Authors’ Reply to Kindermann et al.’s Comment on: “Athlete’s Heart: Diagnostic Challenges and Future Perspectives”
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We thank Prof. Wilfried Kindermann and colleagues for their interest in our publication  and for the important comments raised in their letter . They understandably underscore the importance of a step-wise approach to cardiovascular assessment of athletes, where the diagnostic work-up needs to be tailored according to the pre-test probability of disease and the clinical context, namely the pre-participation screening of asymptomatic competitive or leisure athletes, and the assessment of athletes reporting specific symptoms, a positive family history, and an abnormal physical examination and/or abnormal resting 12-lead electrocardiogram (ECG) . It should be noted that exercise-induced cardiac remodeling presents a spectrum of adaptations that overlaps with pathological changes seen in inherited or acquired cardiomyopathies. It is up to the clinician to decide where this boundary may be for each individual on the basis of a diagnostic continuum encompassing both...
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No funding was received for the publication of this letter.
Conflict of interest
Carlo De Innocentiis, Fabrizio Ricci, Mohammed Y. Khanji, Nay Aung, Claudio Tana, Elvira Verrengia, Steffen E. Petersen, and Sabina Gallina have no conflicts of interest that are directly relevant to the contents of this letter.
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