The Gragg Center for Cardiovascular Performance
A landmark 2023 gift from Margaret and Smoky Bissell will enable Sanger to establish The Gragg Center for Cardiovascular Performance, which is dedicated to advancing cardiovascular health and improving patient outcomes through personalized exercise guidance and innovative research. Our mission is to provide novel approaches for medically-directed exercise guidance in cardiac patients, offer disease-specific protocols to enhance cardiorespiratory fitness and understand the underlying causes of cardiac limitations to exercise across all age groups and fitness levels.
We achieve this by leveraging the capabilities of our Sports Cardiology Center, CPET Lab and Cardiac Rehabilitation Program, and by developing new service offerings to reach all populations that could benefit from exercise to improve cardiovascular performance.
Sports Cardiology
Sanger is at the forefront of preventing, detecting and managing cardiovascular conditions in competitive athletes and highly active individuals. Our clinical care and research helps them safely return to sports and activities, while developing new approaches that improve care far beyond our walls.
Recent Highlights
Screening athletes in the Major League Baseball (MLB) and National Football League (NFL) draft combines: Sanger’s sports cardiology team of cardiologists, sonographers and nurses journeyed to Phoenix, Ariz., for the MLB combine, where we conducted cardiac screenings on more than 200 elite baseball players. The objective was to ascertain the players’ fitness for engaging in baseball as they strive for professional careers. The sports cardiology team also leads cardiovascular assessment of all prospective NFL players at the NFL Draft Combine.
Partnering with the National Basketball Association (NBA) to provide echo QA review: In 2022 and 2023, Sanger’s sports cardiology and cardiovascular imaging teams collaborated with the NBA to ensure the quality of cardiac assessments conducted on players, guaranteeing their adherence to required standards and protocols. We have evaluated more than 1,000 echocardiograms of players from the NBA, WNBA, and NBA G League to date.
Leading the way in sports cardiology: The Sports Cardiology Center director continued advising the NBA on the cardiac care of its athletes. He also became chair of the NFL Cardiovascular Task Force and served as the 2023 course chair for the American College of Cardiology’s national Sports Cardiology Conference, which focused on care of the athletic heart.
Our performance capabilities include a state-of-the art cardiopulmonary exercise test (CPET) lab with treadmill and cycle ergometer.
Innovations
Studying athletic cardiac remodeling in elite baseball players: In collaboration with MLB, we’ve begun a study to determine the prevalence and extent of exercise-induced cardiac remodeling (EICR), describe predictors of EICR and explore ethnic differences in ECG and echocardiogram measurements among MLB players. This will be a cross-sectional, retrospective study of elite baseball players invited to the MLB combine in 2021, 2022 and 2023.
Rationale and design of the Outcomes Registry for Cardiac Conditions in Athletes study: Sanger is taking a leading role in a prospective, multicenter, longitudinal, observational cohort study designed to monitor clinical outcomes in athletes with potentially life-threatening cardiovascular conditions. The study will assess sports eligibility decision-making, exercise habits, psychosocial well-being and long-term cardiovascular outcomes among young competitive athletes with cardiovascular conditions.
Building a Sports Cardiology Patient Data Registry: This repository contains patient data that enables us to measure clinical outcomes, develop practice standards and fill existing gaps in medical knowledge for the management of this population.
We are the cardiology consultants for the NFL Scouting Combine, MLB Draft Combine and NBA Quality Assurance Program.
Atrium Health is the official healthcare provider for: Charlotte FC, Carolina Panthers, Davidson College, Winthrop University, UNC Charlotte and Charlotte Motor Speedway.
