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Review
. 2021 Oct 5;78(14):1453-1470.
doi: 10.1016/j.jacc.2021.08.003.

Exercise-Induced Cardiovascular Adaptations and Approach to Exercise and Cardiovascular Disease: JACC State-of-the-Art Review

Matthew W Martinez  1 , Jonathan H Kim  2 , Ankit B Shah  3 , Dermot Phelan  4 , Michael S Emery  5 , Meagan M Wasfy  6 , Antonio B Fernandez  7 , T Jared Bunch  8 , Peter Dean  9 , Alfred Danielian  10 , Sheela Krishnan  11 , Aaron L Baggish  6 , Thijs M H Eijsvogels  12 , Eugene H Chung  13 , Benjamin D Levine  14
Affiliations
Free article
Review

Exercise-Induced Cardiovascular Adaptations and Approach to Exercise and Cardiovascular Disease: JACC State-of-the-Art Review

Matthew W Martinez et al. J Am Coll Cardiol. .
Free article

Abstract

The role of the sports cardiologist has evolved into an essential component of the medical care of athletes. In addition to the improvement in health outcomes caused by reductions in cardiovascular risk, exercise results in adaptations in cardiovascular structure and function, termed exercise-induced cardiac remodeling. As diagnostic modalities have evolved over the last century, we have learned much about the healthy athletic adaptation that occurs with exercise. Sports cardiologists care for those with known or previously unknown cardiovascular conditions, distinguish findings on testing as physiological adaptation or pathological changes, and provide evidence-based and "best judgment" assessment of the risks of sports participation. We review the effects of exercise on the heart, the approach to common clinical scenarios in sports cardiology, and the importance of a patient/athlete-centered, shared decision-making approach in the care provided to athletes.

Keywords: athletes; prevention; sports cardiology.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Martinez has served as a consultant for Major League Soccer and Bristol Myers Squibb. Dr Kim has received research funding through the National Institutes of Health; and has received compensation as team cardiologist for the Atlanta Falcons. Dr Bunch has received research grants from Boehringer Ingelheim, Boston Scientific, and Altathera (no personal compensation). Dr Baggish has received support from the National Institute of Health/National Heart, Lung, and Blood Institute, the National Football League Players Association, and the American Heart Association; and receives compensation for his role as team cardiologist from the U.S. Olympic Committee/U.S. Olympic Training Centers, U.S. Soccer, U.S. Rowing, the New England Patriots, the Boston Bruins, the New England Revolution, and Harvard University. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.