Exercise and Heart Disease

From Athletes and Arrhythmias to Hypertrophic Cardiomyopathy and Congenital Heart Disease

Abbas Zaidi; Sanjay Sharma


Future Cardiol. 2013;9(1):119-136. 

In This Article

Future Perspective

In recent months, a number of high-profile sudden death events in the sporting community have heightened awareness of the issues surrounding the inherited cardiac diseases, and have galvanized support among the proponents of preparticipation screening. It seems likely that screening professional athletes will become mandatory in many countries in the coming years, along the lines advocated by the Italian model. With the rapid expansion of sports, such as soccer in Africa and the Far East, further characterization of ethnicity-specific cardiac adaptation to exercise will result in refined screening criteria with improved specificity for disease and greater cost–effectiveness. The burgeoning phenomenon of the middle-aged, leisure-time athlete will create demand for increased access to techniques, such as CT coronary angiography, while differentiation between physiological cardiac remodeling and inherited disease will be facilitated by improvements in other imaging modalities including CMR. Questions regarding to the possibility of exercise-induced cardiac damage will only be satisfactorily answered once the results of large-scale, sequential follow-up studies of large numbers of veteran athletes become available over the next decades. Perhaps the greatest advances in the field of sports cardiology will relate our understanding of the molecular causation of inherited conditions, such that individuals that are genetically free from disease, or those harboring a low-risk mutation, might be reassured without the need for long-term surveillance and sequential evaluation.