{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:23:16Z","timestamp":1791919396782,"version":"4.3.4"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"14","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precaution to ensure a high level of safety for all affected individuals. Valvular heart disease is usually an age-related degenerative process, predominantly affecting individuals in their fifth decade and onwards. However, there is an increasing group of younger individuals with valvular defects. The diagnosis of cardiac disorders during routine cardiac examination often raises questions about on-going participation in competitive sport with a high dynamic or static component and the level of permissible physical effort during recreational exercise. Although the natural history of several valvular diseases has been reported in the general population, little is known about the potential influence of chronic intensive physical activity on valve function, left ventricular remodelling pulmonary artery pressure, and risk of arrhythmia. Due to the sparsity of data on the effects of exercise on VHD, the present document is largely based on clinical experience and expert opinion.<\/jats:p>","DOI":"10.1093\/eurjpc\/zwab058","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T16:33:38Z","timestamp":1616517218000},"page":"1569-1578","source":"Crossref","is-referenced-by-count":29,"title":["Athletes with valvular heart disease and competitive sports: a position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology"],"prefix":"10.1093","volume":"28","author":[{"given":"Frank","family":"van Buuren","sequence":"first","affiliation":[{"name":"Clinic for General and Interventional Cardiology\/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum , Bad Oeynhausen,","place":["Germany"]},{"name":"Catholic Hospital Southwestfalia, St. Martinus Hospital Olpe ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabiha","family":"Gati","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College , London,","place":["UK"]},{"name":"Department of Cardiology, Royal Brompton Hospital , London, SW3 6NP,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Sharma","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, St. George\u2019s, University of London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, St. George\u2019s, University of London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Emilio","family":"Adami","sequence":"additional","affiliation":[{"name":"Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Niebauer","sequence":"additional","affiliation":[{"name":"University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University , Salzburg,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pelliccia","sequence":"additional","affiliation":[{"name":"Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Clinic for General and Interventional Cardiology\/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum , Bad Oeynhausen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"B\u00f6rjesson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine; Center for Health and Performance, Gothenburg University"},{"name":"Department of Medicine, Sahlgrenzska University Hospital\/\u00d6stra , Gothenburg,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Carre","sequence":"additional","affiliation":[{"name":"Sport Medicine Department, Rennes University Hospital, LTSI INSERM UMR 1099 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Solberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Diakonhjemmet Hospital , Oslo,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Heidbuchel","sequence":"additional","affiliation":[{"name":"Antwerp University and University Hospital , Cardiology, Antwerp,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Caselli","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Corrado","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School , Padova,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Serratosa","sequence":"additional","affiliation":[{"name":"Hospital Universitario Quironsalud Madrid ,","place":["Spain"]},{"name":"Ripoll y De Prado Sport Clinic, FIFA Medical Centre of Excellence , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Biffi","sequence":"additional","affiliation":[{"name":"Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Pressler","sequence":"additional","affiliation":[{"name":"Centre for General, Sports and Preventive Cardiology , Munich,","place":["Germany"]},{"name":"Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmied","sequence":"additional","affiliation":[{"name":"Kardiologisches Ambulatorium, Sportmedizin\/Sportkardiologie, University Heart Center, Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M","family":"Panhuyzen-Goedkoop","sequence":"additional","affiliation":[{"name":"Amsterdam Medische Centra, locatie AMC & Sport Medisch Centrum Papendal Arnhem , Arnhem,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Kruse","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bisbebjerg University Hospital , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"La Gerche","sequence":"additional","affiliation":[{"name":"Baker Heart and Diabetes Institute , Melbourne,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lothar","family":"Faber","sequence":"additional","affiliation":[{"name":"Clinic for General and Interventional Cardiology\/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum , Bad Oeynhausen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Bogunovic","sequence":"additional","affiliation":[{"name":"Clinic for General and Interventional Cardiology\/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum , Bad