François Carré

• MD, PhD
• Head of Department at Centre Hospitalier Universitaire de Rennes-Rennes1 Unviersity

The primary objective of this study was to investigate the associations between sport participation and weight status with physical fitness among French adolescents. The secondary aim was to establish sex- and age-specific physical fitness percentiles for French adolescents. The sample comprised 8084 adolescents (4126 boys, 3958 girls), aged 10–14...

Introduction Prolonged and repeated exercise performed during an ultra-endurance event can induce general and cardiac fatigue known as exercise-induced cardiac fatigue. Our objective was to find a possible correlation between the cardiac function and the autonomic cardiac function. Methods During a multistage ultra-endurance event, a female well-t...

Background Cardiorespiratory fitness (CRF) is a strong marker of current and future health. The aim of this study was to assess the national temporal trends in CRF for French children and adolescents between 1999 and 2022. Methods CRF data were obtained from several cross‐sectional studies on 15 420 (51.1% boys) French children and adolescents age...

Purpose Effects of intense and/or prolonged exercise have been studied extensively in male athletes. Nevertheless, data are scare on the effect of long duration events on cardiac function in female athletes. Our aim was to investigate the effect of a long-lasting moderate-intensity stage cycling event on cardiac function of young female athletes....

Background: There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France. Methods: Based on...

Background There is strong evidence showing that sedentary behaviour (SB) increase the risk to develop several chronic diseases and to premature death (Chau et al., 2015). A dose response relation is observed with a more marked risk when people spend more than 7 hours/day in sitting position (Ekelund et al., 2019). The study INCA 3 on the lifestyle...

Background There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France. Methods Based on in...

Purpose: This study aimed at assessing the prevalence of adverse cardiac events, as identified in the media, in world-class athletes according to their sex and sports discipline. Methods: All female and male' athletes, from 30 individual Olympic sports, ranked in the international yearly top 10 between 2006-2018, were included. The name of each...

Purpose: Data are scarce concerning the sustainable effects of cardiac rehabilitation (CR), on cardiorespiratory fitness (CRF) of patients with coronary artery disease (CAD). This study, carried out using data from a French multicenter study, aimed to clarify the evolution of the CRF of patients with CAD 1 yr after the end of a CR stay. Methods:...

Background: Echocardiographic signs of exercise-induced cardiac fatigue (EICF) have been described after strenuous endurance exercise. Nevertheless, few data are available on the effects of repeated strenuous exercise, especially when associated with other constraints as sleep deprivation or mental stress which occur during military selection boot...

Background: Cardiac rehabilitation (CR) is the right place to optimize the medical treatment in coronary artery disease (CAD) patients. Aims: To report the medical management in CAD patients during CR and evaluate the consequences. Methods: CAD patients who attended a CR program within less than three months of an acute coronary syndrome (ACS)...

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...

Background Appropriate advice for the practice of sport in patients with a cardiomyopathy is a challenging issue. Recent evolution towards more comprehensive and tailored recommendations may facilitate the clinical practice. However, neither their application in real life has been evaluated nor the concordance within clinicians. Methods We submitt...

Background Heart rate (HR) and HR variability (HRV) indices are established tools to detect abnormal recovery status in athletes. A low HR and vagally mediated HRV index change between supine and standing positions reflected a maladaptive training stress-recovery status. Objectives Our study was focused on a female multistage cycling event. Its ov...

Background and Objectives: Hemodynamic stress during resistance training is often a reason why this training method is not used in cardiac patients. A lifting protocol that imposes rests between repetitions (IRRT) may provide less hemodynamic stress compared to traditional resistance training (TT). The aim of this study was to verify differences be...

L’activité physique adaptée (APA) se définit comme une activité physique ou sportive adaptée aux capacités de personnes à besoins spécifiques : atteintes de maladies chroniques, vieillissantes, en situation de handicap ou vulnérables. Elle mobilise des connaissances scientifiques pluridisciplinaires pour évaluer les ressources et les besoins des in...

Background and Objectives: Hemodynamic stress during resistance training is often a reason why this training method is not used in cardiac patients. A lifting protocol that imposes rests between repetitions (IRRT) may provide less hemodynamic stress compared to traditional resistance training (TT). The aim of this study was to verify differences be...

