Axel Pressler - Textbook of Sports and Exercise Cardiology

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Sports and exercise cardiology have been increasingly acknowledged in recent years as important components of diagnostic and treatment pathways in modern medicine. Originating historically from the evaluation of the impact of intensive exercise on cardiac morphology and function, they have developed over time into much broader subspecialties in covering all aspects of both positive and potentially negative associations of regular physical activity and exercise with the cardiovascular system. Given both the drastic increase in inactive, obese individuals at high risk for subsequent cardiometabolic diseases and, in turn, millions of leisure time athletes participating in strenuous exercise events, specialists are increasingly needed who have been appropriately educated and trained to enable both patients and athletes to safely benefit from participation in leisure time or competitive sports.

Regarding sports cardiology, besides competitive athletes in their adolescent and young adult years, also an increasing number of those who exercise not only do so leisurely but strive to participate in competitions. These leisure time athletes increasingly practice at volumes and intensities that come close to or even exceed that of full-fledged athletes. In both groups, adaptations of the cardiovascular system occur that are commonly summarized as athletes heart and may mimic pathologies that are known to be associated with cardiovascular complications including sudden cardiac death. It is the aim of sports cardiology to protect the physically active from untoward effects of exercise training and therefore to identify physiologic cardiac adaptations secondary to an increased hemodynamic demand from overt pathologies.

Regarding exercise cardiology, physical activity and exercise training have become the mainstay of prevention and treatment of noncommunicable diseases. National and international recommendations and guidelines from leading professional organizations attest the highest level of evidence. Nonetheless, just like any other potent drug, exercise not only helps prevent disease but also has its side effects, and thus may trigger, among others, sudden cardiac death or disease progression. Exercise is medicine and must be applied as such. The choice of activity or sport as well as the dosage has to be tailored individually in order to maximize benefit and minimize risk.

Nonetheless, in both medical schools and specialist training, physical activity and exercise training do still not receive the attention they deserve and require, leaving the vast majority of colleagues rather oblivious to the benefits but also to theinherent risks. To overcome these educational limits, working groups on sports and exercise cardiology worldwide have proposed specific curricula enabling interested candidates to qualify themselves as specialists in sports and exercise cardiology by acquiring specific knowledge and skills beyond the traditional education pathways. In Germany, for example, sports cardiology can now be acquired as official subspecialty after following a specific curriculum endorsed by the German Cardiac Society.

This book is intended to support interested students and medical professionals in these undertakings by providing a comprehensive overview on all aspects of sports and exercise cardiology. In combining profound theoretical background with precise practical recommendations, it addresses a broad readership, ranging from inquisitive students who consider starting a career as sports and exercise cardiologists over clinicians searching for precise information readily transferable to everyday care up to experienced professionals who will find up-to-date reviews on scientific and clinical backgrounds. We are happy, grateful, and proud of having assembled the worlds leading experts in the field of sports and exercise cardiology, sharing with readers their wealth of knowledge in order to serve as a support duringamong othersthe process of pre-participation screening, comprehensive but sport- and exercise-specific diagnostics, and athletes and patients counseling, which shall result in healthy as well as efficient and effective exercise training. We hope that this book will become a companion during daily practice, as it encompasses all major aspects a physician in the field of physical activity, exercise training, cardiac prevention and rehabilitation, and above all sports cardiology needs to know.