Oeynhausen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"D\u2019Ascenzi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Siena,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus Peter","family":"Mellwig","sequence":"additional","affiliation":[{"name":"Clinic for General and Interventional Cardiology\/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universit\u00e4t Bochum , Bad Oeynhausen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"2026080911073162200_zwab058-B1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet (Lond, Engl)"},{"key":"2026080911073162200_zwab058-B2","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1093\/eurheartj\/ehi325","article-title":"Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology","volume":"26","author":"Pelliccia","year":"2005","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/HJR.0b013e3282ef9973","article-title":"Recommendations for the management of individuals with acquired valvular heart diseases who are involved in leisure-time physical activities or competitive sports","volume":"15","author":"Mellwig","year":"2008","journal-title":"Eur J Prev Cardiol"},{"key":"2026080911073162200_zwab058-B4","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1161\/CIRCULATIONAHA.118.034075","article-title":"Mitral valve prolapse, ventricular arrhythmias, and sudden death","volume":"140","author":"Basso","year":"2019","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B5","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1161\/CIRCULATIONAHA.115.016291","article-title":"Arrhythmic mitral valve prolapse and sudden cardiac death","volume":"132","author":"Basso","year":"2015","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B6","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1001\/jama.300.11.1317","article-title":"Outcomes in adults with bicuspid aortic valves","volume":"300","author":"Tzemos","year":"2008","journal-title":"JAMA"},{"key":"2026080911073162200_zwab058-B7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1136\/bjsm.2008.047407","article-title":"Effects of sports activity in athletes with bicuspid aortic valve and mild aortic regurgitation","volume":"44","author":"Galanti","year":"2010","journal-title":"Br J Sports Med"},{"key":"2026080911073162200_zwab058-B8","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jacc.2014.09.094","article-title":"Under-recognition of aortic and aortic valve disease and the risk for sudden death in competitive athletes","volume":"65","author":"Harris","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026080911073162200_zwab058-B9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1055\/s-2007-965110","article-title":"The natural course of bicuspid aortic valve in athletes","volume":"29","author":"Spataro","year":"2008","journal-title":"Int J Sports Med"},{"key":"2026080911073162200_zwab058-B10","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.116.005292","article-title":"Reference values of aortic root in male and female white elite athletes according to sport","volume":"9","author":"Boraita","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B11","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1093\/ehjci\/jez001","article-title":"Bicuspid aortic valve behaviour in elite athletes","volume":"20","author":"Boraita","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B12","article-title":"2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease: The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC)","author":"Pelliccia","year":"2020","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B13","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1136\/heartjnl-2018-313372","article-title":"Exercise recommendations in patients with valvular heart disease","volume":"105","author":"Gati","year":"2019","journal-title":"Heart"},{"key":"2026080911073162200_zwab058-B14","doi-asserted-by":"crossref","first-page":"3664","DOI":"10.1093\/eurheartj\/ehy511","article-title":"Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC)","volume":"39","author":"Niebauer","year":"2018","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B15","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/eurheartj\/ehy408","article-title":"Recommendations for participation in leisure time or competitive sports in athletes-patients with coronary artery disease: a position statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC)","volume":"40","author":"Borjesson","year":"2019","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B16","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/eurheartj\/ehy730","article-title":"Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC)","volume":"40","author":"Pelliccia","year":"2019","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B17","doi-asserted-by":"crossref","first-page":"e262","DOI":"10.1161\/CIR.0000000000000237","article-title":"Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 1: classification of sports: dynamic, static, and impact: a scientific statement from the American Heart Association and American College of Cardiology","volume":"132","author":"Levine","year":"2015","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B18","doi-asserted-by":"crossref","first-page":"483","DOI":"10.4065\/mcp.2009.0706","article-title":"Valvular heart disease: diagnosis and management","volume":"85","author":"Maganti","year":"2010","journal-title":"Mayo Clin Proc"},{"key":"2026080911073162200_zwab058-B19","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B20","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1056\/NEJMoa1714719","article-title":"Outcomes of cardiac screening in adolescent soccer players","volume":"379","author":"Malhotra","year":"2018","journal-title":"N Engl J