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2. Running in Rowing

Author

Spataro, Antonio, Canata, Gian Luigi, editor, Jones, Henrique, editor, Krutsch, Werner, editor, Thoreux, Patricia, editor, and Vascellari, Alberto, editor

Published
2022
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3. Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

Author

Bernardi, Marco, Romano, Silvio, Squeo, Maria Rosaria, Guerra, Emanuele, Adami, Paolo Emilio, Alviti, Federica, Mattei, Antonella, Corsi, Loretta, Lanzano, Riccardo, Curatulo, Pietro Giacomo, Mandolesi, Dimitri, Parisi, Fabiana, Di Giacinto, Barbara, Dante, Donatella, Marini, Claudio, Mashkovskiy, Evgeny, Ordonez, Francisco Javier, and Spataro, Antonio

Published
2021
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5. Periodic health evaluation in athletes competing in Tokyo 2020: from SARS-CoV-2 to Olympic medals

Author

Squeo, Maria Rosaria, primary, Monosilio, Sara, additional, Gismondi, Alessandro, additional, Perrone, Marco, additional, Gregorace, Emanuele, additional, Lemme, Erika, additional, Di Gioia, Giuseppe, additional, Mango, Ruggiero, additional, Prosperi, Silvia, additional, Spataro, Antonio, additional, Maestrini, Viviana, additional, Di Giacinto, Barbara, additional, and Pelliccia, Antonio, additional

Published
2023
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14. Systematic Cardiovascular Screening in Olympic Athletes before and after SARS-CoV-2 Infection

Author

Maestrini, Viviana, primary, Filomena, Domenico, additional, Birtolo, Lucia Ilaria, additional, Serdoz, Andrea, additional, Fiore, Roberto, additional, Tatangelo, Mario, additional, Lemme, Erika, additional, Squeo, Maria Rosaria, additional, Mango, Ruggiero, additional, Di Gioia, Giuseppe, additional, Fedele, Francesco, additional, Gualdi, Gianfranco, additional, Spataro, Antonio, additional, Pelliccia, Antonio, additional, and Di Giacinto, Barbara, additional

Published
2022
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15. Efficacy and Safety of a Combined Aerobic, Strength and Flexibility Exercise Training Program in Patients with Implantable Cardiac Devices

Author

Squeo, Maria Rosaria, primary, Di Giacinto, Barbara, additional, Perrone, Marco Alfonso, additional, Santini, Massimo, additional, Sette, Maria Luisa, additional, Fabrizi, Emanuele, additional, Vaquer, Antonia, additional, Parisi, Attilio, additional, Spataro, Antonio, additional, and Biffi, Alessandro, additional

Published
2022
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19. COVID-19 Test Before Tokyo2020 Paralympic Games: An Implemented Protocol to Protect Paralympic Athletes

Author

Muti, Greta E., primary, Muti-Schuenemann, Giovanna, additional, Pimpinelli, Fulvia, additional, Spataro, Antonio, additional, Fiore, Antonio, additional, Ciasullo, Francesca, additional, Olivieri, Daniela, additional, Rigoni, Marta, additional, Delbue, Serena, additional, Pariani, Elena, additional, Muzi, Fabio, additional, Donzelli, Sara, additional, Strano, Sabrina, additional, Morrone, Aldo, additional, Blandino, Giovanni, additional, and Muti, Paola, additional

Published
2022
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25. Aerobic fitness is a potential crucial factor in protecting paralympic athletes with locomotor impairments from atherosclerotic cardiovascular risk

Author

Bernardi, Marco, primary, Romano, Silvio, additional, Squeo, Maria Rosaria, additional, Guerra, Emanuele, additional, Adami, Paolo Emilio, additional, Alviti, Federica, additional, Mattei, Antonella, additional, Corsi, Loretta, additional, Lanzano, Riccardo, additional, Curatulo, Pietro Giacomo, additional, Mandolesi, Dimitri, additional, Parisi, Fabiana, additional, Di Giacinto, Barbara, additional, Dante, Donatella, additional, Marini, Claudio, additional, Mashkovskiy, Evgeny, additional, Ordonez, Francisco Javier, additional, and Spataro, Antonio, additional

Published
2020
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27. Outcomes in athletes with marked ECG repolarization abnormalities

Author

Pellicia, Antonio, Di Paolo, Fernando M., Quattrini, Filippo M., Basso, Cristina, Culasso, Franco, Popoli, Gloria, De Luca, Rosanna, Spataro, Antonio, Biffi, Alessandro, Thiene, Gaetano, and Maron, Barry J.

