Sports cardiology screening, follow-up and physical fitness evaluation of special athlete populations
Babity Máté
Szív-és Érgyógyászati Tagozat
Dr. Merkely Béla
SE Városmajori Szív- és Érgyógyászati Klinika Nagy előadóterem
2026-06-10 16:00:00
Szív és érrendszeri betegségek élettana és klinikuma
Dr. Merkely Béla
Dr. Merkely Béla, Dr. Kiss Orsolya
Dr. Jambrik Zoltán
Dr. Balázs Erika
Dr. Varga János Tamás
Dr. Kiss Dénes Zsolt
Dr. Hortobágyi Tibor
Regular physical activity reduces cardiovascular disease risk and all-cause mortality, yet high-intensity exercise could be contraindicated in certain cardiovascular conditions. Limited data exists on cardiovascular screening and physical fitness of special athlete populations, including referees and post-infectious athletes. Our aim was to examine cardiovascular risk factors and fitness status of elite handball referees and post-COVID-19 athletes at the Heart and Vascular Center in a cross-sectional setup.
We evaluated the top 100 Hungarian handball referees, revealing prevalent risk factors, including dyslipidaemia (41%), elevated resting blood pressure (38%), and positive medical history (24%). Stress-ECG was positive in 19%, and imaging abnormalities found in 19%. Interventions included lifestyle modifications, antihypertensive or lipid-lowering therapy, and iron supplementation in many cases. These results emphasise that, despite athletic activity, multiple cardiovascular risk factors could occur in special athlete populations.
Referees demonstrated good aerobic fitness (V̇O2max: 44.6 ± 6.1 ml/kg/min range: 25.3–62.4 ml/kg/min) with substantial individual variability. Second division referees were younger, trained more, and achieved longer treadmill exercise time, whereas referees from both divisions had similar V̇O2max values. Regarding our physical fitness measurements, large individual differences were observed across many aspects among the referees, despite the fact that they contribute to similar matches.
Three months after a SARS-CoV-2 infection, most athletes achieved satisfactory fitness levels, though exercise-induced abnormalities, including arrhythmias, significant ST-depression, ischemic heart disease, and hypertension were detected in some cases. In athletes with pre-COVID data, self-controlled CPET comparisons were performed, fitness parameters improved, likely due to intensive retraining, though 6 showed decreased capacity. Some cases with SARS-CoV-2-related or non-related pathologies requiring further examinations, treatment, or follow-up were revealed.
In summary, comprehensive cardiac evaluation and systematic screening should be recommended for all athletes at least once during their careers to detect heart conditions and reduce the risk of sudden cardiac death.
