ROME (ITALPRESS) – The frontier of cardiology is being applied to sports, and specifically to athletes’ responses to cardiac stresses. Dramatic recent cases of heart problems encountered during competitions have rekindled the debate about the health of athletes and the potential of medicine to read risks in advance and identify solutions. This was discussed in Rome during the XXI Romacuore 2024 Congress, organized by the Federative College of Cardiology, where Professor Gianfranco Gualdi, a medical luminary and scientific director of the “Diagnostic Imaging” service of the CONI Institute of Medicine and Sport Sciences, gave a talk entitled “The role of advanced imaging in sports fitness: between physiology and pathology.”Professor Gualdi’s talk focused on “changes that may occur in athletes undergoing competitive activity in cardiac structures with identification of the thin margin between physiological and pathological in order to ascertain their sports fitness,” and specifically on the role of magnetic resonance imaging as the most effective tool in the gold standard diagnostic method for morpho-functional assessment of cardiac chambers. In fact, MRI is able to surpass echocardiography as it allows a much more reliable formal quantification of the size, geometry and function of both ventricles. It also offers the possibility of performing tissue characterization of the myocardium by contrast medium or even by methods that do not require contrast medium.According to the latest European Union guidelines, MRI is now indicated as class one in the diagnostic pathway in patients with cardiomyopathy. And in fact, even in the world of sports, the prescription of MRI is greatly increased, especially when certain abnormalities occur in cardiovascular screening, such as ventricular extrasystole, or abnormalities in the electrocardiogram.It is to be considered, of course, that intense and prolonged physical activity causes structural, functional and electrical remodeling of the heart, an entity known as the “athlete’s heart.” Hence the importance of defining a precise boundary between the physiological and the pathological is essential to prevent sudden cardiac death in a population of apparently healthy young subjects. And so the application of cardiovascular screening among athletes has made it possible to greatly reduce sudden deaths on the playing field.
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