Subjects
Athletes -- Health aspects, Electrocardiogram -- Patient outcomes, Electrocardiography -- Patient outcomes, Cardiomyopathy -- Diagnosis, Heart diseases -- Diagnosis
Abstract

A study to examine the long-term clinical outcomes among athletes with abnormal 12-lead electrocardiograms (ECGs) characterized by marked repolarization abnormalities is conducted. Results conclude that marked abnormal ECGs are an indicator of underlying adverse cardio outcomes and merit continued clinical surveillance.

Published
2008

29. Cardiovascular Risk Factors and Haematological Indexes of Inflammation in Paralympic Athletes with Different Motor Impairments

Author

Bernardi, Marco, primary, Fedullo, Anna Lucia, additional, Di Giacinto, Barbara, additional, Squeo, Maria Rosaria, additional, Aiello, Paola, additional, Dante, Donatella, additional, Romano, Silvio, additional, Magaudda, Ludovico, additional, Peluso, Ilaria, additional, Palmery, Maura, additional, and Spataro, Antonio, additional

Published
2019
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34. Recommendations for competitive sports participation in athletes with cardiovascular disease: A consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology

Author

Pelliccia, Antonio, Fagard, Robert, Bjørnstad, Hans Halvor, Anastassakis, Aris, Arbustini, Eloisa, Assanelli, Deodato, Biffi, Alessandro, Borjesson, Mats, Carrè, François, Corrado, Domenico, Delise, Pietro, Dorwarth, Uwe, Hirth, Asle, Heidbuchel, Hein, Hoffmann, Ellen, Mellwig, Klaus P., Panhuyzen-Goedkoop, Nicole, Pisani, Angela, Solberg, Erik E., van-Buuren, Frank, Vanhees, Luc, Blomstrom-Lundqvist, Carina, Deligiannis, Asterios, Dugmore, Dorian, Glikson, Michael, Hoff, Per Ivar, Hoffmann, Andreas, Hoffmann, Erik, Horstkotte, Dieter, Nordrehaug, Jan Erik, Oudhof, Jan, McKenna, William J., Penco, Maria, Priori, Silvia, Reybrouck, Tony, Senden, Jeff, Spataro, Antonio, and Thiene, Gaetano

Published
2005

35. Athlete's heart in women: echocardiographic characterization of highly trained elite female athletes

Author

Pelliccia, Antonio, Maron, Barry J., Culasso, Franco, Spataro, Antonio, and Caselli, Giovanni

Subjects
Women athletes -- Physiological aspects, Heart -- Physiological aspects
Abstract

