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Recommendations for Physical Activity and Recreational Sports Participation for Young Patients With Genetic Cardiovascular Diseases
Open accessAbstract
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 111 and in patients with known coronary disease, as well.112”
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“Inactive individuals are at increased risk of development of coronary artery disease, 113 cardiac arrest, 114 and death.111”
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“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”
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“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”
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Loeys, B., Dietz, H. C., Braverman, A. C., Callewaert, B. L., Backer, J. F. A. D., Devereux, R. B., Hilhorst‐Hofstee, Y., Jondeau, G., Faivre, L. O., Milewicz, D. M., et al. (2010) · Journal of Medical Genetics · doi:10.1136/jmg.2009.072785 · Cited by 2,245
2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy
Gersh, B. J., Maron, B. J., Bonow, R. O., Dearani, J. A., Fifer, M. A., Link, M. S., Naidu, S. S., Nishimura, R. A., Ommen, S. R., Rakowski, H., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318223e2bd · Cited by 2,116
Self-citationIsselbacher, E. M., Preventza, O., Hamilton Black, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001106 · Cited by 2,082
Metadata
- 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
- Published
- 2004-06-08
- Volume
- 109
- Issue
- 22
- Pages
- 2807-2816
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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
- bronze
- doi.org
- 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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