According to recent epidemiologic studies, myocarditis represents one of the major causes of sudden cardiac death among young competitive athletes. Myocarditis can be caused by infectious agents (with viral myocarditis being the leading cause), systemic auto-immune diseases, medical drugs and toxic agents. Since myocarditis is an acquired disease,...

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...

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...

Background The new North American guidelines for participation in competitive sport in patients with coronary artery disease (CAD) are less restrictive than previous guidelines. Aim To evaluate the incidence of major adverse cardiac events (MACE) in men with CAD who practise intensive physical activity after a stenting procedure. MACE included in-...

Objectives This study aimed to analyze the daily heart rate variability (HRV) in well-trained female cyclists during the 2017 Tour de France circuit and to relate it to the load and perceived exertion response. Methods Ten female cyclists volunteered to participate in the study. HRV was recorded with a portable heart rate monitor each morning at r...

Exercise is a major stress for the cardiovascular system, and therefore many adverse cardiac events can occur during intense exercise. Thus it makes sense to perform maximal exercise testing when assessing an athlete presenting with exertional symptoms, with a known cardiac disease, or for pre-participation evaluation. Nevertheless, the limits of e...

Sport and exercise have been intensely advocated as protective lifestyle measures, preventing or reducing the risk of severe health issues including cardiovascular disease. More extreme forms of sport (for instance at high altitudes) have been identified as an important way of promoting cardiovascular adaptation, but have also been associated with...

Background: In the ICD Sports Safety Registry, death, arrhythmia- or shock-related physical injury did not occur in athletes who continue competitive sports after implantable cardioverter-defibrillator (ICD) implantation. However, data from non-competitive ICD recipients is lacking. This report describes arrhythmic events and lead performance in i...

Ce document présente la synthèse et les recommandations issues des travaux du groupe d’experts réunis par l’Inserm dans le cadre de la procédure d’expertise collective (voir annexe) pour répondre à la demande du Ministère chargé des sports concernant la prévention et le traitement des maladies chroniques par l’activité physique1. Ce travail s’appui...

It is established that an intensive training results in a lower average resting heart rate. Management of bradycardia in an athlete can be difficult given the underlying mechanisms are not clearly understood. The authors reviewed the different mechanisms described in the literature, including recent advances in physiology regarding remodeling of io...

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...

Résumé Les objectifs comportementaux du patient coronarien nécessitent une prise en charge active de la part du cardiologue. Tout fumeur doit être clairement informé des conséquences cardiovasculaires du tabagisme et des bénéfices majeurs liés au sevrage. Le seul conseil d’« arrêter de fumer » ne suffit pas. Il faut utiliser les « traitements » val...

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...

The exercise test is still a key examination in cardiology, used for the diagnosis of myocardial ischemia, as well as for the clinical evaluation of other heart diseases. The cardiopulmonary exercise test can further define functional capacity and prognosis for any given cardiac pathology. These new guidelines focus on methods, interpretation and i...

The exercise test is performed routinely in cardiology; its main indication is the diagnosis of myocardial ischemia, evaluated along with the subject's pretest probability and cardiovascular risk level. Other criteria, such as analysis of repolarization, must be taken into consideration during the interpretation of an exercise test, to improve its...

Long QT syndrome (LQTS) is an inherited channelopathy which exposes athletes to a risk of sudden cardiac death. Diagnosis is more difficult in this population because: The QT interval is prolonged by training; and the extreme bradycardia frequently observed in athletes makes the QT correction formula less accurate. Based on limited clinical data wh...

The study objectives are (1) to draw up an inventory of the use of heart rate recovery (HRR) and heart rate variability (HRV) by European professional football clubs, and (2) to analyse these practices in relation with the scientific literature. A survey was filled by 137 clubs playing in the top European divisions. The survey had the aim of identi...

Aims: The distinction between left ventricular (LV) dilation with mildly reduced LV ejection fraction (EF) in response to regular endurance exercise training and an early cardiomyopathy is a frequently encountered and difficult clinical conundrum. We hypothesized that exercise rather than resting measures would provide better discrimination betwee...

