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Alessandro Biffi

Alessandro Biffi
Med-Ex Medicine & Exercise s.r.l. · Cardiovascular Prevention

M.D., FESC
Scientific Director at Med-Ex - Medicine & Exercise srl

About

135
Publications
59,646
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9,208
Citations
Citations since 2017
44 Research Items
4441 Citations
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Publications

Publications (135)
Article
Full-text available
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children's weights and nutritional habits during the COVID-19 pandemic in Italy. In this cross-sectional observat...
Article
Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psych...
Article
The current guidelines of the European Society of Cardiology on cardiovascular (CV) prevention highlighted the importance of implementing coordinated set of action, including worksite, aimed at eliminating or minimizing the impact of CV disease and their related disabilities. Workplace wellness programs tend to focus on modifiable risk factors of n...
Article
Full-text available
Background Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatment of this syndrome are still poorly understood, even if evidences suggest the potential role of physical rehabilitation in improving symptoms in these patients. Aim of the study The aim of...
Article
Full-text available
Purpose: The “FIDE Project” (Fitness Implantable DEvice) was organized by the Institute of Sports Medicine and Science and the World Society of Arrhythmias with the aim of demonstrating the usefulness of exercise training in improving functional capacity in patients with implantable cardiac devices. Materials and Methods: Thirty sedentary patients...
Article
Molecular genetic testing is an increasingly available test to support the clinical diagnosis of inherited cardiovascular diseases through identification of pathogenic gene variants and to make a preclinical genetic diagnosis among proband's family members (so-called “cascade family screening”). In athletes, the added value of molecular genetic tes...
Article
Full-text available
Background Several pre-participation screening algorithms (PPSAs) have been proposed to assess sports eligibility in different populations. They are usually based on self-administered questionnaires, without further medical assessment if no risk factors are documented. The Med-Ex “Formula Benessere” worksite program includes a complete cardiovascul...
Article
Background Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID–19 infection. Natural history and treatments of this syndrome are still poorly understood, even if evidence suggests the potential role of physical rehabilitation in improving symptoms in these subjects. Aim The aim of the present...
Article
Background Ischemic cerebral and cardiac events are the leading causes of mortality and morbidity in Minor non–Disabling Stroke (MiNDS) patients. Control of cardiovascular risk factors, including physical activity levels, is a key strategy in secondary prevention of MiNDS. However, there is a gap between recommendations and real achieved physical a...
Article
Full-text available
Funding Acknowledgements Type of funding sources: None. Background Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatments of this syndrome is still poorly understood. In literature there is currently a lack of data on the real effectiveness of a multi...
Article
Funding Acknowledgements Type of funding sources: None. Background Ischemic cerebral and cardiac events are the leading causes of mortality and morbidity in Minor non-Disabling Stroke (MiNDS) patients. Control of cardiovascular risk factors, including physical activity levels, is a key strategy in secondary prevention of MiNDS. However, there is a...
Article
Full-text available
Background: Child musculoskeletal (MSK) diseases are common and, even if often benign, sometimes can lead to significant impairment in the future health of children. Italian pre-participation evaluation (PPE), performed by a sports medicine physician, allows for the screening of a wide range of children every year. Therefore, this study aims to ev...
Article
Full-text available
The aim of our study was to evaluate the prevalence, awareness, and control of hypertension in an apparently healthy company population. We conducted a cross-sectional study on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time to the Ferrari corporate wellness program “Formula Benessere”. Hypertension w...
Article
Full-text available
This executive document reflects and updates the key points of a Consensus document on Cardiovascular (CV) Prevention realized through the contribution of a number of Italian Scientific Societies and coordinated by the Italian Society of Cardiovascular Prevention (SIPREC). The aim of this executive document is to analyze and discuss the new recomme...
Chapter
The Formula 1 World Championship is the most popular single-seat race competition worldwide. Several teams participate by developing cars according to FIA (Federation Internationale de l’Automobile) regulations. Drivers and team members are exposed to injuries. Acute injuries could involve drivers during the race’s activities (i.e. accidents) or te...