Female athletes may have enlarged hearts but their hearts seldom exceed normal limits as sometimes occurs in male athletes. Researchers used echocardiography to measure the size of the heart and the thickness of its walls in 600 female athletes. The athletes had larger hearts and thicker walls than a group of 65 sedentary women. In 8% of the athletes, heart size exceeded normal limits and 1% had hearts large enough to qualify as dilated cardiomyopathy. However, wall thickness did not exceed normal limits in any athlete., Objectives--To define the expression of "athlete's heart" in women by determining the alterations in cardiac dimensions associated with long-term intense conditioning in elite female athletes. Design--Prospective cardiovascular assessment conducted from 1986 through 1993. Subjects were evaluated using 2-dimensional, M-mode, and Doppler echocardiographic studies. Setting--Institute of Sports Science, Italian National Olympic Committee, Rome, Italy. Participants--A total of 600 elite female athletes (mean age, 21 years; range, 12-49 years) who had participated in vigorous training (mean duration, 9 years; range, 2-32 years) and had competed in 27 sports, including 211 athletes at the international level and 389 at the national level. A control group consisted of 65 sedentary volunteer women (mean age, 23.7 years; range, 14-41 years) who were free of cardiovascular disease and who did not participate in regular athletic training. Main Outcome Measures--Left ventricular end-diastolic cavity dimension and wall thickness. Results--Athletes demonstrated larger left ventricular end-diastolic cavity dimension (mean [+ or -] SD)(49 [+ or -] 4 mm) and greater maximal wall thickness (8.2 [+ or -] 0.9 mm) than controls (46 [+ or -] 3 mm and 7.2-+0.6 mm; P54 mm) in 47 women (8%), and was within the range consistent with primary dilated cardiomyopathy ([equal to or greater than] 60 mm) in 4 athletes (1%). Training for endurance sports, such as cycling, cross-country skiing, and rowing had the greatest effect on cavity dimension. Left ventricular wall thickness was 6 mm to 12 mm in athletes and did not exceed normal limits or extend into the borderline gray zone with hypertrophic cardiomyopathy in any subject. Compared with data from 738 previously studied male athletes, female athletes showed significantly smaller left ventricular cavity dimension (11% less; P Conclusions--Highly trained women athletes frequently demonstrate cardiac dimensional changes as an adaptation to physical training, although absolute left ventricular cavity size exceeding normal limits was evident in a minority (8%) of women athletes and was rarely (1% of athletes) within the range of dilated cardiomyopathy. Athletic training was not a stimulus for substantial increases in absolute left ventricular wall thickness, which was within normal limits for all women athletes. These findings suggest that the clinical differentiation of athlete's heart and hypertrophic cardiomyopathy appears to be a diagnostic dilemma that is limited to male athletes. JAMA. 1996;276:211-215

Published
1996

38. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes

Author

Pelliccia, Antonio, Maron, Barry J., Spataro, Antonio, Proschan, Michael A., and Spirito, Paolo

Subjects
Athletes -- Diseases, Heart ventricle, Left -- Measurement, Athletes -- Physiological aspects, Cardiomyopathy -- Physiological aspects, Cardiomyopathy -- Diagnosis
Abstract

The left ventricle (LV) of the heart is the chamber responsible for pumping blood to the body after its return from oxygenation by the lungs; in some kinds of heart disease, the LV wall becomes abnormally thick. However, athletic training also produces changes in LV wall thickness that can be hard to distinguish from pathological alterations. In cases of sudden death of athletes, hypertrophic cardiomyopathy (thickening of LV walls and valves) is the most common probable cause, but more data are needed to determine the upper limits of normal LV changes in athletes. To this end, 947 competitive athletes in Italy were studied. The subjects, aged 13 to 49, were part of the group from which Olympic athletes were selected over a two-year period. They participated in soccer, rowing, cycling, track, and other events. Subjects underwent echocardiography (a noninvasive test) to determine LV wall thickness during diastole (the resting phase of heart action); other parameters, including LV mass, were also evaluated. Of interest was the extent of overlap between LV measurements in this group and similar measurements in people diagnosed with hypertrophic cardiomyopathy. Results showed that the LV end-diastolic dimensions (at the end of diastole) fell between 40 and 66 millimeters. The normal value in a nonathletic population is 54 millimeters or less, a level exceeded in 38 percent (363) of these athletes. Sixteen athletes had LV thickness equal to or greater than 13 millimeters (the usual cutoff point for hypertrophic cardiomyopathy). All were men; fifteen were rowers or canoeists. Most of their other cardiac dimensions also fell outside the normal range, but functional measurements (left ventricular filling with blood during diastole) were normal. Seven had abnormalities in their electrocardiograms. These 16 were particularly successful at their sports: eight had received medals. LV wall thickness among the 209 women studied was never greater than 11 millimeters. The greatest LV wall thickness, even among these athletes, was 16 millimeters, which can be taken as a normal upper limit among such a population. These data should be useful for diagnosing cardiac changes among athletes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

41. Aerobic Fitness protects from Atherosclerotic Cardiovascular Risk Paralympic Athletes with a Locomotor Impairment

Author

Bernardi, Marco, Parisi, Fabiana, Corsi, Loretta, Delussu, Anna Sofia, Lanzano, Riccardo, Alviti, Federica, Squeo, Maria Rosaria, Adami, Paolo Emilio, Guerra, Emanuele, Magaudda, Ludovico, Spataro, Antonio, and Pelliccia, Antonio

