Appropriate advice for the practice of sport in patients with a cardiomyopathy is a challenging issue. Recent evolution towards more comprehensive and tailored recommendations may facilitate the clinical practice. However, neither their application in real life has been evaluated nor the concordance within clinicians.
We submitted six cases from real life to an expert panel of eighteen clinicians (7 cardiomyopathy experts, 7 arrhythmia experts, 4 sport physicians). The six athletes had Hypertrophic (HCM, n=3), Dilated (DCM, n=2), Right ventricular arythmogenic (ARVC, n=1) cardiomyopathy. Advice for the practice of sport (competitive or recreational, globally or regarding the main usual activity of the athlete or according to detailed sports classification) was collected through a structured questionnaire.
Experts authorize the practice of the usual sport in 28% of total cases. Global concordance within experts is significant but low (Kendall W=0.34, P<0.001) regarding sport practice graduation (none, recreational or competitive). Experts’ discrepancies are also noticed regarding sport category and intensity. Decision of experts may differentiate from existing recommendations, and overall, experts tended to be more permissive. Recreational sport is unanimously authorized, yet again with high disparity depending on sport category and intensity.
Divergent advices were observed between experts regarding sports activity that can be authorized in athletes with a cardiomyopathy. Advices were also frequently discordant with recent European recommendations. These results underline difficulties for athletes’ personalized recommendation and the need for large prospective studies to progress towards optimal management.Le texte complet de cet article est disponible en PDF.