{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:32:06Z","timestamp":1793946726908,"version":"4.8.0"},"reference-count":0,"publisher":"Kare Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anatol J Cardiol"],"abstract":"<jats:p>Cardiovascular pre-participation evaluation in elite athletes primarily aims to identify cardiovascular conditions associated with sudden cardiac death. Current international recommendations emphasize comprehensive medical history, physical examination, and resting 12-lead electrocardiography (ECG), with additional investigations guided by clini-cal findings and individual risk. However, advances in sports cardiology, cardiovascular imaging, and exercise physiology provide opportunities to integrate cardiovascular risk assessment with physiological performance evaluation. This article proposes a concep-tual, hypothesis-generating framework integrating structural, electrical, and functional cardiovascular assessment in elite athletes. The framework consists of 3 sequential components: comprehensive clinical assessment with resting ECG; transthoracic echo-cardiography for structural evaluation and longitudinal reference; and cardiopulmonary exercise testing (CPET) as an optional complementary investigation. Cardiopulmonary exercise testing may provide information on maximal oxygen uptake, ventilatory thresh-olds, oxygen pulse, ventilatory efficiency, heart rate recovery, and exercise-induced arrhythmias, potentially supporting individualized training prescription and longitudinal physiological monitoring. Cardiac magnetic resonance and coronary computed tomog-raphy angiography (CCTA) may be considered selectively when clinically indicated. A one-time CCTA strategy during an athlete\u2019s career is proposed as a research hypothesis requiring prospective assessment of clinical utility and cost-effectiveness. Importantly, CPET and CCTA are not proposed as universal screening requirements. This framework is intended to complement, rather than replace, current evidence-based international recommendations. As the proposed model is based on available literature and expert opinion and has not undergone prospective clinical validation, future multicenter stud-ies are required to determine whether integrated cardiovascular assessment improves risk stratification, athlete safety, clinical decision-making, performance monitoring, and cost-effectiveness.<\/jats:p>","DOI":"10.14744\/anatoljcardiol.2026.6779","type":"journal-article","created":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:08:46Z","timestamp":1793945326000},"source":"Crossref","is-referenced-by-count":0,"title":["From Sudden Cardiac Death Prevention to Performance Optimization: A Conceptual Framework for Cardiovascular Assessment in Elite Athletes"],"prefix":"10.14744","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2791-9538","authenticated-orcid":false,"given":"Ak\u0131n","family":"Torun","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Atlas University, \u0130stanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5966","published-online":{"date-parts":[[2026]]},"container-title":["The Anatolian Journal of Cardiology"],"original-title":[],"link":[{"URL":"https:\/\/file.paplino.com\/anatoljcardiol\/pdfs\/1791468704-en.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:08:46Z","timestamp":1793945326000},"score":1,"resource":{"primary":{"URL":"https:\/\/anatoljcardiol.com\/article\/AJC-51695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"URL":"https:\/\/doi.org\/10.14744\/anatoljcardiol.2026.6779","relation":{},"ISSN":["2149-2271","2149-2263"],"issn-type":[{"value":"2149-2271","type":"print"},{"value":"2149-2263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}