Sanjay Sharma

Sanjay Sharma
St George's, University of London | SGUL · Cardiovascular Sciences Research Centre

BSc (Hons), MBChB, MD, FRCP FESC

About

785
Publications
260,027
Reads
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22,454
Citations
Introduction
Sanjay Sharma currently works at the Cardiovascular Sciences Research Centre, St George's, University of London. His group specialises in research in sports cardiology, sudden cardiac death in the young, cardiomyopathies, ion channel disease, and preventative strategies for young sudden cardiac death'. Over the past few years the main publications relate to (1) diagnostic yield and outcomes of cardiac screening in a well characterised athlete cohort. (2) precise cause of sudden cardiac death in competitive athletes. (3) novel diseases entities implicated in sudden cardiac death in the young. (4) novel risk stratification tools for diseases implicated in young sudden cardiac death. (5) characterising cardiovascular adaptation in master athletes.
Additional affiliations
February 2010 - present
St George's, University of London
Position
  • Professor (Full)
Description
  • Head of research for the cardiac clinical and academic group Co-lead for tertiary inherited cardiac diseases service Lead for large sports cardiology unit Lead for the CRY pre-participation cardiac screening in the young
February 2010 - present
St George's, University of London
Position
  • Head of Department

Publications

Publications (785)
Article
Full-text available
To describe the overlap between structural abnormalities typical of arrhythmogenic right ventricular cardiomyopathy (ARVC) and physiological right ventricular adaptation to exercise and differentiate between pathologic and physiologic findings using CMR. We compared CMR studies of 43 patients (mean age 49 ± 17 years, 49% males, 32 genotyped) with a...
Article
Background: Physiological cardiac remodeling in highly trained athletes may overlap with dilated cardiomyopathy (DCM). Objectives: the aim of this study was to investigate the role of the electrocardiogram (ECG) in differentiating between physiological and pathological remodeling. Methods: The study population consisted of 30 patients with DCM...
Article
Funding Acknowledgements Type of funding sources: None. Background Non-specific myocardial fibrosis (NSMF) is a heterogeneous entity whose clinical significance remains unknown. Purpose We aimed to evaluate a cohort of young competitive athletes with and without NSMF to establish potentially clinically significance. Methods We analysed data from...
Article
Funding 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...
Article
The use of substances and medications with potential cardiovascular effects among those practicing sports and physical activity has progressively increased in recent years. This is also connected to the promotion of physical activity and exercise as core aspects of a healthy lifestyle, which has led also to an increase in sport participation across...
Article
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Background: Asian representation in sport is increasing, yet there remains a lack of reference values for the Asian athlete’s heart. Consequently, current guidelines for cardiovascular screening recommend using Caucasian athletes’ norms to evaluate Asian athletes. This study aims to outline electrocardiographic and echocardiographic characteristics...
Article
Full-text available
Aims Physiological cardiac remodelling in highly trained athletes may overlap with dilated cardiomyopathy (DCM). The aim of this study was to investigate the role of the ECG in differentiating between physiological and pathological remodelling. Methods and results The study population consisted of 30 patients with DCM who revealed a pathogenic var...
Article
Objective We assessed the diagnostic yield and costs of an ECG-based national screening programme in elite cricket players and the incremental value of transthoracic echocardiography (TTE) and periodic evaluation. Design Cross-sectional study. Method Between 2008 and 2019, 1208 cricketers underwent screening with health questionnaire (HQ), 12‑lea...
Conference Paper
Full-text available
Introduction Bicuspid aortic valve (BAV) is the most common congenital cardiovascular abnormality. Cardiac MRI (CMR) is commonly used to screen for aortic dilatation and associated abnormalities. Sudden death has been reported, often due to aortic stenosis (AS) or dissection, but it has been hypothesised that areas of fibrosis may be a substrate fo...
Article
Participation in regular exercise of moderate intensity is associated with a plethora of systemic benefits, including a reduction in risk factors for coronary atherosclerosis; however, intensive exercise may paradoxically culminate in sudden cardiac arrest among individuals harboring arrhythmogenic substrates. The precise mechanism for arrhythmogen...
Article
Abundance of brown plant hopper (BPH) Nilaparvatalugens (Stål) (Delphacidae: Homoptera) is modulated by prevalent weather conditions of rice growing seasons and locations. Categorization of BPH adults caught in light traps (nos/week/trap) into low, moderate and high and formulation of criteria accounting weather variables [maximum/ minimum/ mean te...
Article
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Background Electrophysiological, imaging, and pathological studies have reported the presence of subtle structural abnormalities in hearts from patients with Brugada syndrome (BrS). However, data concerning disease involvement outside of the right ventricular outflow tract are limited. Objectives This study sought to characterize the presence and...
Article