Abstract

Aim: This study, carried out on Paralympic athletes (PA) with a locomotor impairment (LI), was aimed at: 1. assessing the prevalence of atherosclerotic cardiovascular disease (ACVD) risk factors (RF) in PA with either a spinal cord injury (PA-SCI) or other (different from SCI) LI (PA-OLI); 2. evaluating the hypothesis that aerobic fitness (oxygen uptake peak - VO2peak) was inversely related to ACVD RF. Methods: A total of 135 male PA (72 PA-SCI, 28 PA with lower limb amputation, 12 PA with a cerebral palsy/brain injury, 7 PA with poliomyelitis, 9 PA with other neurological disorders and 7 PA with other orthopedic disorders) were screened through anthropometric and blood pressure (BP) measurements, laboratory blood tests and graded cardiopulmonary maximal exercise test, to estimate both an ACVD-RF score and VO2peak. The ACVD-RF score was assessed summing 1 point for each of the following RF: obesity –OB- (BMI≥30 or waist circumference ≥102 cm), hypertension –HT- (systolic BP ≥ 140 mm Hg and diastolic BP ≥ 90 mm Hg), dyslipidemia -DL- (total Cholesterol -C- ≥200 mg·dl-1 or LDL-C ≥130 mg·dl-1 or HDL-C, Italian Journal of Anatomy and Embryology, Vol. 122, No. 1 (Supplement) 2017

Published
2017
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44. Morphology of the 'athlete's heart' assessed by echocardiography in 947 elite athletes representing 27 sports

Author

Spirito, Paolo, Pelliccia, Antonio, Proschan, Michael A., Granata, Maristella, Spataro, Antonio, Bellone, Pietro, Caselli, Giovanni, Biffi, Alessandro, Vecchio, Carlo, and Maron, Barry J.

Subjects
Athletes -- Physiological aspects, Heart enlargement, Health
Abstract

In the present study, we used echocardiography to investigate the morphologic adaptations of the heart to athletic training in 947 elite athletes representing 27 sports who achieved national or international levels of competition. Cardiac morphology was compared for these sports, using multivariate statistical models. Left ventricular (LV) diastolic cavity dimension above normal (>54 mm, ranging up to 66 mm) was identified in 362 (38%) of the 947 athletes. LV wall thickness above normal (>12 mm, ranging up to 16 mm) was identified in only 16 (1.7%) of the athletes. Athletes training in the sports examined showed considerable differences with regard to cardiac dimensions. Endurance cyclists, rowers, and swimmers had the largest LV diastolic cavity dimensions and wall thickness. Athletes training in sports such as track sprinting, field weight events, and diving were at the lower end of the spectrum of cardiac adaptations to athletic training. Athletes training in sports associated with larger LV diastolic cavity dimensions also had higher values for wall thickness. Athletes training in isometric sports, such as weightlifting and wrestling, had high values for wall thickness relative to cavity dimension, but their absolute wall thickness remained within normal limits. Analysis of gender-related differences in cardiac dimensions showed that female athletes had smaller LV diastolic cavity dimension (average 2 mm) and smaller wall thickness (average 0.9 mm) than males of the same age and body size who were training in the same sport. Our results demonstrate that sports differ greatly with regard to their impact on LV dimensions and that, in general, athletes training in sports associated with large diastolic cavity dimension also have relatively high values for wall thickness. Our findings also show that gender has an influence on the morphology of the athlete's heart' independent of type of sport, age, and body size. (Am J Cardiol 1994;74:802-M)

Published
1994

45. Absence of left ventricular wall thickening in athletes engaged in intense power training

Author

Pelliccia, Antonio, Spataro, Antonio, Caselli, Giovanni, and Maron, Barry J.

Subjects
Weight training -- Physiological aspects, Heart enlargement -- Causes of, Heart ventricle, Left -- Physiological aspects, Athletes -- Health aspects, Health
Abstract

