CURRENT CONTROVERSIES IN EXERCISE AND CARDIOVASCULAR DISEASE (CCC-209)

Saturday, October 28, 2023

16:30 – 17:15 EST

Location: Palais, 513ABC

Target Audience: General: All cardiovascular (clinical and research) health professionals, Clinical cardiologists, Trainee (clinical)

Chair(s)

JM

James McKinney, MD, FRCP(C)

Clinical Assistant Professor
University of British Columbia
SportsCardiologyBC

Co-Chair(s)

Nathaniel Moulson, MD

Clinical Assistant Professor
University of British Columbia
University of British Columbia

Presenter(s)

Paul Dorian, MD, MSc

Professor of Medicine , University of Toronto
CHRS
University of Toronto
EK

Erin Karlstedt, MD, FRCPC (she/her/hers)

Cardiologist, Clinical Assistant Professor
Libin Cardiovascular Institute, University of Calgary
University of Calgary
Dominique J. Kushneriuk, MD, FRCPC (she/her/hers)

Clinical Assistant Professor
University of Saskatchewan
University of Saskatchewan

Handouts
Noah Lewis, MD, FRCPC

Cardiology Resident
142444
University of Toronto
Marie-Eve Piché, MD, Ph.D

Cardiologist
Quebec Heart and Lung Institute
Laval University
Ryan Quinn (he/him/his)

Cardiovascular Performance Fellow
Massachusetts General Hospital

Planning Committee Member(s)

Christina Luong, MD

Clinical Assistant Professor, Echocardiographer
CSE
University of British Columbia
BM

Barbara Morrison

PhD student
PP

Paul Poirier, MD Ph.D

Cardiologist
IUCPQ
Universite Laval

Disclosure(s):

James McKinney, MD, FRCP(C): No financial relationships to disclose

Nathaniel Moulson, MD: Amgen: Speaker/Honoraria (Terminated, November 30, 2022); HLS therapeutics: Speaker/Honoraria (Ongoing); Novartis: Speaker/Honoraria (Ongoing); Pfizer: Speaker/Honoraria (Ongoing)

Paul Dorian, MD, MSc: No financial relationships to disclose

Erin Karlstedt, MD, FRCPC: No financial relationships to disclose

Dominique J. Kushneriuk, MD, FRCPC: No financial relationships to disclose

Noah Lewis, MD, FRCPC: No financial relationships to disclose

Ryan Quinn: No financial relationships to disclose

Learning Objectives / Objectifs d'apprentissage:

At the end of this session participants will be able to / Au terme de cette conférence, vous serez:

become familiar with the current controversies and risk of exercise in persons with cardiovascular disease, including atherosclerotic coronary artery disease, inherited cardiomyopathies, and inflammatory heart disease;
become familiar with the management of exercise and cardiovascular disease, including atherosclerotic coronary artery disease, inherited cardiomyopathies, and inflammatory heart disease; and
gain an approach to return-to-sport for patients with a cardiovascular diagnosis, including the importance of shared-decision making.

Workshop Description: Exercise is associated with a marked reduction in cardiovascular morbidity and mortality. However, the physiologic and metabolic stress of exercise may increase the risk of cardiac morbidity and mortality in patients with cardiovascular disease and in some instances exercise in may potentiate disease progression and/or cardiac events (myocardial infarction, arrhythmia or sudden cardiac arrest). Traditional management has focused predominantly on restriction of exercise to attempt to mitigate any risk. Accumulating clinical experience and evidence has shifted the recommended approach to a more permissive one. However, significant clinical uncertainties in management remain.

The workshop will be case-based and present three commonly encountered conditions in clinical cardiology: 1) coronary artery disease (CAD), 2) myocarditis, and 3) hypertrophic cardiomyopathy. Each condition will be presented in a clinical case format followed by panel discussion of current controversies, evidence and recommendations. Panel and audience engagement will then commence.

‘Return-to-play’ guideline recommendations for patients with cardiovascular disease are often overly binary and may be difficult to apply at the individual patient level in clinical practice. This workshop will focus on highlighting these uncertainties, and their management, including highlighting updates from the literature when possible.

The workshop will provide a framework for the management of patients with cardiovascular disease who wish to participate in higher volumes and intensity of exercise, focusing on three common conditions and scenarios encountered in clinical practice. This framework will include the principles of exercise prescription and safe exercise that can be applied to all patients with cardiovascular disease.

Case presenters and discussants will present succinct cases and discussion to highlight any risk of exercise, dispel misconceptions, and provide guidance towards guideline-based recommendations for management of patients with cardiovascular disease performing higher volumes and intensity of exercise.