Med"},{"key":"2026080911073162200_zwab058-B21","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1007\/s11886-011-0169-2","article-title":"Exercise hemodynamics in valvular heart disease","volume":"13","author":"Booher","year":"2011","journal-title":"Curr Cardiol Rep"},{"key":"2026080911073162200_zwab058-B22","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1161\/CIRCULATIONAHA.117.033395","article-title":"Prevalence and clinical outcome of athletes with mitral valve prolapse","volume":"137","author":"Caselli","year":"2018","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B23","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B24","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","article-title":"Prendergast B, Wendler O, Bonis MD, Tribouilloy C, Evangelista A, Bogachev-Prokophiev, A, Apor A, Ince H, Laroche C, Popescu, BA, Pi\u00e9rard L, Haude M, Hindricks G, Ruschitzka F, Windecker S, Bax JJ, Maggioni A, Vahanian A, and the EORP VHD II Investigators Contemporary presentation and management of valvular heart disease","volume":"140","author":"Iung","year":"2019","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B25","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jcmg.2015.02.010","article-title":"Valve stress echocardiography: a practical guide for referral, procedure, reporting, and clinical implementation of results from the HAVEC Group","volume":"8","author":"Garbi","year":"2015","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B26","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1161\/CIRCULATIONAHA.107.755942","article-title":"Left ventricular response to mitral regurgitation","volume":"118","author":"Gaasch","year":"2008","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B27","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S0735-1097(86)80286-8","article-title":"Mitral valve prolapse: definition and implications in athletes","volume":"7","author":"Jeresaty","year":"1986","journal-title":"J Am Coll Cardiol"},{"key":"2026080911073162200_zwab058-B28","doi-asserted-by":"crossref","first-page":"342","DOI":"10.21037\/qims.2018.04.01","article-title":"Multimodality imaging for the quantitative assessment of mitral regurgitation","volume":"8","author":"Chew","year":"2018","journal-title":"Quant Imaging Med Surg"},{"key":"2026080911073162200_zwab058-B29","doi-asserted-by":"crossref","first-page":"e292","DOI":"10.1161\/CIR.0000000000000241","article-title":"Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 5: valvular heart disease: a scientific statement from the American Heart Association and American College of Cardiology","volume":"132","author":"Bonow","year":"2015","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/238694","article-title":"Exercise training in athletes with bicuspid aortic valve does not result in increased dimensions and impaired performance of the left ventricle","volume":"2014","author":"Stefani","year":"2014","journal-title":"Cardiol Res Pract"},{"key":"2026080911073162200_zwab058-B31","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1080\/AC.68.5.2994470","article-title":"Elite athletes with mitral or aortic regurgitation and their cardiopulmonary capability","volume":"68","author":"Langer","year":"2013","journal-title":"Acta Cardiol"},{"key":"2026080911073162200_zwab058-B32","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B33","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1056\/NEJMra1207059","article-title":"Aortic dilatation in patients with bicuspid aortic valve","volume":"370","author":"Verma","year":"2014","journal-title":"N Engl J Med"},{"key":"2026080911073162200_zwab058-B34","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1001\/jama.2011.1286","article-title":"Incidence of aortic complications in patients with bicuspid aortic valves","volume":"306","author":"Michelena","year":"2011","journal-title":"JAMA"},{"key":"2026080911073162200_zwab058-B35","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.1161\/CIRCULATIONAHA.107.740878","article-title":"Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community","volume":"117","author":"Michelena","year":"2008","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B36","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)","volume":"35","author":"Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B37","first-page":"24","article-title":"The effect of exercise on the aortic root diameter in young elite athletes with bicuspid aortic valve disease","volume":"37","author":"Malhotra","year":"2016","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B38","article-title":"Determinants of aortic root dilatation over time in patients with essential hypertension: the Campania Salute Network","author":"Canciello","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2026080911073162200_zwab058-B39","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1136\/heartjnl-2018-314288","article-title":"Prevalence and progression of aortic root dilatation in highly trained young athletes","volume":"105","author":"Gati","year":"2019","journal-title":"Heart"},{"key":"2026080911073162200_zwab058-B40","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1161\/CIRCULATIONAHA.109.901074","article-title":"Prevalence and clinical significance of aortic root dilation in highly trained competitive athletes","volume":"122","author":"Pelliccia","year":"2010","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B41","doi-asserted-by":"crossref","first-page":"100428","DOI":"10.1016\/j.cpcardiol.2019.06.002","article-title":"Risk stratification in bicuspid aortic valve aortopathy: emerging evidence and future perspectives","volume":"46","author":"Della Corte","year":"2021","journal-title":"Curr Probl