Participation in Competitive Sports by Patients With Congenital Heart Disease: AHA/ACC and EAPC/ESC/AEPC Guidelines Comparison

Kamel Shibbani; Ali Abdulkarim; Werner Budts; Jolien Roos-Hesselink; Jan Müller; Keri Shafer; Prashob Porayette; Ali Zaidi; Jacqueline Kreutzer; Tarek Alsaied

doi:10.1016/j.jacc.2023.10.037

Participation in Competitive Sports by Patients With Congenital Heart Disease: AHA/ACC and EAPC/ESC/AEPC Guidelines Comparison

J Am Coll Cardiol. 2024 Feb 20;83(7):772-782. doi: 10.1016/j.jacc.2023.10.037.

Authors

Affiliations

¹ Division of Cardiology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA; University of California-San Diego, Rady Children's Hospital, Department of Pediatrics, San Diego, California, USA. Electronic address: [email protected].
² Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Congenital and Structural Cardiology, University Hospitals, and Department of Cardiovascular Sciences, Catholic University, Leuven, Belgium.
⁴ Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands; ERN-GUARD HEART (European Reference Network).
⁵ Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany.
⁶ Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.
⁷ Division of Cardiology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
⁸ Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁹ Heart Institute, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

PMID: 38355248
DOI: 10.1016/j.jacc.2023.10.037

Abstract

Sports participation in patients with congenital heart disease is an evolving subject. The American Heart Association/American College of Cardiology released a set of guidelines that advise the type and level of sports participation based primarily on anatomical defects with secondary consideration given to hemodynamic effects. Recently, the European Association of Preventive Cardiology/European Society of Cardiology/Association for European Paediatric and Congenital Cardiology offered a contrasting approach to sports participation that is based on hemodynamic and electrophysiological profiles of each patient, regardless of anatomical consideration. These guidelines are drastically different in their approaches but do have some similarities. In this review, we compare both documents, focusing on the aim, population, classification of sports, and the methodology of making recommendations. This review aims to assist practicing cardiologists in integrating the available published data and recommendations when counseling patients for sports participation.

Keywords: AHA/ACC; EAPC/ESC/AEPC; adult congenital heart disease; guidelines; sports participation.

Publication types

Review

MeSH terms

American Heart Association
Cardiac Electrophysiology
Cardiologists*
Cardiology*
Child
Heart Defects, Congenital* / therapy
Humans
Sports*
United States / epidemiology