The Sports Cardiology Team: Personalizing Athlete Care Through a Comprehensive, Multidisciplinary Approach

Juliette C van Hattum; Sjoerd M Verwijs; P Jeff Senden; Jessica L Spies; S Matthijs Boekholdt; Maarten Groenink; Nicole M Panhuyzen-Goedkoop; Albert R Willems; Ingmar Knobbe; Nicolaas A Blom; Cornelis A C M Wijne; Gustaaf Reurink; Saskia N van der Crabben; Nick R Bijsterveld; Evert A L M Verhagen; Yigal M Pinto; Arthur A M Wilde; Harald T Jørstad

doi:10.1016/j.mayocpiqo.2022.08.006

The Sports Cardiology Team: Personalizing Athlete Care Through a Comprehensive, Multidisciplinary Approach

Mayo Clin Proc Innov Qual Outcomes. 2022 Oct 12;6(6):525-535. doi: 10.1016/j.mayocpiqo.2022.08.006. eCollection 2022 Dec.

Authors

Juliette C van Hattum¹, Sjoerd M Verwijs¹, P Jeff Senden², Jessica L Spies¹, S Matthijs Boekholdt¹, Maarten Groenink¹, Nicole M Panhuyzen-Goedkoop^{1

3}, Albert R Willems⁴, Ingmar Knobbe⁵, Nicolaas A Blom⁵, Cornelis A C M Wijne⁶, Gustaaf Reurink⁶, Saskia N van der Crabben⁷, Nick R Bijsterveld^{1

8}, Evert A L M Verhagen⁹, Yigal M Pinto¹, Arthur A M Wilde¹, Harald T Jørstad^{1

3}

Affiliations

¹ Department of Cardiology, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
² Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands.
³ Department of Cardiology, Sports Medical Centre Papendal, Arnhem, the Netherlands.
⁴ Department of Cardiology and Hospital Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
⁵ Department of Paediatric Cardiology, and University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
⁶ Department of Sports Medicine, Hospital Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
⁷ Department of Clinical Genetics, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
⁸ Department of Cardiology, Flevoziekenhuis, Almere, the Netherlands.
⁹ Department of Epidemiology of Sports, Exercise & Health, Amsterdam UMC, Amsterdam, the Netherland.

Abstract

Objective: To systematically investigate and document the infrastructure, practices, recommendations, and clinical consequences of a structured, organized sports cardiology multidisciplinary team (MDT) for athletes and patients who wish to engage in sports and exercise.

Patients and methods: We established bimonthly sports cardiology MDT meetings, with a permanent panel of experts in sports cardiology, genetics, pediatric cardiology, cardiovascular imaging, electrophysiology, and sports and exercise medicine. Cases were referred nationally or internationally by cardiologists/sports physicians. We retrospectively analyzed all MDT cases (April 10, 2019 through May 13, 2020) and collected clinical follow-up data up to 1 year after the initial review.

Results: A total of 115 athletes underwent MDT review; of them, 11% were women, 65% were recreational athletes, and 54% were performing "mixed" type of sports; the mean age was 32±16 years. An MDT review led to a diagnosis revision of "suspected cardiac pathology" to "no cardiac pathology" in 38% of the athletes and increased the number of definitive diagnoses (from 77 to 109; P=.03). We observed fewer "total sports restrictions" (from 6 to 0; P=.04) and more tailored sports advice concerning "no peak load/specific maximum load" (from 10 to 26; P=.02). At the 14±6-month follow-up, 112 (97%) athletes reported no cardiovascular events, 111 (97%) athletes reported no (new) cardiac symptoms, 113 (98%) athletes reported adherence to the MDT sports advice, and no diagnoses were revised.

Conclusion: Our experiences with a comprehensive sports cardiology MDT demonstrate that this approach leads to higher percentages of definitive diagnoses and fewer cardiac pathology diagnoses, more tailored sports advice with excellent rates of adherence, and fewer total sports restrictions. Our findings highlight the added value of sports cardiology MDTs for patient and athlete care.

Keywords: Amsterdam UMC, Amsterdam University Medical Centers; CVD, cardiovascular disease; ICD, implantable cardioverter-defibrillator; MDT, multidisciplinary team; SEM, sports and exercise medicine.