There is a widely held perception that power training increases left ventricular (LV) wall thickness. Consequently, in individual power-trained athletes, confusion may legitimately occur with regard to the differential diagnosis of athlete's heart and nonobstructive hypertrophic cardiomyopathy. To investigate the effects of systematic strength training on cardiac dimensions (particularly absolute LV wall thickness), 100 relatively young and highly conditioned athletes participating in weight and power lifting, wrestling, bobsledding and weight-throwing events for 3 to 24 years (mean 7) were studied by echocardiography. No athlete showed a maximal absolute LV wall thickness that exceeded the generally accepted upper limits of normal (i.e., 12 mm; range 8 to 12). When compared with 26 normal, sedentary control subjects of similar age and body surface area, maximal septal thickness was mildly but significantly greater in athletes (9.6 [+ or -] 0.8 vs 9.0 [+ or -] 0.5 mm; p 0.05). Consequently, echocardiographic data in this selected group of purely strength-trained athletes show that whereas this form of conditioning is associated with increased LV mass and a disproportionate increase in wall thickness in relation to cavity dimension, only modest alterations in absolute wall thickness occur (which do not exceed upper normal limits). Therefore, in highly conditioned, strength-trained, competitive athletes, the presence of substantial LV wall thickening (>13 mm) should suggest alternative explanations, such as the diagnosis of pathologic hypertrophy (i.e., hypertrophic cardiomyopathy). (Am J Cardiol 1993;72:1048-1054)

Published
1993

46. Left ventricular hypertrophy in world class elite athletes is associated with signs of improved cardiac autonomic regulation

Author

Oggionni, Gianluigi, Spataro, Antonio, Pelliccia, Antonio, Malacarne, Mara, Pagani, Massimo, and Lucini, Daniela

Abstract

Aim In this study we sought to assess whether in elite athletes the physiological increase in cardiac mass attending severe long-term training leading to athlete's heart is accompanied by an improvement of autonomic performance, as assessed by post exercise vagal indices and a novel unitary Autonomic Nervous System Index for sports (ANSIs).Methods The study involved 500 elite athletes (23.9 ± 6.4 years) participating in a screening organised by the National Italian Olympic Committee. All subjects underwent a complete medical examination, rest and stand autonomic assessment (heart rate variability) as well as bicycle exercise. ANSIs was also derived as radar plot from rest, stand and heart rate recovery individual proxies of autonomic nervous system regulation. All subjects were grouped into those with left ventricular hypertrophy present (LVH(+)), or not (LVH(–)), according to recognised thresholds.Results We observed that LVH(+) athletes (24.8%) showed a marked increase of post-exercise vagal indices (p< 0.001) and of ANSIs (p< 0.001), while no difference was observed for heart-rate variability indices. These changes were contingent upon sport intensity categories.Conclusions Elite athletes with physiological cardiac hypertrophy (LVH(+)) present a selective profile of indices of autonomic nervous system performance, characterised by increases of markers of vagal recovery and of the novel unitary autonomic index for sports while RR variance and spectral indices seem to be unmodified. Athlete's heart may be characterised by a specific combination of anatomical and neurocardiac remodeling. This approach might furnish potential warning signs differentiating normal training induced physiology from pathological adaptation.

Published
2024
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48. RV Remodeling in Olympic Athletes

Author

D’Ascenzi, Flavio, primary, Pisicchio, Cataldo, additional, Caselli, Stefano, additional, Di Paolo, Fernando M., additional, Spataro, Antonio, additional, and Pelliccia, Antonio, additional

Published
2017
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49. ADAPTED EVALUATION PROTOCOLS FOR TEENAGE ATHLETES COMPETING AT YOUTH OLYMPIC GAMES: SAFEGUARDING AND PROTECTING YOUNG CHAMPIONS

Author

Adami, Paolo Emilio, primary, Squeo, Maria Rosaria, additional, Quattrini, Filippo Maria, additional, Paolo, Fernando Maria Di, additional, Pisicchio, Cataldo, additional, Ciardo, Roberto, additional, Verdile, Luisa, additional, Caselli, Stefano, additional, Maestrini, Viviana, additional, Spataro, Antonio, additional, and Pelliccia, Antonio, additional

Published
2017
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50. Are Olympic athletes free from cardiovascular diseases? Systematic investigation in 2352 participants from Athens 2004 to Sochi 2014

Author

Pelliccia, Antonio, primary, Adami, Paolo Emilio, additional, Quattrini, Filippo, additional, Squeo, Maria Rosaria, additional, Caselli, Stefano, additional, Verdile, Luisa, additional, Maestrini, Viviana, additional, Di Paolo, Fernando, additional, Pisicchio, Cataldo, additional, Ciardo, Roberto, additional, and Spataro, Antonio, additional

Published
2016
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