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Comment on: “Athlete’s Heart: Diagnostic Challenges and Future Perspectives”

  • Wilfried Kindermann
  • Axel Urhausen
  • Jürgen Scharhag
Letter to the Editor

Dear Editor,

The athlete’s heart has been a diagnostic challenge for many decades. In an interesting review, the authors present strategies to differentiate exercise-induced physiological from pathological cardiac changes [1]. It is emphasized that the athlete’s heart is characterized by a biventricular remodeling, regardless of the type of sports. We would like to comment on a few issues.

The diagnostic procedure presented in Fig. 1 is debatable, while the order of diagnostic tools is adequately presented in Table 2 [1]. If the first-line examinations including resting electrocardiogram (ECG) are abnormal, the next step should be exercise ECG, possibly combined with cardiopulmonary exercise testing (CPET). Unfortunately, the importance of ECG stress testing was hardly mentioned. The exercise ECG can be useful to detect arrhythmias and especially in middle-aged and older athletes to identify coronary heart disease [2]. The diagnostic accuracy of exercise ECG in athletes, however, is...

Notes

Compliance with Ethical Standards

Conflict of interest

The authors—Wilfried Kindermann, Axel Urhausen, and Jürgen Scharhag—declare that they have no conflicts of interest.

Funding

No funding was received for the publication of this letter.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Institute of Sports and Preventive MedicineSaarland UniversitySaarbrückenGermany
  2. 2.Médecine du Sport et de PreventionCentre de Hospitalier LuxemburgLuxembourgLuxembourg
  3. 3.Sports and Exercise PhysiologyUniversity ViennaViennaAustria

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