IJCS | Volume 32, Nº4, July/August 2019

324 Claudio Gil Soares de Araújo, MD, PhD Director of Research and Education Exercise Medicine Clinic - CLINIMEX cgaraujo@iis.com.br Barry Franklin PhD William Beaumont Hospital - Cardiac Rehabilitation Royal Oak, Michigan - USA Barry.Franklin@beaumont.edu Philip Millar PhD University of Guelph - Department of Human Health and Nutritional Sciences Guelph, Ontario - Canada pmillar@uoguelph.ca Jurgen Scharhag MD University of Vienna Wien, Wien - Austria juergen.scharhag@univie.ac.at Josef Niebauer MD, PhD, MBA Paracelsus Medical University Salzburg - Institute of Sports Medicine, Prevention and Rehabilitation Salzburg, Salzburg - Austria j.niebauer@salk.at Jonathan Myers PhD Stanford University - VA Palo Alto Health Care System Palo Alto, California – USA drj993@aol.com Jari laukkanen MD, PhD University of Jyvaskyla - Faculty of Sport and Health Sciences Jyvaskyla - Finland jari.a.laukkanen@jyu.fi 1. Ross R, Blair SN, Arena R, Church TS, Despres JP, Franklin BA, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016;134(24):e653-e99. 2. Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, et al. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. Circulation. 2018;138(4):345-55. 3. Kokkinos P, Faselis C, Franklin B, Lavie CJ, Sidossis L, Moore H, et al. Cardiorespiratory fitness, body mass index and heart failure incidence. Eur J Heart Fail. 2019;21(4):436-44. 4. Quindry JC, Franklin BA, ChapmanM, Humphrey R, Mathis S. Benefits and Risks of High-Intensity Interval Training in Patients With Coronary Artery Disease. Am J Cardiol. 2019;123(8):1370-7. 5. Laukkanen JA, Makikallio TH, Rauramaa R, Kiviniemi V, Ronkainen K, Kurl S. Cardiorespiratory fitness is related to the risk of sudden cardiac death: a population-based follow-up study. J Am Coll Cardiol. 2010;56(18):1476-83. 6. Laukkanen JA, Kujala UM. Low Cardiorespiratory Fitness Is a Risk Factor for Death: Exercise InterventionMay Lower Mortality? J AmColl Cardiol. 2018;72(19):2293-6. 7. Laukkanen JA, Lavie CJ, KhanH, Kurl S, Kunutsor SK. Cardiorespiratory Fitness and the Risk of Serious Ventricular Arrhythmias: A Prospective Cohort Study. Mayo Clin Proc. 2019;94(5):833-41. 8. Jae SY, Franklin BA, Kurl S, Fernhall B, Kunutsor SK, Kauhanen J, et al. Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years. Am J Cardiol. 2018;122(5):775-9. References Araújo et al. Exercise/sport & cardiovascular Health: an update Int J Cardiovasc Sci. 2019;32(4):319-325 Viewpoint coronary syndromes and cardiac diseases and normalize within two to three days, and therefore are considered as physiologic, corresponding to a release from the cytosol of the cardiomyocyte. 22-26 However, so far clear cut-off values for Tn and BNP/ NTpro-BNP differentiating between physiological and pathological exercise-induced increases in athletes without and with cardiac diseases are still missing. Therefore, exercise-induced increases in cardiac biomarkers can get clinicians into trouble, and it is of utmost importance to take clinical symptoms into consideration and perform additional non-invasive examinations (e.g. ECG, echocardiography) in unclear cases, for not to treat the blood test only.