Aims: Intensive endurance sport practice is associated with an increased risk of atrial fibrillation (AF) in male veteran athletes. Paroxysmal AF (PAF) is the very beginning step of this disease. The description of atrial remodelling occurring at this early stage might enable to depict predictive factors of AF in veteran athletes in order to give...

Background: Cardiovascular events related to high-intensity sport practice are rare but dramatic. Coronary artery disease (CAD) is the leading cause of these events after the age of 35 years. The value of a maximal exercise test (ET) for detection of athletes at risk remains a matter of debate. Aim: The aim of this prospective multicentre study...

Background: Previous studies have demonstrated that global longitudinal strain (GLS) is altered in patients with hypertrophic cardiomyopathy (HCM) in comparison with athletes. Nevertheless, these results rely on studies comparing sedentary patients with HCM with healthy athletes. The aims of this study were to confirm these findings in an appropri...

The aim of this study was to evaluate whether endurance athletes who exhibit deep bradycardia are more prone to arrhythmias and reflex syncope than their non-bradycardic peers. 46 healthy men (ages 19-35) were divided into 3 groups based on whether they were sedentary (SED,<2 h/week) or endurance trained (ET,>6 h/week), and non-bradycardic (NB, res...

It is unknown whether commencing structured endurance training after 40 years of age is powerful enough to induce beneficial cardiovascular adaptations in later life. 34 men between the ages of 55 and 75 were included: 10 life-long sedentary seniors (SED), 13 endurance master athletes who commenced training≤30 years of age (ET30), and 11 endurance...

Describing and analyzing heart multiphysics requires the acquisition and fusion of multisensor cardiac images. Multisensor image fusion enables a combined analysis of these heterogeneous modalities. We propose to register intra-patient multiview 2D+t ultrasound (US) images with multiview late gadolinium-enhanced (LGE) images acquired during cardiac...

Head up tilt test is a well-known medical procedure used to diagnose vasovagal syncope. Several studies have focused on the early prediction of the outcomes of this test to predict syncope before its occurrence. Therefore, the evaluation of the dynamic interactions between several cardiovascular variables can play an important role to improve our u...

Aims: Rest echocardiography plays a role in hypertrophic cardiomyopathy (HCM) diagnosis and risk stratification because left atrial enlargement, severe left ventricle (LV) hypertrophy, and rest LV outflow tract (LVOT) gradients ≥50 mmHg are sudden cardiac death risk factors that have been highlighted in recent guidelines. Conversely, the lack of e...

We are pleased to address questions raised by Wheeler and colleagues concerning the identified high prevalence of hypertrophic cardiomyopathy (HCM) in our recent publication.1 The aim of our study was to prospectively determine the prevalence of cardiac pathology in athletes presenting with pathological T-wave inversion (PTWI), and to examine the e...

Regular intensive exercise in athletes increases the relative risk of sudden cardiac death (SCD) compared with the relatively sedentary population. Most cases of SCD are due to silent cardiovascular diseases, and pre-participation screening of athletes at risk of SCD is thus of major importance. However, medical guidelines and recommendations diffe...

Introduction Les patients dialysés subissent une dysfonction musculaire progressive. Une part d’entre eux ne peut pas suivre de réentraînement classique. L’électromyostimulation (EMS) qui entraîne une contraction musculaire non volontaire par stimulation percutanée est utilisée avec succès chez les patients insuffisants cardiaques et respiratoires....

The analysis of cardiac dynamics based on time series extracted from cardiovascular signals (e.g. electrocardiogram, blood pressure) is relevant for differentiating between normal and pathological cases with feasible functions in the diagnosis and risk estimation. In this study, the dynamic behavior of cardiovascular time series is analyzed using r...

There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about availab...

Essentials moderate and regular physical activity is beneficial at any age and whatever medical and surgical history. His practice must always be encouraged. The practice of a sport competition has no additional health benefit. The signs of athlete's heart may exit standards, we must know them to prevent against abusive indications. In some typical...

Subepicardial delayed gadolinium enhancement (DGE) patches without underlying cardiomyopathy is poorly understood. It is often reported as the result of prior silent myocarditis. Its prognostic relevance in asymptomatic athletes is unknown; therefore, medical clearance for competitive sports participation is debated. This case series aims to relate...