Cardiol"},{"key":"2026080911073162200_zwab058-B42","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1161\/CIRCULATIONAHA.109.914762","article-title":"Exercise testing in nonatherosclerotic heart disease: hypertrophic cardiomyopathy, valvular heart disease, and arrhythmias","volume":"123","author":"Morise","year":"2011","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B43","first-page":"1012","article-title":"Exercise testing and stress imaging in valvular heart disease","volume":"30","author":"Henri","year":"2014","journal-title":"Can J Cardiol"},{"key":"2026080911073162200_zwab058-B44","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jcmg.2013.10.013","article-title":"Physical exercise reduces aortic regurgitation: exercise magnetic resonance imaging","volume":"7","author":"Stern","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B45","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jcmg.2017.01.002","article-title":"Cardiac imaging for assessing low-gradient severe aortic stenosis","volume":"10","author":"Clavel","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B46","doi-asserted-by":"crossref","DOI":"10.1136\/heartjnl-2018-314288","article-title":"Prevalence and progression of aortic root dilatation in highly trained young athletes","volume":"105","author":"Gati","year":"2019","journal-title":"Heart"},{"key":"2026080911073162200_zwab058-B47","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.amjcard.2007.02.108","article-title":"Aortic root size and prevalence of aortic regurgitation in elite strength trained athletes","volume":"100","author":"Babaee Bigi","year":"2007","journal-title":"Am J Cardiol"},{"key":"2026080911073162200_zwab058-B48","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1161\/CIRCULATIONAHA.112.000974","article-title":"A meta-analysis of aortic root size in elite athletes","volume":"127","author":"Aline","year":"2013","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B49","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1007\/s00330-016-4520-2","article-title":"Acute effect of static exercise in patients with aortic regurgitation assessed by cardiovascular magnetic resonance: role of left ventricular remodelling","volume":"27","author":"Alegret","year":"2017","journal-title":"Eur Radiol"},{"key":"2026080911073162200_zwab058-B50","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.ijcard.2017.09.183","article-title":"Six-minute walking test and long term prognosis in patients with asymptomatic aortic valve stenosis","volume":"249","author":"Sigvardsen","year":"2017","journal-title":"Int J Cardiol"},{"key":"2026080911073162200_zwab058-B51","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.jcmg.2018.08.036","article-title":"Diagnostic and prognostic utility of cardiac magnetic resonance imaging in aortic regurgitation","volume":"12","author":"Kammerlander","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026080911073162200_zwab058-B52","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1161\/CIRCULATIONAHA.111.083600","article-title":"Aortic regurgitation quantification using cardiovascular magnetic resonance","volume":"126","author":"Myerson","year":"2012","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B53","first-page":"2047487319892112","article-title":"Aortic regurgitation in competitive athletes: the role of multimodality imaging for clinical decision-making","author":"Antonopoulos","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"2026080911073162200_zwab058-B54","doi-asserted-by":"crossref","first-page":"e123-5","DOI":"10.1161\/CIRCULATIONAHA.115.016315","article-title":"The forgotten valve: isolated severe tricuspid valve stenosis","volume":"132","author":"Al-Hijji","year":"2015","journal-title":"Circulation"},{"key":"2026080911073162200_zwab058-B55","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/echo.13458","article-title":"A new and simple method for clarifying the severity of tricuspid regurgitation","volume":"34","author":"Izgi","year":"2017","journal-title":"Echocardiography"},{"key":"2026080911073162200_zwab058-B56","first-page":"320","article-title":"Comparison of the American College of Cardiology\/American Heart Association and the European Society of Cardiology guidelines for the management of patients with valvular heart disease","volume":"29","author":"Alame","year":"2017","journal-title":"J Invasive Cardiol"},{"key":"2026080911073162200_zwab058-B57","doi-asserted-by":"crossref","first-page":"2463","DOI":"10.1093\/eurheartj\/ehi426","article-title":"Recommendations for the management of patients after heart valve surgery","volume":"26","author":"Butchart","year":"2005","journal-title":"Eur Heart J"},{"key":"2026080911073162200_zwab058-B58","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.pcad.2011.02.010","article-title":"Exercise in valvular heart disease: risks and benefits","volume":"53","author":"Parker","year":"2011","journal-title":"Prog Cardiovasc Dis"},{"key":"2026080911073162200_zwab058-B59","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)","volume":"36","author":"Habib","year":"2015","journal-title":"Eur Heart J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/14\/1569\/60914038\/zwab058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/14\/1569\/60914038\/zwab058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T15:07:42Z","timestamp":1786288062000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/28\/14\/1569\/6224365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,13]]},"references-count":59,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,4,13]]},"published-print":{"date-parts":[[2021,12,20]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwab058","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,4,13]]}}}