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Cited by 591Cardiovascular Effects of ExerciseCardiomyopathy and Myosin StudiesCardiac electrophysiology and arrhythmias

Recommendations for Physical Activity and Recreational Sports Participation for Young Patients With Genetic Cardiovascular Diseases

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Maron, Barry J., Chaitman, Bernard R., Ackerman, Michael J., Bayés de Luna, Antonio, Corrado, Domenico, Crosson, Jane E., Deal, Barbara J., Driscoll, David J. +9 more·2004·Circulation
DOI 10.1161/01.cir.0000128363.85581.e1
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Abstract

A group of relatively uncommon but important genetic cardiovascular diseases (GCVDs) are associated with increased risk for sudden cardiac death during exercise, including hypertrophic cardiomyopathy, long-QT syndrome, Marfan syndrome, and arrhythmogenic right ventricular cardiomyopathy. These conditions, characterized by diverse phenotypic expression and genetic substrates, account for a substantial proportion of unexpected and usually arrhythmia-based fatal events during adolescence and young adulthood. Guidelines are in place governing eligibility and disqualification criteria for competitive athletes with these GCVDs (eg, Bethesda Conference No. 26 and its update as Bethesda Conference No. 36 in 2005). However, similar systematic recommendations for the much larger population of patients with GCVD who are not trained athletes, but nevertheless wish to participate in any of a variety of recreational physical activities and sports, have not been available. The practicing clinician is frequently confronted with the dilemma of designing noncompetitive exercise programs for athletes with GCVD after disqualification from competition, as well as for those patients with such conditions who do not aspire to organized sports. Indeed, many asymptomatic (or mildly symptomatic) patients with GCVD desire a physically active lifestyle with participation in recreational and leisure-time activities to take advantage of the many documented benefits of exercise. However, to date, no reference document has been available for ascertaining which types of physical activity could be regarded as either prudent or inadvisable in these subgroups of patients. Therefore, given this clear and present need, this American Heart Association consensus document was constituted, based largely on the experience and insights of the expert panel, to offer recommendations governing recreational exercise for patients with known GCVDs.

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  • The benefits of exercise are well-described, improving survival in healthy individuals and in patients with known coronary disease.

    “The benefits of exercise are well-described, improving survival in healthy individuals 111 and in patients with known coronary disease, as well.112”

    From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [111]

    Citation 112 is attached to the claim that exercise improves survival in patients with known coronary disease. The Scope of the Problem section describes general health benefits of exercise, but does not report a survival benefit in that population. Searches for coronary disease, survival, and mortality found no passage establishing the cited claim. (LLM, conf=0.76)

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  • Inactive individuals are at increased risk of development of coronary artery disease, cardiac arrest, and death.

    “Inactive individuals are at increased risk of development of coronary artery disease, 113 cardiac arrest, 114 and death.111”

    From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [111]

    Citation 111 is attached to “death.” The Premises section (page unavailable) says sudden death can occur during sedentary activity, but does not say inactive individuals have a higher risk of death than active individuals. A search for inactivity, mortality, and comparative risk found no passage establishing that claim. (LLM, conf=0.76)

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  • Although some studies have shown frequent brisk walking to be as beneficial as more vigorous exercise, most show a graded effect of exertion.

    “Although some studies have shown frequent brisk walking to be as beneficial as more vigorous exercise, 114 most show a graded effect of exertion.111,113”

    From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [111]

    Citation 114 is attached to the claim that frequent brisk walking can be as beneficial as more vigorous exercise, not to the later claim about graded effects. The Scope of the Problem discusses benefits of moderate exercise, and the Patient Recommendations list brisk walking as an acceptable low-intensity activity for patients with genetic cardiovascular diseases. Neither passage compares the benefits of brisk walking with those of vigorous exercise. (LLM, conf=0.76)

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  • Overwhelming evidence shows adverse effects of tobacco products and secondhand smoke on cardiovascular disease, cancer, and other serious illness.

    “On the basis of the overwhelming evidence for the adverse effects of tobacco products and secondary exposure to tobacco smoke on CVD, as well as cancer and other serious illness, the AHA strongly and unequivocally endorses efforts to eliminate the use of tobacco products and minimize exposure to second-hand smoke.26 -28”

    From Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee (2006) · cites this paper as [27]

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2 of the 88 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. [15]15. N Engl J Med. 1997;336:1575-1586.
  2. [29]29. Mitchell JH, Maron BJ, Epstein SE. 16th Bethesda Conference: car- diovascular abnormalities in the athlete: recommendations regarding eligibility for competition. J Am Coll Cardiol. 1985;6:1186 -1232.
  3. [44]44. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323-341.
  4. [49]49. Albert CM, Mittleman MA, Chae CU, et al. Triggering of sudden death by vigorous exertion. N Engl J Med. 2000;343:1355-1361.
  5. [70]70. Priori SG, Aliot E, Blomstrom-Lundqvist C, et al. Task Force on Sudden Cardiac Death, European Society of Cardiology. Europace. 2002;4:3-18.

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Authors
Maron, B. J., Chaitman, B. R., Ackerman, M. J., Bayés de Luna, A., Corrado, D., Crosson, J. E., Deal, B. J., Driscoll, D. J., Estes, N. A. M., Araújo, C. G. S., Liang, D. H., Mitten, M. J., Myerburg, R. J., Pelliccia, A., Thompson, P. D., Towbin, J. A., & Van Camp, S. P.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-06-08
Volume
109
Issue
22
Pages
2807-2816
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000128363.85581.e1
OpenAlex
W2151750374
Cited by
591
References
88
Citations by year
2026: 5 · 2025: 16 · 2024: 13 · 2023: 23 · 2022: 24 · 2021: 22 · 2020: 22 · 2019: 15 · 2018: 15 · 2017: 25 · 2016: 38 · 2015: 46 · 2014: 26 · 2013: 44 · 2012: 39
FWCI
18.11
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
leisure-time physical activity, sports participation, hypertrophic cardiomyopathy, long QT syndrome, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, sudden cardiac death, exercise safety, exercise recommendations, young adults
MeSH terms
Adolescent, Adult, Cardiovascular Diseases, Humans, Life Style, Sports, Sports Medicine, Exercise, Death, Sudden, Cardiac

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