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Cardiovascular screening of athletes.Marwaha S, Sharma S.Indian Pacing Electrophysiol J. 2025 Dec 1:S0972-6292(25)00219-0. doi: 10.1016/j.ipej.2025.11.012. Online ahead of print.PMID: 41338414Role of exercise in atrial fibrillation management.Marwaha S, Sharma S.Br J Sports Med. 2025 Aug 26;59(17):1197-1199. doi: 10.1136/bjsports-2025-110191.PMID: 40730425 No abstract available.Validation and refinement of a non-invasive algorithm for differentiating physiological LV enlargement and dilated cardiomyopathy in athletes with an enlarged and low resting LVArticleBackground Participation in regular intensive exercise is associated with physiological left ventricular (LV) remodelling, which can overlap with features of early dilated cardiomyopathy (DCM). We proposed a non-invasive multiparametric algorithm to differentiate between the two entities(1). However, the distinctive data were derived from our own c&#8230;viewFibrosis patterns and arrhythmia risk in athletes with dilated left ventriclesArticleBackground Myocardial fibrosis is a recognised hallmark of dilated cardiomyopathy (DCM) and is implicated in potentially fatal cardiac arrhythmias.The presence of myocardial scar is often used as a marker to differentiate physiological left ventricular (LV) remodelling from dilated cardiomyopathy (DCM) in athletes. This study aims to assess the pre&#8230;viewUtility of cardiopulmonary stress testing in differentiating LV remodelling and dilated cardiomyopathy in athletes with an enlarged ventricle and baseline depressed LV functionArticleIntroduction Cardiopulmonary exercise testing (CPET) is an excellent tool for assessing functional capacity in the general population and in athletes. Peak oxygen consumption, measured during CPET is largely determined by peak cardiac output and may be useful in differentiating physiological remodelling in athletes from dilated cardiomyopathy. The&#8230;viewInsights into the aetiology and temporal trends in cardiac mortality in the young: a 21-year review of national and registry data in the united kingdomArticleBackground An accurate representation of the incidence and aetiology of cardiac and sudden cardiac death (SCD) is vital for healthcare policymakers to effectively allocate resources for preventative strategies. Purpose We aimed to report on the incidence and causes of cardiac and SCD among individuals under 35-years-old in England and Wales for 21&#8230;viewNon-specific myocardial fibrosis in young competitive athletes: clinical significance and risk prediction by a powerful machine learning-based modelArticleFull-text availableBackground Non-specific myocardial fibrosis (NSMF) is a heterogeneous entity. We aimed to evaluate young athletes with and without NSMF to establish potentially clinically significance. Methods We analysed data from 328 young athletes. We identified 61 with NSMF and compared them with 75 matched controls. Athletes with NSMF were divided into Group&#8230;Anabolic steroids in athletes: the interplay of hormones and inflammation leading to the heart’s vulnerabilityArticleDOI:10.1093/eurjpc/zwae253Abstract We147: The Utility of Cardiopulmonary Exercise Testing (CPET) Amongst Male and Female athletes to Differentiate Between Physiological Left Ventricular Enlargement and Mildly Depressed Resting Systolic Function and Athletic Individuals with Dilated Cardiomyopathy.ArticleBackground: Athletes frequently reveal a dilated left ventricle (LV),some also demonstrate a co-existent mildly depressed LV ejection fraction, raising the possibility of mild dilated cardiomyopathy (DCM). The maximal oxygen consumption(VO2max) is a valuable tool for assessing fitness, largely determined by cardiac output. References ranges derived&#8230;The impact of drug use in athletes on resting LV systolic function and contractile reserveArticleBackground Consumption of recreational or performance enhancing agents can have long term adverse effects on the cardiovascular system, however, the effect of these agents on left ventricle size and the contractile reserve is unclear. Method 145 male athletes with dilated left ventricle (LV) completed a confidential questionnaire enquiring about r&#8230;2 Insights into the aetiology and temporal trends in cardiac mortality in the young: a 21-year review of national and registry data in england and walesConference PaperBackground An accurate representation of the incidence and aetiology of cardiac and sudden cardiac death (SCD) is vital for healthcare policymakers to effectively allocate resources for preventative strategies. Aim We aimed to report on the incidence and causes of cardiac and SCD among individuals under the age of 35 years in England and Wales over&#8230;Sex-related differences in the association between septal wall thickness and survivalArticleCoronary artery anomalies and the role of echocardiography in pre-participation screening of athletes: a practical guideArticleTransthoracic echocardiography is an essential and widely available diagnostic tool for assessing individuals reporting cardiovascular symptoms, monitoring those with established cardiac conditions and for preparticipation screening of