Article
Full-text available
AimTo evaluate the incidence and clinical significance of impaired cardiorespiratory fitness (CRF) and the association with baseline blood pressure (BP) levels and hypertensive response to exercise (HRE).MethodsA cross-sectional study was conducted on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time at...
Chapter
This chapter analyzes the most frequent benign arrhythmias and conduction defects in athletes. These usually do not require an advanced diagnostic work-up, unless associated with other cardiac abnormalities. Therefore, these abnormalities are not usually reason of exclusion from competitive sports. If a suspicion of underlying cardiac disease is pr...
Conference Paper
Background: Several pre-participation screening algorithms (PPSAs) have been proposed to assess sports eligibility in different populations. Usually, they are based on self-administered questionnaires, without further medical assessment if no risk factors are documented. The Med-Ex “Formula Benessere” worksite Program includes a complete cardiovasc...
Article
Full-text available
Cardiovascular prevention represents one of the most important strategies of public health, since cardiovascular diseases are the first cause of morbidity and mortality worldwide. Measures to promote a healthy lifestyle and an adequate control of risk factors need be highlighted also during the COVID-19 outbreak, which has dramatically changed the...
Article
Full-text available
Since 1989, SIC Sport and a FMSI, in partnership with leading Italian Cardiological Scientific Associations (ANCE, ANMCO and SIC) have produced Cardiological Guidelines for Completive Sports Eligibility for athletes with heart disease (COCIS -- 1989, 1995, 2003, 2009 and 2017). The English version of the Italian Cardiological Guidelines for Competi...
Article
Full-text available
This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precauti...
Article
Full-text available
Preventive cardiology encompasses the whole spectrum of cardiovascular disease (CVD) prevention, at individual and population level, through all stages of life. This includes promotion of cardiovascular (CV) health, management of individuals at risk of developing CVD, and management of patients with established CVD, through interdisciplinary care i...
Article
In 2020, the Sars-Cov-2 pandemic is causing a huge and dramatic impact on healthcare systems worldwide. During this emergency, fragile patients suffering from other comorbidities, especially patients susceptible to or affected by cardiovascular disease, are the ones most exposed to the poorer outcomes. Therefore, it is still mandatory to continue t...
Chapter
Because of the neuro-autonomic remodeling with increased vagal tone, trained athletes commonly develop benign rhythm and conduction disturbances including sinus bradycardia, junctional rhythm, first-degree and second-degree Mobitz type-I atrioventricular block, that disappear with adrenergic stimulation during exercise and do not preclude sports pa...
Article
Full-text available
Introduction Age, gender, body mass index percentiles and the adherence to Mediterranean diet were investigated as potential predictor factors in this assessment. Aim To assess the parental perception of children's weight status. Methods This cross-sectional observational study was carried out during a corporate wellness program (Ferrari Formula...
Article
Full-text available
This paper presents a brief summary of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology (EAPC) on sports-participation in patients with coronary artery disease, coronary artery anomalies or spontaneous dissection of the coronary arteries, all entities being associated with myocardial ischae...
Article
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Article
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Owing to its undisputed multitude of beneficial effects, European Society of Cardiology guidelines advocate regular physical activity as a class IA recommendation for the prevention and treatment of cardiovascular disease. Nonetheless, competitive athletes with arterial hypertension may be exposed to an increased risk of cardiovascular events. Guid...
Chapter
Fitness centres are a major location for exercise. There is a lack of data on adverse cardiac events and the structure of cardiovascular safety at such centres. No European recommendation is available. However, sudden cardiac arrest at such centres has a documented higher survival rate. Potentials for prevention of cardiac events thus exist, althou...
