Zusammenfassung
Erstmals sind Leitlinien für Sportkardiologie von der European Society of Cardiology (ESC) veröffentlicht worden. Hintergrund ist die Frage nach Empfehlungen zu körperlicher Aktivität, körperlichem Training sowie Möglichkeiten der Teilnahme an Freizeitsport oder auch Freigabe für den Leistungssport bei Patienten mit kardiovaskulären Risikofaktoren oder Herzerkrankungen. Die Leitlinien umfassen Empfehlungen für Patienten mit kardiovaskulären Risikofaktoren, chronischer koronarer Herzerkrankung, chronischer Herzinsuffizienz, Herzklappenerkrankungen, Aortenerkrankungen, Kardiomyopathien, nach Myokarditis und Perikarditis, bei Rhythmusstörungen, Ionenkanalerkrankungen oder kongenitalen Herzerkrankungen. Basis für die Bewertung der Sport- und Wettkampftauglichkeit sowie der individuellen Empfehlungen zu Belastbarkeit und Training ist die kombinierte kardiologische und sportmedizinische Diagnostik. In der Zusammenschau dieser Ergebnisse und der individuellen medizinischen sowie sportlich-körperlichen Ansprüche muss im Sinne des „shared decision making“ eine fundierte Empfehlung gegeben werden. Diese ist nicht immer einfach, weil die Empfehlungen in der ESC Leitlinie Sportkardiologie häufig auf Basis von schwacher wissenschaftlicher Evidenz ausgesprochen werden und sehr durch Erfahrungen und spezifische Erkenntnisse geprägt sind. Deshalb ist eine spezielle Weiterbildung innerhalb der Kardiologie notwendig, welcher durch die Zusatzqualifikation der DGK Rechnung getragen wird.
Abstract
For the first time guidelines on sports cardiology have been published by the European Society of Cardiology (ESC). The background is the need for recommendations regarding physical activity, exercise, training as well as options for amateur and elite sports in patients with heart diseases. These include recommendations for patients with cardiovascular risk factors, chronic coronary syndrome, chronic heart failure, valvular heart disease, aortic pathology, cardiomyopathy, myocarditis, pericarditis, arrhythmias and channelopathies or adult congenital heart disease. The basis for the judgement on eligibility for sports and competitions as well as individual recommendations for exercise intensity and training is the combined cardiological as well as sports medical examinations and diagnostics. Individual recommendations are given on these results together with the individual situation of the athlete (shared decision making). These recommendations are often not easy and straightforward as scientific data and research in this area are still scarce and often determined by the individual expertise of the sports cardiologist. Therefore, a specific educational program is necessary, which has recently been officially accredited by the German Society of Cardiology.
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M. Halle, C. Burgstahler, S. Gielen, R. Hambrecht, R. Laszlo und C. Tiefenbacher geben an, dass kein Interessenkonflikt besteht.
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Aus Gründen der besseren Lesbarkeit und Verständlichkeit wird in dieser Springer-Publikation das generische Maskulinum als geschlechtsneutrale Form verwendet. Diese Form impliziert immer alle Geschlechter.
Alle Autoren sind Mitglied der Deutsche Gesellschaft für Kardiologie (DGK). Martin Halle, Christof Burgstahler und Roman Laszlo sind zusätzlich Mitglieder der Deutschen Gesellschaft für Sportmedizin und Prävention e. V. (DGSP). Martin Halle, Christof Burgstahler, Rainer Hambrecht und Roman Laszlo sind Mitglied der Arbeitsgruppe 32 Sportkardiologie der DGK.
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Halle, M., Burgstahler, C., Gielen, S. et al. Kommentar zu den Leitlinien (2020) der ESC zu Sportkardiologie und körperlichem Training für Patienten mit kardiovaskulären Erkrankungen. Kardiologe 15, 364–369 (2021). https://doi.org/10.1007/s12181-021-00483-8
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DOI: https://doi.org/10.1007/s12181-021-00483-8