athletes. While its use is well-defined in hospital and clinic settings, echocardiography is increasingly being ut&#8230;Submaximal in addition to peak stress echocardiogram differentiates pathological LV dilatation from physiological dilatation and could help facilitate early heart failure diagnosisArticleBackground Left ventricular dimensions in athletes overlap with those observed in patients with dilated cardiomyopathy (DCM). Among athletes with concomitant baseline low left ventricular ejection fraction (LVEF), the differentiation between the two entities may be difficult. Purpose We compared the role of changes in left ventricular ejection fra&#8230;The aortic root in young adultsArticleBackground Aortic size varies between individuals and is influenced by age, gender, body size and blood pressure. There are numerous studies aimed at defining normative aortic root measurements, but the vast majority of these are in older adults, or limited by a small sample size. Purpose To screen a large number of young individuals (≤35 years) t&#8230;Ethnic and sex-related differences at presentation in apical hypertrophic cardiomyopathy: An observational cross-sectional studyArticleBackground: We investigated whether ethnicity and sex are associated with different clinical presentations and cardiovascular magnetic resonance (CMR) findings in individuals with apical hypertrophic cardiomyopathy (ApHCM). Methods: A retrospective observational cohort study of consecutive ApHCM patients from a large tertiary referral center in&#8230;Focused echocardiographic screening of the aortic valve and aorta in elite rugby playersArticleFunding Acknowledgements Type of funding sources: Other. Main funding source(s): Grant from the charitable organisation Cardiac Risk in the Young. Background Pre-participation cardiac screening (PPS) of professional rugby players in the United Kingdom consists of an ECG-based evaluation. However, structural abnormalities that would not manifest on&#8230;11 The bicuspid aortic valve &#8211; how does it present?Conference PaperIntroduction Bicuspid aortic valve (BAV) is the most common congenital cardiac abnormality affecting 1-2% of the general population. Subjects with BAV are frequently asymptomatic and are diagnosed incidentally, unless BAV is associated with significant valvular dysfunction with aortic stenosis (AS) or aortic regurgitation (AR). This study aims to i&#8230;201 Exploring the relationship between physical activity and covid-19 infection in a young, non-hospitalized cohort in the united kingdomConference PaperBackground Regular moderate-intensity exercise offers numerous health benefits. However, little is known about the prevalence of COVID-19 infection, illness duration and its association with cumulative physical activity among non-hospitalized young individuals. Aim We aimed to investigate the risk of COVID-19, and the relationship between illness&#8230;192 Prevalence and significance of right bundle branch block in young individuals; the experience of a nationwide cardiac screening programmeConference PaperBackground There is limited information on the clinical significance of complete right bundle branch block (CRBBB) in young asymptomatic individuals. We sought to determine the prevalence and prognostic significance of CRBBB by reporting on clinical outcomes of a nationwide cardiac screening programme for young individuals in the United Kingdom. M&#8230;2 Understanding cardiac and sudden death in young individuals: novel insights from the office for national statistics (ONS) in the United KingdomConference PaperBackground Previous data from the Office for National Statistics (ONS) (2002-2005) reported an incidence of sudden cardiac death (SCD) in the young of 1.8 per 100,000 per year. Aim We aimed to report on the incidence of cardiac and sudden cardiac death in individuals under the age of 35 years in England and Wales between 2013 and 2021, with the go&#8230;Prevalence and diagnostic significance of de-novo 12-lead electrocardiogram patterns following covid-19 infection in elite soccer playersArticleFunding Acknowledgements Type of funding sources: None. Background Considering that myocarditis is implicated in 5-15% of all exercise related sudden cardiac deaths in athletes, following a novel viral pandemic, the identification and risk-stratification of affected athletes remains an important priority. Given its widespread availability, the inc&#8230;Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer playersArticleBackground and aim The efficacy of pre-COVID-19 and post-COVID-19 infection 12-lead ECGs for identifying athletes with myopericarditis has never been reported. We aimed to assess the prevalence and significance of de-novo ECG changes following COVID-19 infection. Methods In this multicentre observational study, between March 2020 and May 2022, we&#8230;Prevalence and diagnostic significance of novel 12-lead ECG patterns following COVID-19 infection in elite soccer playersArticleBackground Identification of athletes with cardiac inflammation following COVID-19 can prevent exercise fatalities. The efficacy of pre and post COVID-19 infection electrocardiograms (ECGs) for detecting athletes with