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Sports Cardiology and Health Promotion Through Personalized Exercise Prescription
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Sports Cardiology and Health Promotion Through Personalized Exercise Prescription

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 5015

Special Issue Editor

Dr. Luna Cavigli

E-Mail Website
Guest Editor
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
Interests: sports cardiology; sports medicine; cardiomyopathies; personalized exercise prescription; cardiovascular prevention; cardiac rehabilitation; cardiopulmonary exercise test; cardiac imaging

Special Issue Information

Dear Colleagues,

Sports cardiology is an emerging sub-specialty field of Cardiology and Sports Medicine which aims to improve the knowledge in the diagnosis, risk stratification and clinical management of athletes who present a physiological cardiac remodeling induced by training or a cardiac condition that may increase the risk of sudden cardiac death or that may worsen with intensive exercise (e.g., cardiomyopathies). In cases of disqualification from sports competition, it is crucial to evaluate the subject for a tailored personalized exercise prescription to avoid physical inactivity, a well-recognized leading risk factor for overweight, obesity, diabetes, ischemic heart disease, cancer, all-cause mortality and major cardiovascular events. Exercise prescriptions should also be considered in sedentary individuals who do not want to practice competitive sports but are interested in a personalized training program for primary or secondary prevention.

The aim of this Special Issue is to invite original research articles, notable clinical findings and critical and relevant reviews that present and discuss the advancement of research in the knowledge of athletes’ heart and cardiac diseases, with a particular focus on primary and secondary cardiovascular prevention and health promotion through a tailored personalized exercise prescription.

Dr. Luna Cavigli
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. Journal of Personalized Medicine 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 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
  • sports medicine
  • cardiomyopathies
  • personalized exercise prescription
  • cardiovascular prevention
  • cardiac rehabilitation
  • cardiopulmonary exercise test
  • cardiac imaging

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Published Papers (4 papers)

