2025
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Abstract
Background/Objectives: Cardiorespiratory fitness (CRF) represents a strong and consistent predictor of mortality among adults. It is ideally expressed as the maximum or peak rate of oxygen consumption per kilogram of body mass (VO2max) determined by the cardiopulmonary exercise test (CPX). Variance [...] Read more.
Background/Objectives: Cardiorespiratory fitness (CRF) represents a strong and consistent predictor of mortality among adults. It is ideally expressed as the maximum or peak rate of oxygen consumption per kilogram of body mass (VO2max) determined by the cardiopulmonary exercise test (CPX). Variance in CRF is mainly attributable to genetics and physical training; nevertheless, strong behavioral and socioeconomic confounders need to be considered. Among those, psychosocial stress may play an important role. Some papers show an association between low CRF and chronic stress conditions; nevertheless, CRF is generally estimated by indirect assessment and not directly measured by CPX. Methods: CRF was directly assessed by performing a CPX in 145 consecutive subjects (56 male, 89 female) (age 19–65 years) who attended our Exercise Medicine unit for health check-ups. Weekly total volume of physical activity (PA) was evaluated using a validated questionnaire (IPAQ); perceptions of stress, fatigue, and somatic symptoms were assessed using a self-administered questionnaire. Results: VO2max was negatively correlated with perception of stress (p = 0.03), fatigue (p < 0.001), and somatic symptoms (p < 0.001); as expected, it was positively correlated with the weekly volume of PA (p < 0.001). This link was further evidenced by the observation that subjects who did not meet the PA goals as indicated by WHO guidelines presented a higher perception of stress, fatigue, and symptoms, as compared to physically active subjects. Conclusions: This direct link might, on the one hand, corroborate the role of exercise as a tool to manage stress and, on the other hand, focus on the role of stress as a possible determinant of CRF. Full article
(This article belongs to the Special Issue Advancements in Diagnostic Innovations in Sports Cardiology)
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13 pages, 655 KB  
Article
How to Evaluate Kidney Function in Elite Endurance Athletes: Pros and Cons of Different Creatinine-Based Formulas
by Giuseppe Di Gioia, Armando Ferrera, Andrea Serdoz, Alessandro Spinelli, Roberto Fiore, Lorenzo Buzzelli, Domenico Zampaglione and Maria Rosaria Squeo
J. Clin. Med. 2025, 14(9), 2955; https://doi.org/10.3390/jcm14092955 - 24 Apr 2025
Viewed by 2515
Abstract
Background: Various creatinine-based equations are used to estimate the glomerular filtration rate (eGFR) in athletes, but each has limitations. The aim of our study was to identify the most suitable formula for use in athletes. Methods: We evaluated 490 Olympic athletes (27 ± [...] Read more.
Background: Various creatinine-based equations are used to estimate the glomerular filtration rate (eGFR) in athletes, but each has limitations. The aim of our study was to identify the most suitable formula for use in athletes. Methods: We evaluated 490 Olympic athletes (27 ± 5.3 yo) with normal values of serum creatinine and no history of kidney diseases. Athletes were divided into those practicing skills and endurance disciplines. The EGFR was calculated with Cockcroft–Gault (CG), MDRD, MCQE and CKD-EPI, and classified as stages G1–G5 according to the Kidney Disease Improving Global Outcomes (KDIGO) GFR categories. Results: Endurance athletes showed higher serum creatinine (0.91 ± 0.14 mg/dL vs. 0.88 ± 0.13 mg/dL in skills, p = 0.014). The eGFR calculated with the CKD-EPI and MCQE formulas showed no differences between the groups. The CG formula produced a lower eGFR for endurance athletes (113.6 ± 27 mL/min/1.73 m2) compared to skills athletes (122.6 ± 30.8, p = 0.008), while MDRD produced higher values for endurance athletes (129.3 ± 25.8 vs. 122.6 ± 24 mL/min/1.73 m2, p = 0.004). According to CKD-EPI, all athletes were in G1, while with MCQE, 0.5% of skills athletes and 1% of endurance athletes were in G2. With the CG formula, a significant percentage of athletes were in G2 (13.2% of skills athletes and 18.5% of endurance athletes, p = 0.125). With the MDRD formula, 29 athletes (5.9%) were in G2 (6% for skills athletes and 5.8% for endurance athletes, p = 0.927). Conclusions: CKD-EPI and MCQE showed better stability and reliability, making them the most suitable for kidney function evaluation in athletes. Full article
(This article belongs to the Special Issue Advancements in Diagnostic Innovations in Sports Cardiology)
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Other

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19 pages, 2158 KB  
Systematic Review
Mitral Valve Prolapse in Athletes: Prevalence, Arrhythmic Associations, and Clinical Implications—A Systematic Review
by Andrea Sonaglioni, Gian Luigi Nicolosi, Michele Lombardo and Massimo Baravelli
J. Clin. Med. 2025, 14(21), 7475; https://doi.org/10.3390/jcm14217475 (registering DOI) - 22 Oct 2025
Abstract
Background: Mitral valve prolapse (MVP) is the most common valvular abnormality in the general population and has been linked to mitral regurgitation, arrhythmias, and sudden cardiac death. Its prevalence and prognostic significance in athletes remain uncertain, raising important questions for pre-participation screening, [...] Read more.
Background: Mitral valve prolapse (MVP) is the most common valvular abnormality in the general population and has been linked to mitral regurgitation, arrhythmias, and sudden cardiac death. Its prevalence and prognostic significance in athletes remain uncertain, raising important questions for pre-participation screening, eligibility for competition, and long-term follow-up. Methods: We systematically searched PubMed, Scopus, and EMBASE databases from inception through August 2025 for original studies reporting MVP prevalence in athletes, diagnosed by echocardiography or pathological assessment. Data on study characteristics, diagnostic definitions, prevalence, arrhythmias, and outcomes were independently extracted by three reviewers. Methodological quality was appraised using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: Twelve studies published between 1987 and 2024 met inclusion criteria, enrolling 19,463 athletes from diverse sports and competitive levels. A total of 407 MVP cases were identified, corresponding to a crude pooled prevalence of 2.4%. Prevalence estimates varied substantially (0.2–20%), reflecting heterogeneity in study populations and diagnostic definitions. When all studies were pooled using a random-effects model, the overall prevalence was 2.0% (95% CI 1.2–2.8%). A sensitivity analysis restricted to contemporary, unselected athletic cohorts yielded a prevalence of 1.1% (95% CI 0.4–1.9%), closely aligning with population-based estimates. Ventricular arrhythmias were more frequent than supraventricular arrhythmias, particularly in association with bileaflet prolapse, leaflet thickening, or significant mitral regurgitation. Most athletes were asymptomatic, and only one prospective study provided long-term follow-up, confirming a generally benign prognosis, though rare adverse events (atrial fibrillation, valve surgery) were documented. Conclusions: MVP is relatively uncommon in athletes and occurs at rates similar to the general population. In most cases, prognosis is favorable and should not preclude sports participation. Nonetheless, recognition of high-risk phenotypes with arrhythmogenic potential highlights the need for individualized evaluation and tailored surveillance strategies in sports cardiology practice. Full article
(This article belongs to the Special Issue Advancements in Diagnostic Innovations in Sports Cardiology)
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