Background The relationship between resting echocardiographic measures of cardiac function and exercise capacity is weak. The details of ventricular augmentation may provide insight into determinants of cardiac efficiency for optimal exercise performance. The aims of this study were to establish how much of the variability in exercise performance c...
Article
Funding 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...
Article
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The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC)
Conference Paper
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Objectives To investigate the effect of lifelong exercise on right heart size and function in a large group of female master athletes. Background The benefits of moderate exercise are well known, however several studies have raised concerns about the association between excessive endurance exercise and adverse right ventricular (RV) cardiac remode...
Conference Paper
Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regimes. Purpose To assess the feasibility, safety and outcomes of an individually tailored, HIT programme in yo...
Conference Paper
Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regimes. PurposeTo assess the feasibility, safety and outcomes of an individually tailored, HIT programme in youn...
Conference Paper
Background Ostensibly healthy male master endurance athletes have a greater prevalence of high coronary calcium (CAC) scores and coronary artery plaque burden, compared to similar aged, healthy sedentary counterparts. A number of theories have been postulated but reasons remain unclear. Hypertension is the leading cardiovascular risk factor in the...
Article
Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Cardiac Risk in the Young Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regim...
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
Moderate physical exercise is associated with an irrefutable reduction in cardiac morbidity and mortality. The current guidelines recommend at least 150 min of moderate exercise or 75 min of vigorous exercise per week. Endurance athletes perform exercise at a level that is 10- to 20-fold greater than these recommendations. These athletes reveal sev...
Article
Full-text available
The cessation of amateur and recreational sport has had significant implications globally, impacting economic, social and health facets of population well-being. As a result, there is pressure to resume sport at all levels. The ongoing prevalence of SARS-CoV-2 and subsequent ‘second waves’ require urgent best practice guidelines to be developed to...
Article
Full-text available
Aims: There is limited information on the role of screening with electrocardiography (ECG) for identifying cardiovascular diseases associated with sudden cardiac death (SCD) in a non-select group of adolescents and young adults in the general population. Methods and results: Between 2012 and 2014, 26 900 young individuals (aged 14-35 years) were...
Article
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Funding Acknowledgements Type of funding sources: Other. Main funding source(s): I have received a research fellowship grant from the UK based charity Cardiac Risk in the Young Objectives We investigated the effect of long-term exercise and sex on left ventricular (LV) geometry in a large group of female and male masters athletes. Background Stud...
Article
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Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Barts Cardiovascular Biomedical Research Centre Onbehalf The Marathon Study Consortium Introduction Cardiovascular function depends on the inter-relation between heart and vasculature. The contribution of aort...
Article
Full-text available
The diagnosis of a potentially lethal cardiovascular disease in a young athlete presents a complex dilemma regarding athlete safety, patient autonomy, team or institutional risk tolerance and medical decision-making. Consensus cardiology recommendations previously supported the ‘blanket’ disqualification of athletes with hypertrophic cardiomyopathy...
Article
Myocardial disarray is defined as disorganized cardiomyocyte spatial distribution, with loss of physiological fibre alignment and orientation. Since the first pathological descriptions of hypertrophic cardiomyopathy (HCM), disarray appeared as a typical feature of this condition and sparked vivid debate regarding its specificity to the disease and...
Article
As our understanding of the complications of coronavirus disease-2019 (COVID-19) evolve, subclinical cardiac pathology such as myocarditis, pericarditis, and right ventricular dysfunction in the absence of significant clinical symptoms represents a concern. The potential implications of these findings in athletes are significant given the concern t...
Article
Full-text available
Background - Brugada syndrome (BrS) is characterized by the type 1 Brugada ECG pattern. Pathogenic rare variants in SCN5A (mutations) are identified in 20% of BrS families in whom incomplete penetrance and genotype-negative phenotype-positive individuals are observed. E1784K- SCN5A is the most common SCN5A mutation identified. We determined the ass...
Article
Background Contemporary studies in hypertrophic cardiomyopathy (HCM) suggest that moderate intensity exercise can improve cardiorespiratory fitness without raising significant safety concerns. Although low/moderate intensity exercise may be appropriate for older HCM patients, it is unlikely to attract younger, often asymptomatic patients, who wish...
Chapter
Exercise-related sudden death from a previously quiescent cardiac disorder is a highly visible event, particularly when a high-profile athlete is affected. A comprehensive assessment to identify the diverse spectrum of potential causes is cost-prohibitive, given the rarity of such catastrophes. The 12-lead ECG, which is among the simplest of cardia...
Article
Full-text available