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Research

13 pages, 883 KB  
Article
From Preparticipation Screening to Diagnosis: Long-Term Outcomes of Athletes with Ventricular Repolarization Abnormalities and Normal Echocardiography
by Massimiliano Bianco, Fabrizio Sollazzo, Stefania Manes, Andrea Giovanni Cristaudo, Gloria Modica, Riccardo Monti, Michela Cammarano, Paolo Zeppilli and Vincenzo Palmieri
J. Pers. Med. 2026, 16(3), 136; https://doi.org/10.3390/jpm16030136 - 1 Mar 2026
Viewed by 240
Abstract
Background/Objectives: Ventricular repolarization abnormalities (VRA) represent a grey area in athlete screening: some patterns are physiological, while others are precursors to heart disease. Objective: to clarify the natural history of VRA and the associated factors of structural diagnosis. Methods: Retrospective observational [...] Read more.
Background/Objectives: Ventricular repolarization abnormalities (VRA) represent a grey area in athlete screening: some patterns are physiological, while others are precursors to heart disease. Objective: to clarify the natural history of VRA and the associated factors of structural diagnosis. Methods: Retrospective observational single-center study of athletes with resting or stress VRA at the first evaluation, with normal echocardiography; minimum follow-up of 2 years. Clinical data, resting and stress ECG, echocardiography, and selective advanced imaging throughout follow-up were collected. Primary outcome: cardiovascular diagnosis at follow-up; time-to-event analysis and associations between ECG characteristics and diagnosis. Results: Fifty-three athletes (mean age 22.2 ± 9.2 years; 92.5% male) were included; 60.4% had resting VRA, and 100% had exercise-induced VRA at baseline. Over 7.3 ± 4.5 years, 28/53 (52.8%) received a diagnosis; median time-to-detection was 7.0 years (95% CI 6.0–not reached); RMST10 was 6.7 years (95% CI 5.7–7.7). Diagnoses included hypertrophic cardiomyopathy (24.5%), non-ischaemic left-ventricular scar (11.3%), myocardial bridging (7.5%), hypertensive remodelling (5.7%), coronary anomaly (1.9%), and ventricular pre-excitation (1.9%). Persistence of resting VRA from baseline to follow-up was more frequent in athletes with a final diagnosis (p = 0.01), whereas topography and exercise-induced abnormalities did not discriminate groups. Advanced imaging contributed substantially to case ascertainment. No major adverse cardiovascular events have been identified throughout follow-up. Conclusions: In athletes with screening-detected VRA and normal echocardiography, persistence of resting VRA was associated with higher detection of a cardiovascular diagnosis, while exercise-induced changes alone show limited diagnostic yield. The long median time-to-detection supports prolonged, pre-planned surveillance, with priority for advanced imaging in profiles with persistent abnormalities. These findings align with a risk-adapted, personalized management strategy in sports cardiology. Full article
(This article belongs to the Special Issue Sports Cardiology and Health Promotion Through Personalized Exercise Prescription)
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38 pages, 2813 KB  
Article
Long COVID Does Not Impair Hemodynamic, Vascular, or Autonomic Responses to Maximal Exercise: Sex-Stratified Study in Young Adults
by Carla Nascimento dos Santos Rodrigues, Fernanda Rico Angelotto, Vitória Luiz Diotto, Daniel da Motta Cristofoletti, Tatiana Oliveira Passos de Araújo, Marco Antonio de Lima, José Campanholi Neto, Jonato Prestes, James Navalta and Guilherme Borges Pereira
J. Pers. Med. 2026, 16(1), 38; https://doi.org/10.3390/jpm16010038 - 7 Jan 2026
Viewed by 846
Abstract
Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise—an essential component of personalized medicine—are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up [...] Read more.
Background/Objectives: Long COVID (LC) has been linked to fatigue, exercise intolerance, and autonomic dysfunction, but sex-stratified data on cardiovascular responses to maximal exercise—an essential component of personalized medicine—are scarce. This study aimed to examine hemodynamic, autonomic, and functional responses during and up to 24 h after a cardiopulmonary exercise test (CPET) in young adults with and without Long COVID (LC). Methods: In this cross-sectional study, we assessed 38 physically active adults, who were allocated into four subgroups stratified by clinical condition (LC or control) and biological sex: control–female (CON-F; n = 10), LC–female (LC-F; n = 10), control–male (CON-M; n = 10), and LC–male (LC-M; n = 8). Outcomes included systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), cardiac output (CO), total (TPR) and peripheral vascular resistance (PVR), pulse wave velocity (PWV), augmentation index (AIx@75), and heart rate variability (HF, LF, LF/HF), assessed at rest, peak effort, recovery (1, 3, 5, 10, 30, and 60 min), and through 24 h ambulatory blood pressure monitoring (ABPM) after CPET. Results: SBP increase appropriately during exercise, with higher peaks in males (p < 0.01), and returned to baseline within 5 min across all groups. HR recovery was preserved; however, LC-F showed lower values than CON-F at 3, 5, and 10 min (126 vs. 144 bpm, p = 0.020; 119 vs. 136 bpm, p = 0.020; 94 vs. 109 bpm, p = 0.011), though all groups normalized by 60 min. PWV, AIx@75, TPR and PVR exhibited expected sex-related patterns without LC-related impairments. HRV indices showed transient post-exercise shifts (HF↓, LF↑, LF/HF↑). Ambulatory monitoring confirmed preserved circadian modulation, with normal systolic dipping (11–13%) and no abnormal nocturnal patterns. Conclusions: Young physically active adults with LC showed preserved hemodynamic, autonomic, and vascular responses during and after maximal exercise. These findings contribute to personalized medicine by showing that individualized, sex-stratified cardiovascular assessments reveal no clinically relevant impairments in this population, supporting tailored clinical decision making and exercise prescription. Full article
(This article belongs to the Special Issue Sports Cardiology and Health Promotion Through Personalized Exercise Prescription)