myopericarditis has never been reported. We aimed to assess the prevalence and diagnostic significance of novel 12-lead ECG patterns&#8230;Mending the broken Valentine heart: A Case report.ArticleFull-text availableBackground Mortality from myocardial infarction has been decreasing since the introduction of primary percutaneous intervention. Late complications still pose a dilemma, such as deterioration of left ventricle (LV) function, LV aneurysms and LV thrombus formation. If not adequately managed in a timely manner this can result in life threatening cons&#8230;viewC Outcomes of a nationwide cardiac screening programme in young individualsConference PaperBackground There is limited information on the impact of screening for conditions associated with sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in young individuals, outside the context of elite sport. We sought to determine the diagnostic yield of cardiac screening in young individuals and the incidence of SCA and SCD amongst individu&#8230;view11 Is pulmonary artery dilatation part of the athletic adaptation to exercise?Conference PaperIntroduction The ‘Athlete’s Heart’ is a well-established term used to describe the spectrum of structural and electrical cardiac adaptations to intensive exercise. Several studies have demonstrated the development of ventricular dilatation and hypertrophy in athletic individuals and cardiac magnetic resonance imaging (CMR) is well suited to assess&#8230;viewA Prevalence and diagnostic significance of novel 12-lead ECG patterns following COVID-19 infection in elite soccer playersConference PaperBackground Identification of athletes with cardiac inflammation following COVID-19 can prevent exercise fatalities. The efficacy of pre and post COVID-19 infection electrocardiograms (ECGs) for detecting athletes with myopericarditis has never been reported. Purpose To assess the prevalence and diagnostic significance of novel 12-lead ECG patterns&#8230;view2 Prevalence and diagnostic significance of novel 12-lead ecg patterns following COVID-19 infection in elite soccer playersConference PaperBackground Identification of athletes with cardiac inflammation following COVID-19 can prevent exercise fatalities. The efficacy of pre and post COVID-19 infection electrocardiograms (ECGs) for detecting athletes with myopericarditis has never been reported. Purpose To assess the prevalence and diagnostic significance of novel 12-lead ECG patterns&#8230;163 Outcomes of a nationwide cardiac screening programme in young individualsConference PaperBackground There is limited information on the impact of screening for conditions associated with sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in young individuals, outside the context of elite sport. We sought to determine the diagnostic yield of cardiac screening in young individuals and the incidence of SCA and SCD amongst individu&#8230;viewPrevalence and outcomes of WPW pattern in the young: a report from a nationwide cardiac screening programmeArticleFunding Acknowledgements Type of funding sources: None. Background Individuals with accessory pathways, also referred as the Wolff-Parkinson-White pattern (WPWp), are usually asymptomatic and fatal arrhythmias may be the first presentation. Risk stratification is recommended, with electrophysiological study (EPS) being the gold standard. Catheter&#8230;Cardiovascular Screening For AthletesChapterRace, gender and clinical presentation in apical hypertrophic cardiomyopathyArticleFunding Acknowledgements Type of funding sources: None. Background The apical variant of hypertrophic cardiomyopathy (ApHCM) has male predominance and is a relatively rare phenotype in Western population. Characteristics of female and black patients diagnosed with ApHCM are very limited in the existing literature. Purpose We aimed to investigate&#8230;viewClinical practice Exercise in the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) era: A Question and Answer session with the experts Endorsed by the section of Sports Cardiology & Exercise of the European Association of Preventive Cardiology (EAPC)ArticleRegular exercise has multiple benefits for physical and mental health, including the body&#8217;s ability to combat infections. The current COVID-19 pandemic and the social distancing measures employed to curtail the impact of the infection are likely to reduce the amount of usual physical activity being performed by most individuals, including habitual&#8230;viewGeneration of self-renewing immature dendritic cells from mouse spleen that can take up mycobacteria and present antigens to T cellsArticlePal R, Marwaha S, Pepponi I, Mann JFS, Paul MJ, Reljic R. Generation of self-renewing immature dendritic cells from mouse spleen that can take up mycobacteria and present antigens to T cells. APMIS 2010; 118: 729–38. Dendritic cells (DC) play a key role in driving the adaptive immune response to Mycobacterium tuberculosis (MTB), the causative patho&#8230;view

Dr. Sarandeep Marwaha

Consultant Cardiologist | Preventative & Specialist Heart Care

MBBS BSC, MRCP, PHD

Consultant Cardiologist | Preventative & Specialist Heart Care

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