Article
AIMS: The aim of our study was to assess the clinical significance of the exercise stress testing endpoints, namely 85% of maximal theoretical heart rate (MTHR), metabolic equivalent of task, and rating of perceived exertion (RPE), and their relation to electrocardiographic (ECG) changes in a healthy adult population. METHODS: A cross-sectional st...
Article
Full-text available
Myocardial diseases are associated with an increased risk of potentially fatal cardiac arrhythmias and sudden cardiac death/cardiac arrest during exercise, including hypertrophic cardiomyopathy, dilated cardiomyopathy, left ventricular non-compaction, arrhythmogenic cardiomyopathy, and myo-pericarditis. Practicing cardiologists and sport physicians...
Article
Full-text available
Current guidelines of the European Society of Cardiology advocate regular physical activity as a Class IA recommendation for the prevention and treatment of cardiovascular disease. Despite its undisputed multitude of beneficial effects, competitive athletes with arterial hypertension may be exposed to an increased risk of cardiovascular events. Thi...
Article
IntroductionPreventive strategies based on advice and interventions on lifestyle habits represent the most powerful resource available to reduce the burden of cardiovascular (CV) diseases. Workplace represents an unmissable context for lifestyle changes at population level. AimTo evaluate the mid-term efficacy of a corporate wellness program in a c...
Article
The difference between men and women is clear even just by looking at an electrocardiogram: females present higher resting heart rate, a shorter QRS complex length and greater corrected QT interval. The development of these differences from pubertal age onward suggests that sexual hormones play a key role, although their effect is far from being co...
Article
Trapezius muscle has a fundamental role in cervico-dorsal pain and posture. Often, in movements involving trapezius, the predominant activity is carried out by the upper trapezius, and many times this may be a risk factor for the integrity of the cervico-dorsal structures. To investigate the effects of physical exercise with the new device called t...
Article
Background Exercise-induced ventricular tachyarrhythmias raise clinical concern as a marker of increased risk in the presence of underlying cardiovascular disease. Objective The clinical significance of exercise-induced ventricular tachyarrhythmias in competitive athletes without evident cardiac abnormalities. Methods Exercise-ECG testing was per...
Article
Full-text available
The long-term outcome of athletes with frequent ventricular premature complexes (VPCs) and apparently normal heart has not been fully clarified. To evaluate the clinical and prognostic significance of VPCs and the influence of continuing sports activity during follow-up, we studied 120 healthy athletes (96 men; median age 16 years) in whom frequent...
Article
Full-text available
In Italy the existence of a law on health protection of competitive sports since 1982 has favored the creation and the revision of these cardiological guidelines (called COCIS), which have reached their fourth edition (1989-2009). The present article is the second English version, which has summarized the larger version in Italian. The experience o...
Chapter
Full-text available
Competitive sports activity is associated with an increase in the risk of sudden cardiovascular death in adolescents and young adults with clinically silent cardiovascular disorders. Strategies for primary prevention include screening programs based on history and physical examination alone or including electrocardiogram (ECG). ECG screening is mor...
Article
Sports-related cardiovascular events may occur in both young athletes and the general population, the latter having a higher absolute risk. In mass gathering sports events, the availability of an onsite emergency response plan including early access to automated external defibrillators by trained lay rescuers has been shown to improve survival amon...
Article
The Silences of the Archives, the Reknown of the Story. The Martin Guerre affair has been told many times since Jean de Coras and Guillaume Lesueur published their stories in 1561. It is in many ways a perfect intrigue with uncanny resemblance, persuasive deception and a surprizing end when the two Martin stood face to face, memory to memory, befor...
Article
Frequent ventricular premature beats (VPBs) may be discovered during preparticipation screening in asymptomatic apparently healthy athletes. Some authors hypothesize that they may be a manifestation of 'athlete's heart' and suggest a deconditioning period, which should document a regression of arrhythmias, to exclude a concealed disease. To test th...
Article
Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiogr...
