De Bosscher · BMJ open sport & exercise medicine 2022 · prospective cohort study protocol · n=300 planned

Rationale and design of the PROspective ATHletic Heart (Pro@Heart) study: long-term assessment of the determinants of cardiac remodelling and its clinical consequences in endurance athletes.

Cited 38 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Study protocol paper presenting design and rationale with no empirical data

PubMed 35368514 · doi:10.1136/bmjsem-2022-001309 · record verified 2026-08-29

What was done

This paper describes the protocol and rationale for the Pro@Heart study, a prospective multicentre cohort study. The planned design enrolls 300 elite endurance athletes aged 14 to 23 years with comprehensive cardiovascular phenotyping via echocardiography, cardiac MRI, 12-lead ECG, exercise-ECG, and 24-hour Holter monitoring. Genotyping will use a custom cardiomyopathy gene panel and high-density single-nucleotide polymorphism arrays. Longitudinal follow-up includes online training load tracking, with repeat phenotyping scheduled at 2, 5, 10, and 20 years.

What was found

No numerical results or outcome data are reported in the abstract. The paper reports only study design, recruitment targets, phenotyping methods, and planned endpoints.

Why it matters

Exercise-induced cardiac remodelling can overlap phenotypically with inherited cardiomyopathies. Establishing a 20-year cohort linking quantified training dose and genetic architecture to structural changes may clarify which athletic cardiac adaptations are benign and which represent pathology.

Limits

The abstract reports no empirical findings or completed observations. The protocol is restricted to young elite endurance athletes aged 14 to 23 years, limiting direct generalisability to older athletes, recreational exercisers, or non-endurance sports. A 20-year multi-timepoint longitudinal design faces inherent risks of participant drop-out and incomplete long-term training load tracking.

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