{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:43:56Z","timestamp":1790214236001,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>While the exacerbating effect of physical exercise and its correlation with arrhythmic outcomes have been demonstrated for arrhythmogenic right ventricular cardiomyopathy, the impact of physical exercise on other forms of cardiomyopathies is poorly characterized. This study aimed to investigate the relationship between lifelong exercise intensity and the development of cardiac manifestations in subjects carrying a likely pathogenic (LP) or pathogenic (P) truncating variant of titin (TTNtv).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Truncating variant of titin carriers\u2014patients and family members\u2014were interviewed regarding their exercise habits from birth until diagnosis (type of activity, hours\/week, weeks\/months, months\/years, and number of years of exercise). Those engaging in \u22654\u2005h of vigorous exercise per week [equivalent to \u22651440 metabolic equivalents (METs) \u00d7 minutes\/week] for a minimum of 6 years were classified as athletes. All others were classified as non-athletes. The correlation between vigorous physical activity and the development of left ventricular systolic dysfunction (LVSD), defined as left ventricular ejection fraction below 45% (LVEF &amp;lt; 45%), was explored. Additionally, secondary endpoints included the occurrence of life-threatening ventricular arrhythmias [LTA\u2014i.e. aborted cardiac arrest due to hyperkinetic arrhythmias, documented sustained ventricular tachycardia (SVT), or appropriate implantable cardioverter-defibrillator therapy], non-LTA ventricular arrhythmias [i.e. &amp;gt; 1000 premature ventricular complexes\/24\u2005h and\/or non-sustained ventricular tachycardia (NSVT)], and the development of atrial fibrillation and\/or atrial flutter (AF\/AFL) during follow-up. Among the 117 subjects (73% male, median age 45\u2014interquartile range 35\u201357 years), 38 (32%) were athletes. Vigorous exercise was not associated with the development of LVEF &amp;lt; 45% (adjusted odds ratio 0.663, 95% confidence interval 0.261\u20131.685, P 0.388), nor with the occurrence of LTA (P = 0.607), non-LTA (P = 0.648), and supraventricular arrhythmias (P = 0.701). Comparable results were obtained when considering the total amount of METs \u00d7 hours\/life burned by subjects as a continuous variable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In carriers of TTNtv, vigorous physical activity was not associated with LVSD and LTA development.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf094","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T13:15:56Z","timestamp":1740489356000},"page":"1094-1100","source":"Crossref","is-referenced-by-count":6,"title":["Exercise intensity and cardiac disease development in carriers of titin truncating variants"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6324-9821","authenticated-orcid":false,"given":"Giulio","family":"Savonitto","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5823-3777","authenticated-orcid":false,"given":"Alessia","family":"Paldino","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Setti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]},{"name":"Division of Cardiology, Department of Medicine, University of Verona , Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Berra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Radesich","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Perotto","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Del Mestre","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Cittar","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Tavcar","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio Luciano","family":"Ribichini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona , Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Barbati","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Department of Medicine, University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Gigli","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Member of the European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart 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