Article
This article is a report of an international symposium, endorsed by the Section on Sports Cardiology of the European Association for Cardiovascular Prevention and Rehabilitation, the Italian Society of Sports Cardiology, and the Italian Federation of Sports Medicine, which was held within the 11th International Workshop on Cardiac Arrhythmias (Veni...
Article
Full-text available
Cardiovascular remodelling in the conditioned athlete is frequently associated with physiological ECG changes. Abnormalities, however, may be detected which represent expression of an underlying heart disease that puts the athlete at risk of arrhythmic cardiac arrest during sports. It is mandatory that ECG changes resulting from intensive physical...
Article
Full-text available
Participation in sports activity and regular physical training is associated with physiological structural and electrical changes in the heart (athlete's heart) that enable sustained increases in cardiac output for prolonged periods. Cardiovascular remodelling in the conditioned athlete is often associated with ECG changes. In rare cases, abnormali...
Article
This young elite tennis player, 14 years old, was referred for cardiologic evaluation in our Institute (in the year 1977) because of a second-degree atrio-ventricular (AV) block, type 1 observed on resting 12-lead ECG, performed at preparticipation screening. No known cardiovascular disease or symptoms (such as syncope, pre-syncope or dizziness and...
Article
Full-text available
Epidemiological, clinical and laboratory studies have yielded definitive evidence that physical activity is able to reduce the morbidity and mortality of cardiovascular diseases and to improve physical fitness and quality of life. Moreover, physical activ- ity seems to be capable of significantly reducing the risk of developing other chronic diseas...
Article
The aim of this study was to analyze the relation between the magnitude of training-induced left ventricular (LV) hypertrophy and the frequency and complexity of ventricular tachyarrhythmias in a large population of elite athletes without cardiovascular abnormalities. Ventricular tachyarrhythmias are a common finding in athletes, but it is unresolv...
Article
Epidemiological, clinical and laboratory studies have provided definitive evidence that physical activity is able to improve fitness and reduce cardiovascular morbidity and mortality. Moreover, physical exercise also seems to significantly reduce the risk of developing other chronic diseases such as obesity, osteoporosis, diabetes, tumours and depr...
Article
Epidemiological, clinical and laboratory studies have provided definitive evidence that physical activity is able to improve fitness and reduce cardiovascular morbidity and mortality. Moreover, physical exercise also seems to significantly reduce the risk of developing other chronic diseases such as obesity, osteoporosis, diabetes, tumours and depr...
Article
Full-text available
Epidemiological, clinical and laboratory studies have provided definitive evidence that physical activity is able to improve fitness and reduce cardiovascular morbidity and mortality. Moreover, physical exercise also seems to significantly reduce the risk of developing other chronic diseases such as obesity, osteoporosis, diabetes, tumours and depr...
Article
The Authors examined the electrocardiographic (ECC) traces of 6 387 children and pre-adolescents undergoing examination for the issuing of the "good health" certificate (Ministerial Decree of 28/02/1983) for admission to non-competitive sporting activities or for the medical certification for leisure sporting activities. The use of a basal ECG enab...
Article
The purpose of this study was to evaluate the impact of a long-term athletic training on the clinical course of bicuspid aortic valve. A group of 81 athletes (73 M, 8 F, 22.7 +/- 5.6 years) with bicuspid aortic valve was collected. Based on clinical and echocardiographic criteria, athletes were initially divided into 2 groups: the low-risk (51 athl...
Article
Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs character...
Article
This article is the report of an International Symposium endorsed by the European Society of Cardiology, held within the Venice Arrhythmias 2007: 10 International Workshop on Cardiac Arrhythmias (Venice, October 2007). The topics of the Symposium are the following: how to stratify the risk of sudden death in athletes; the role of different diagnost...
Article
Young competitive athletes are perceived by the general population to be the healthiest members of society. The possibility that highly trained athletes may have a potentially serious cardiac condition that can predispose to life-threatening tachyarrhythmias or sudden cardiac death seems paradoxical. Thus, differentiating the benign, exercise-induc...