Sports Medicine

, Volume 49, Issue 3, pp 495–496 | Cite as

Authors’ Reply to Kindermann et al.’s Comment on: “Athlete’s Heart: Diagnostic Challenges and Future Perspectives”

  • Carlo De Innocentiis
  • Fabrizio RicciEmail author
  • Mohammed Y. Khanji
  • Nay Aung
  • Claudio Tana
  • Elvira Verrengia
  • Steffen E. Petersen
  • Sabina Gallina
Letter to the Editor

Dear Editor,

We thank Prof. Wilfried Kindermann and colleagues for their interest in our publication [1] and for the important comments raised in their letter [2]. 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) [3]. 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...


Compliance with Ethical Standards


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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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Institute of Cardiology, Department of Neuroscience, Imaging and Clinical Sciences“G. d’Annunzio” UniversityChietiItaly
  2. 2.Institute for Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences“G. d’Annunzio” University of Chieti-PescaraChietiItaly
  3. 3.Department of Clinical SciencesFaculty of Medicine, Lund University, Clinical Research CenterMalmöSweden
  4. 4.William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonLondonUK
  5. 5.Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS TrustLondonUK
  6. 6.Internal Medicine and Critical Subacute Care Unit, Medicine and Geriatrics Rehabilitation DepartmentUniversity-Hospital of ParmaParmaItaly

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