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Sports Cardiology: Current Status and Future Challenges

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

Deadline for manuscript submissions: 27 October 2026 | Viewed by 1372

Editor


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Guest Editor
Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 00197 Rome, Italy
Interests: athlete’s heart; cardiomyopathies; dyslipidemia; hypertension; heart remodelling
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Special Issue Information

Dear Colleagues,

Sports cardiology is a rapidly evolving multidisciplinary field that integrates cardiovascular medicine, exercise physiology, imaging, genetics, and performance science to optimize the cardiovascular health and safety of athletes and physically active individuals. Growing participation in recreational and competitive sports across all age groups, together with increasing longevity of elite athletes, has increased the need for precise cardiovascular evaluation, risk stratification, and individualized clinical management. At the same time, advances in cardiac imaging, wearable technologies, artificial intelligence, and molecular medicine are reshaping diagnostic and preventive strategies, creating new opportunities and challenges for clinicians and researchers.

This Special Issue will provide an up-to-date overview of the current clinical status of sports cardiology while highlighting emerging concepts and future directions. Topics of interest include, but are not limited to, athlete’s heart characterization and differential diagnosis from cardiomyopathies, arrhythmia risk assessment, sudden cardiac death prevention, sex- and age-specific cardiovascular adaptations, and return-to-play decision-making. Particular emphasis is placed on advanced echocardiography and cardiac magnetic resonance imaging, myocardial and atrial mechanics, cardiopulmonary exercise testing, biomarkers, and the integration of multimodal data for personalized risk assessment.

In addition, the Special Issue welcomes contributions addressing the impacts of different training modalities (endurance, power, mixed, and skill sports) on cardiac remodeling and function, as well as the cardiovascular implications of extreme exercise, detraining, and long-term athletic exposure. Innovative methodologies, including machine learning approaches, digital health solutions, and large-scale registries, are strongly encouraged. Translational studies linking physiological mechanisms with clinical outcomes are also of high interest.

This Special Issue will stimulate interdisciplinary dialogue, promote methodological rigor, and foster clinically meaningful research to improve screening strategies, clinical decision-making, and athlete safety. Original research articles, systematic reviews, narrative reviews, and consensus-oriented perspectives are welcome. By bridging current evidence with future challenges, it seeks to support clinicians, scientists, and sports medicine professionals in advancing precision sports cardiology and evidence-based practice.

Dr. Giuseppe Di Gioia
Guest Editor

Manuscript Submission Information

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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
  • athlete’s heart
  • cardiac remodeling
  • sudden cardiac death prevention
  • advanced cardiac imaging
  • cardiopulmonary exercise testing (CPET)
  • myocardial and atrial strain
  • arrhythmia risk stratification
  • wearable technologies and digital health
  • precision medicine in sports

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Published Papers (1 paper)

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Research

13 pages, 428 KB  
Article
Gender-Specific Association of Cigarette Smoking with Spirometry and Cardiopulmonary Exercise Parameters in Elite Athletes—Impact of Cigarette Smoking in Elite Athletes
by Giuseppe Di Gioia, Ilaria Menichini, Armando Ferrera, Alessandro Spinelli, Giacomo Canelli, Pier Giorgio Tiberi, Andrea Serdoz and Maria Rosaria Squeo
J. Clin. Med. 2026, 15(7), 2677; https://doi.org/10.3390/jcm15072677 - 1 Apr 2026
Viewed by 1082
Abstract
Background: The impact of cigarette smoking on cardiopulmonary function in elite athletes remains poorly characterised. This study aimed to evaluate the prevalence of smoking and its effects on pulmonary and exercise performance parameters among top-level competitors across different sport disciplines. Methods: [...] Read more.
Background: The impact of cigarette smoking on cardiopulmonary function in elite athletes remains poorly characterised. This study aimed to evaluate the prevalence of smoking and its effects on pulmonary and exercise performance parameters among top-level competitors across different sport disciplines. Methods: 1005 Olympic-level athletes participating underwent comprehensive pre-participation screening, including spirometry and cardiopulmonary exercise testing (CPET). Smoking status was determined according to WHO definitions. Results: Among the 1005 athletes (53.4% males; mean age 26 ± 8.8 years), 117 (11.6%) were current smokers, predominantly males (70.9%). No smokers were identified among endurance athletes. Compared to non-smokers (n = 679), smokers were older (28 ± 5.8 vs. 25.5 ± 10.4 years, p = 0.026) and more frequently involved in mixed and skill disciplines (p = 0.043 and p = 0.006, respectively). In male smokers, spirometry revealed lower FVC (97.2 ± 10.3% vs. 101.1 ± 11.7%, p = 0.006), FEV1 (97.3 ± 12.4% vs. 101.4 ± 10.3%, p = 0.002), and MVV (p = 0.010). CPET showed reduced functional capacity (W/kg, p < 0.0001), lower VO2max (38.5 ± 7.8 vs. 42.2 ± 6.8 mL/min/kg, p < 0.0001), decreased O2 pulse (p = 0.007) and lower first and second ventilatory thresholds (respectively p = 0.025; and p = 0.004), Similar but less pronounced reductions in VO2max were found in female smokers (p = 0.003). Conclusions: Chronic smoking is associated with early spirometric and ventilatory impairments in elite athletes associated with lower aerobic capacity, despite their high levels of fitness. These effects are more marked in males, while females may exhibit partial protection. These findings highlight the importance of integrating smoking cessation and respiratory monitoring into athlete health programs. Full article
(This article belongs to the Special Issue Sports Cardiology: Current Status and Future Challenges)
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