Background—The phenotype of individuals with hypertrophic cardiomyopathy (HCM) who exercise regularly is unknown. This study characterized the clinical profile of young athletes with HCM. Methods and Results—The electrical, structural, and functional cardiac parameters from 106 young (14–35 years) athletes with HCM were compared with 101 sedentar...

The purpose of the present study was to evaluate the prognostic value of left atrial (LA) mechanics and stiffness in a prospective cohort of 82 asymptomatic patients (31 men, mean age 73±10 years) with severe aortic stenosis (AS) and normal left ventricular ejection fraction. Methods: By the use of 2-dimensional speckle tracking echocardiography, L...

Abstract Background Although atrial function has prognostic significance in many cardiovascular conditions, changes during exercise have not previously been assessed. The aim of this study was to evaluate left atrial (LA) and right atrial (RA) volume and function during incremental exercise, both in normal individuals, healthy athletes, and in pati...

We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities). This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA d...

The observation of T-wave inversion (TWI) on the resting 12-Lead ECG of an asymptomatic athlete is one of the most troublesome sports cardiology conundrums. TWI (except in leads aVR, III and V1, V1-V3 in young adolescent athletes (<16 years old) and in V1-V4 when preceded by domed ST segment in asymptomatic Afro-Caribbean athletes only) is rarely o...

Pathological T-wave inversion (PTWI) is rarely observed on the ECG of healthy athletes, whereas it is common in patients with certain cardiac diseases. All ECG interpretation guidelines for use within athletes state that PTWI (except in leads aVR, III and V1 and in V1-V4 when preceded by domed ST segment in asymptomatic Afro-Caribbean athletes only...

Points essentiels L’activité physique régulière et modérée est bénéfique à tout âge et quels que soient les antécédents médico-chirurgicaux. Sa pratique doit donc toujours être encouragée. La pratique d’une activité sportive de compétition ne présente aucun effet bénéfique sanitaire supplémentaire. Les signes du cœur d’athlète peuvent sortir des no...

Purpose: Although delayed-enhancement magnetic resonance imaging (DEMRI) is essential for diagnosis of cardiac sarcoidosis (CS), the test was not available when pacemaker was implamted. Recently, MR-conditional pacemaker has become avilable and we hypothesized that this device would be useful for diagnosis and management of CS. The aim of this stud...

Non-traumatic sudden death related to sport is a rare but always dramatic event. Its causes are mainly cardiovascular. Prevention of sudden death depends on effective medical examination involving history, physical examination and resting ECG, as education of athletes who must follow the rules for safe sport practice and lastly training for emergen...

This study aims to analyze the autonomic nervous system response during head-up tilt test (HUTT), by exploring the changes in dynamic properties of heart rate variability in subjects with and without syncopes, to predict the outcome of HUTT. Baroreflex response, as well as linear and non-linear parameters of RR-interval time series, have been extra...

The aim of this study is to evaluate the cost-effectiveness of ECG in combination with family and personal history and physical examination in order to detect cardiovascular diseases that might cause sudden death in athletes. The study was conducted on a cohort of 6,634, mainly young professional and recreational athletes, 1,071 from Algeria and 5,...

Non-traumatic sudden death related to sport is a rare but always dramatic event. Its causes are mainly cardiovascular. Prevention of sudden death depends on effective medical examination involving history, physical examination and resting ECG, as education of athletes who must follow the rules for safe sport practice and lastly training for emergen...

Implantable cardioverter-defibrillators (ICDs) prevent sudden arrhythmic death in patients with different arrhythmogenic cardiac diseases. Because intense physical activity may trigger ventricular arrhythmias and may favour inappropriate shock delivery that impacts quality of life, current international recommendations only give clearance for moder...

Recent efforts have focused on improving specificity of the European Society of Cardiology (ESC) criteria for ECG interpretation in athletes. These criteria are derived predominantly from white athletes (WAs) and do not account for the effect of Afro-Caribbean ethnicity or novel research questioning the relevance of several isolated ECG patterns. W...

In this study, we evaluate the ability to automatically predict syncope and differentiate between patients with positive response to head up tilt test (HUTT) and other with negative response, using only 12-min RR-interval time series for the supine position, preceding HUTT. An original method, based on the analysis of heart rate variability dynamic...