Sports cardiology: A growing need
a Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Universitat de Barcelona, Spain
The field of cardiology dedicated to detecting cardiac diseases in subjects who do sports and the study of how the heart adapts to sports practice is known as Sports Cardiology. In spite of the high prevalence of serious cardiac diseases in our society, such as ischemic cardiopathy, generally little attention has been paid to the hearts of athletes, the paradigm of health. I.e., cardiologists have not spent much time on Sports Cardiology. This is because fortunately the majority of people who do sports are healthy, and if anything has been proven about sports and physical exercise, it is that they are highly useful in preventing cardiovascular disease.
Nevertheless, in recent decades two clear demands for care have emerged. This is due to the boom in mass sports events and the unthinking adoption of intensive physical exercises together, on occasions, with poor preparation. On the one hand there is a need for measures to prevent the terrible occurrence of sudden death while practicing sport. Even though this was known in ancient Greece, the popularisation of sport and the mass media have increased social awareness of this problem. There is therefore interest and a growing need to introduce programs that minimise the incidence of these fatal events. On the other hand, these practices have given rise to increasing evidence for ‘‘differentiated’’ cardiac adaptation in some subjects, which may even seem to be the early phases of some cardiac diseases. Differential diagnosis and specific preventive treatment of these is currently a challenge for cardiology, in a scenario in which the ‘‘disease’’ certainly is ahead of scientific knowledge. A second need therefore consists of the need to gain more in-depth knowledge about how the heart adapts to exercise and training. This will make it possible to distinguish between individual variability and the normality of the pathology, and also to evaluate the impact of physical activity on certain preclinical findings. This is a major challenge for this field of cardiology, which has multiplied its scientific production by five in the last 15 years, in terms of the number of papers published per year (source: Web of Knowledge).
Catalonia has always been a pioneering region, and this is also the case for our cardiologists. Thus although traditionally cardiology has paid little attention to this field, for many years Catalan cardiology has had experts who centre on sports cardiology. They include Dr. Santiago Tintoré and Dr. J. Ricard Serra-Grima, who are both internationally recognised experts in this field. It is therefore unsurprising that the tradition has been perpetuated, and we still continuously produce scientific work in this area, as is shown by the current edition of the journal Apunts, ‘‘Sports Medicine’’, which covers different cardiological subjects in connection with those who do sports.
However, this fruitful history would not have been possible without the involvement, help and drive of Sports Medicine in Catalonia. The large healthcare network, teaching and research facilities have supported the development of Sports Medicine as well as aiding the development of Sports Cardiology. First line healthcare for athletes helped to develop the first of these, while the second line of consultancies helped to develop the second. This model has made it possible to reach many people who do sports, and like all multidisciplinary teams it has brought out the best in each individual member. Sports doctors have gained specialised cardiological expertise, while the cardiologists now understand that those who practice sports have special needs and peculiarities that differentiate them from the patients they usually see in a hospital or cardiological consultancy, so that they require specific care. We hope that this collaboration, which is so necessary to cover sports people’s increasing needs for care, grows and prospers for many more years.