Healthcare services globally are combating the impact of SARS-CoV-2 and associated COVID-19 infection, which has caused significant morbidity and mortality across all affected countries.1 Whilst the medical community and resources have focused on this pandemic, it is important to consider that cardiovascular disease remains the most common cause of...
Article
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Introduction: Although there is evidence that a significant proportion of veteran athletes have coronary atherosclerotic disease (CAD), its prevalence in recreational athletes with low to intermediate cardiovascular (CV) risk is not established. This study aimed to characterize the coronary atherosclerotic burden in veteran male recreational athle...
Article
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Purpose: Stringent variant interpretation guidelines can lead to high rates of variants of uncertain significance (VUS) for genetically heterogeneous disease like long QT syndrome (LQTS) and Brugada syndrome (BrS). Quantitative and disease-specific customization of American College of Medical Genetics and Genomics/Association for Molecular Patholog...
Article
PURPOSE: Stringent variant interpretation guidelines can lead to high rates of variants of uncertain significance (VUS) for genetically heterogeneous disease like long QT syndrome (LQTS) and Brugada syndrome (BrS). Quantitative and disease-specific customization of American College of Medical Genetics and Genomics/Association for Molecular Patholog...
Article
Full-text available
SARS-CoV-2 is the causative virus responsible for the COVID-19 pandemic. This pandemic has necessitated that all professional and elite sport is either suspended, postponed or cancelled altogether to minimise the risk of viral spread. As infection rates drop and quarantine restrictions are lifted, the question how athletes can safely resume competi...
Chapter
Exercise-related sudden death from a previously quiescent cardiac disorder is a highly visible event, particularly when a high-profile athlete is affected. A comprehensive assessment to identify the diverse spectrum of potential causes is cost-prohibitive, given the rarity of such catastrophes. The 12-lead ECG, which is among the simplest of cardia...
Article
Full-text available
Improved clinical care has led to an increase in the number of adults with congenital heart disease (CHD) engaging in leisure time and competitive sports activities. Although the benefits of exercise in patients with CHD are well established, there is a low but appreciable risk of exercise-related complications. Published exercise recommendations f...
Article
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Regular intensive exercise is associated with a plethora of electrical, structural and functional adaptations within the heart to promote a prolonged and sustained increase in cardiac output. Bradycardia, increased cardiac dimensions, enhanced ventricular filling, augmentation of stroke volume and high peak oxygen consumption are recognised feature...
Article
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Marked adaptation of left ventricular (LV) structure in endurance athletes is well established. However, previous investigations of functional and mechanical adaptation have been contradictory. A lack of clarity in subjects’ athletic performance level may have contributed to these disparate findings. This study aimed to describe structural, functio...
Article
This paper belongs to a series of recommendation documents for participation in leisure-time physical activity and competitive sports by the European Association of Preventive Cardiology (EAPC). Together with an accompanying paper on supraventricular arrhythmias, this second text deals specifically with those participants in whom some form of ventr...
Chapter
A young elite cyclist was investigated for episodes of fast heart rate shortly after exercise. A wide-complex tachycardia with right-bundle branch morphology was recorded and complete work-up documented a structurally normal heart. Electrophysiologic testing confirmed a diagnosis of idiopathic fascicular left ventricular tachycardia and successful...
Article
Full-text available
Regular exercise has multiple benefits for physical and mental health, including the body'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...
Article
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Extensive clinical research has provided robust evidence that exercise is a cost‐effective measure to substantially alleviate the burden of a large number of diseases, many of which belong to the cardiovascular (CV) spectrum. In terms of cardiac benefit, the positive effects of exercise are attributed to improvements in standard risk factors for at...
Article
Full-text available
The original designation of “Arrhythmogenic right ventricular (dysplasia/) cardiomyopathy”(ARVC) was used by the scientists who first discovered the disease, in the pre-genetic and pre-cardiac magnetic resonance era, to describe a new heart muscle disease predominantly affecting the right ventricle, whose cardinal clinical manifestation was the occ...
Article
Aims: Remodelling of the cardiovascular system (including heart and vasculature) is a dynamic process influenced by multiple physiological and pathological factors. We sought to understand whether remodelling in response to a stimulus, exercise training, altered with healthy ageing. Methods: A total of 237 untrained healthy male and female subjects...
Article
Full-text available
Introduction: Cardiac screening in competitive athletes is now recommended by most scientific and sporting organisations. Screening non­athletic young individuals has been challenged. Absence of a definite phenotype can falsely reassure those screened. Genetics may possibly help identify those with a pre­-clinical state. Objectives: To explore th...