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17 pages, 739 KB  
Article
Improvement of Fatigue and Body Composition in Women with Long COVID After Non-Aerobic Therapeutic Exercise Program
by María Miana, Ricardo Moreta-Fuentes, Carmen Jiménez-Antona, César Moreta-Fuentes and Sofía Laguarta-Val
J. Pers. Med. 2025, 15(6), 217; https://doi.org/10.3390/jpm15060217 - 26 May 2025
Cited by 2 | Viewed by 1668
Abstract
Background/Objective: Fatigue is one of the most recurrent and most disabling symptoms of long COVID (LC) and is associated with a worse quality of life. Reducing body fat in these patients could be important to mitigate fatigue and post-exertional worsening. Aerobic exercise [...] Read more.
Background/Objective: Fatigue is one of the most recurrent and most disabling symptoms of long COVID (LC) and is associated with a worse quality of life. Reducing body fat in these patients could be important to mitigate fatigue and post-exertional worsening. Aerobic exercise may not be indicated in LC patients who have orthostatic tachycardia and post-exertional worsening. The aim of this study was to evaluate the effects of a personalized supine therapeutic motor control exercise program on fatigue and fat tissue in women with LC. Methods: A single-arm exploratory case study, with a pre–post format, was conducted on 17 women with LC to test the effects of a plank-based strengthening exercise program on fatigue, which was evaluated by the Modified Fatigue Impact Scale and fat tissue assessed by bioimpedance. The twelve-week program included two weekly sessions. The exercise program was personalized, considering the symptoms and characteristics of the patients. Results: Participants with overweight or obesity (n = 12) comprised 70% of the entire sample. After completing the exercise program this value decreased by 5.9 percentage points. Significant differences were found in the total [(MD  = −1.72, 95% CI −2.57 to −0.86), r = 0.73], trunk, upper and inner limbs body fat percentages (p < 0.05). The overall fatigue decreased at 12 weeks [(MD  =  −14.00, 95% CI −21.69 to −6.31), r = 0.69] as well as the physical and psychosocial fatigue sub-scale (p  <  0.001); no differences were observed in the cognitive sub-scale. Conclusions: The plank-based personalized strengthening exercise program showed rapid improvements in fatigue and fat percentages. It could be an effective strategy to achieve improvements for LC patients. Full article
(This article belongs to the Special Issue Sports Cardiology and Health Promotion Through Personalized Exercise Prescription)
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12 pages, 767 KB  
Article
A First Diastolic Function Evaluation in the Personalized Exercise Prescription Program for Solid Organs Transplanted Subjects: Is Atrial Strain Useful?
by Melissa Orlandi, Marco Corsi, Vittorio Bini, Roberto Palazzo, Stefano Gitto, Claudia Fiorillo, Matteo Becatti, Marco Maglione and Laura Stefani
J. Pers. Med. 2025, 15(1), 32; https://doi.org/10.3390/jpm15010032 - 17 Jan 2025
Viewed by 1403
Abstract
Background/Objectives: Solid organ transplant recipients (OTR) have been recently involved in exercise prescription programs in order to reduce the high prevalence of cardiovascular diseases. The normal systolic and diastolic cardiac function is fundamental to personalizing the prescription. Diastolic dysfunction can be associated [...] Read more.
Background/Objectives: Solid organ transplant recipients (OTR) have been recently involved in exercise prescription programs in order to reduce the high prevalence of cardiovascular diseases. The normal systolic and diastolic cardiac function is fundamental to personalizing the prescription. Diastolic dysfunction can be associated to a higher risk of cardiovascular events and left atrial (LA) strain is an emerging parameter in the evaluation of diastolic compromising, especially in subjects with preserved ejection fraction. Left atrial (LA) strain has never been explored in this category. The study aimed to evaluate the contribution of the LA strain in the assessment of diastolic function of OTR and its potential contribution in the exercise program. Methods: 54 solid OTR (liver and kidney transplants) regularly trained for at least 12 months in a home-based, partially supervised model at moderate intensity estimated by cardiopulmonary exercise test, underwent a complete echocardiographic analysis. The measured variables included left ventricle systolic function (ejection fraction, EF), diastolic function (E/A and E/E’), LA indexed volumes, LA peak atrial longitudinal strain (PALS) and LA peak atrial contraction strain (PACS). The data were compared to those of 44 healthy subjects (HS). Results: The OTR showed an overweight condition (BMI: 25.79 ± 2.92 vs. 22.25 ± 2.95; p < 0.01). Both groups showed a preserved systolic function (EF: OTR 63.1 ± 3.5% vs. HS 66.9 ± 6.1; p < 0.001), while diastolic standard parameters were significantly different (E/A, 1.01 ± 0.4 vs. 1.96 ± 0.74; p < 0.001; E/E’, 9.2 ± 2.7 vs. 6.9 ± 1.3; p < 0.001, in OTR and HS respectively) despite being normal. LA strain was significantly lower in OTR vs. HS (4C PALS, 33.7 ± 9.7 vs. 45.4 ± 14.19; p < 0.001; 4C PACS, 15.9 ± 6.7 vs. 11.6 ± 7.5; p = 0.006; 2C PALS, 35.3 ± 11.1 vs. 47.6 ± 14.9; p < 0.001; 2C PALS, 17.4 ± 4.9 vs. 13.2 ± 14.97; p = 0.001; in OTR and HS respectively). A specific correlation of two- and four-chamber PACs and PALs with BMI has been observed (R for 4C PALS −0.406 ** and 2C PALS −0.276 *). Conclusions: These findings suggest that the coexistence of increased bodyweight in asymptomatic OTR patients can exacerbate the impairment of LA strains. LA strain detection could be useful in the development of a personalized exercise program for OTRs, especially for asymptomatic subjects and those with elevated cardiovascular risk profile, to potentially manage the exercise program in the long term. Larger studies will confirm the role via an eventual structured clinical score index. Full article
(This article belongs to the Special Issue Sports Cardiology and Health Promotion Through Personalized Exercise Prescription)
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