Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact

  • Levine B
  • Baggish A
  • Kovacs R
  • et al.
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Abstract

e262 T he " classification of sports " section has been a part of each iteration of the recommendations for participation in sports and provides a framework by which athletes with heart disease can be prescribed or proscribed specific sports for par-ticipation. 1–3 For the 36th Bethesda Conference, an earlier ver-sion of the Figure was constructed that characterized sports by their strength component, expressed as the relative intensity of static muscle contractions (percentage of a maximal voluntary contraction), and their endurance component, reflected by the relative intensity of dynamic exercise (regular contraction of large muscle groups) or percentage of maximal aerobic power (Vo 2max .) . 3 The rationale for a classification scheme applica-ble to the competitive athlete with cardiac disease is based on the well-described hemodynamics of each different type of exercise (static versus dynamic), 3,4 as well as the apparent cardiac adaptation of athletes who compete in these sports, 5 which reflects the chronic load on the cardiovascular system. The underlying principle is that specific cardiovascular condi-tions may be more or less susceptible to complications (pri-marily ischemia, heart failure, or vascular compromise) based on unique characteristics of each lesion and the load placed on the heart during athletic competition. Static contractions stimulate mechanical and metabolic afferents in skeletal muscle, which leads to large, sus-tained changes in blood pressure via the exercise pressor reflex. 6–8

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Levine, B. D., Baggish, A. L., Kovacs, R. J., Link, M. S., Maron, M. S., & Mitchell, J. H. (2015). Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 1: Classification of Sports: Dynamic, Static, and Impact. Journal of the American College of Cardiology, 66(21), 2350–2355. https://doi.org/10.1016/j.jacc.2015.09.033

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