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1,000+
Echoes reviewed for NBA, WNBA, and NBA G League players
Internal Data, 2023 -
200+
Echoes and ECGs reviewed for MLB players
Internal Data, 2023 -
1,500+
Professional and college athletes screened
Internal Data, 2023 -
700+
High school athletes screened
in partnership with Atrium Health Musculoskeletal Institute
Internal Data, 2023
Martinez KA, Bos JM, Baggish AL, et al. Return-to-Play for Elite Athletes with Genetic Heart Diseases Predisposing to Sudden Cardiac Death. J Am Coll Cardiol. 2023;82(8):661-670. doi: 10.1016/j. jacc.2023.05.059. PMID 37587576
Seshadri DR, Harlow ER, Thom ML, et al. Wearable technology in the sports medicine clinic to guide the return-to-play and performance protocols of athletes following a COVID-19 diagnosis. Digit Health. 2023; 9:20552076231177498. Published 2023 Jul 5. doi:10.1177/20552076231177498. PMID 37434736
Moulson N, Petek BJ, Ackerman MJ, et al. Rationale and Design of the ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) Study. J Am Heart Assoc. 2023;12(11): e029052. doi: 10.1161/ JAHA.122.029052. PMID: 37259981
Corneil H, Liblik K, Varghese SS, et al. Shared Decision-Making in Athletes Diagnosed With a Cardiovascular Condition: A Scoping Review. Curr Probl Cardiol. 2023;48(10):101815. doi:10.1016/j. cpcardiol.2023.101815. PMID 37211302
Hill B, Grubic N, Williamson M, et al. Does cardiovascular preparticipation screening cause psychological distress in athletes? A systematic review. Br J Sports Med. 2023;57(3):172-178. doi:10.1136/ bjsports-2022-105918. PMID: 36418151
Petek BJ, Chung EH, Kim JH, et al. Impact of Sex on Cardiovascular Adaptations to Exercise: JACC Review Topic of the Week. J Am Coll Cardiol. 2023;82(10):1030-1038. doi:10.1016/j.jacc.2023.05.070. PMID: 37648352
“Update on Cardiac Care of the Elite Athlete” Panelist at the NFL Physician Society annual medical meeting. February 28th, 2023
“Beyond “Patient may Self-Restrict” - How I Counsel Athletic Patients with Competitive Sports” American College of Cardiology Scientific Sessions March 5th, 2023.
“Multimodality Imaging Assessment of Exercise Induced Remodeling: Impact of Sport Type” American College of Cardiology Scientific Sessions March 5th, 2023.
“Activity and Exercise after SCAD” Sanger SCAD Conference. April 21st, 2023.
“HCM or Athletic Remodeling: Shrinking the Gray Zone” The Delaware Valley Echo Society Meeting April 27th, 2023.
“How to Perform Strain Imaging – Tips and Tricks” Basic to Advanced Echocardiography: Island Ultrasound. Mayo Clinic. May 10th, 2023.
“Athletes Heart vs Hypertrophic Cardiomyopathy” Basic to Advanced Echocardiography: Island Ultrasound. Mayo Clinic. May 10th, 2023.
“Clinical Applications of LV Strain Imaging in the Evaluation of Cardiomyopathies” Basic to Advanced Echocardiography: Island Ultrasound. Mayo Clinic. May 10th, 2023.
“Echocardiographic Quality in the National Basketball Association.” NBA Combine, Chicago May 19th, 2023.
“Current Cardiac Evaluations and Safety for Teams, Individuals and Leagues. What is the Current Practice Around the World?” NBA Combine, Chicago May 19th, 2023.
“Hypertrophic Cardiomyopathy, A Guideline Update”. The 29th Annual International Conference of the Australasian Sonographers Association” Brisbane, May 26th, 2023.
“ECG Interpretation in the Athlete: Put Your Interpretation Skills to the Test!” American College of Cardiology, Care of the Athletic Heart: From Elite to Enthusiasts, June 8th, 2023.
“Common Mistakes in Imaging the Athletes Heart: What to Avoid!” American College of Cardiology, Care of the Athletic Heart: From Elite to Enthusiasts, June 9th, 2023
“The Great Imaging Quiz: Quick Fire Cases” Panelist. American College of Cardiology, Care of the Athletic Heart: From Elite to Enthusiasts, June 9th, 2023
“The Masters Athlete with Cardiovascular Disease” Panelist. American College of Cardiology, Care of the Athletic Heart: From Elite to Enthusiasts, June 10th, 2023
“Quality and Resources Across Multiple Sites” American Society of Echocardiography, Scientific Sessions, June 24th, 2023.
“Guideline Review: Multimodality CV Imaging in Patients with HCM” American Society of Echocardiography, Scientific Sessions, June 24th, 2023.
“More than the Myocardium: The Role of the Mitral Valve in HCM” American Society of Echocardiography, Scientific Sessions, June 25th, 2023.
Return-to-Play for Elite Level Athletes with Sudden Cardiac Death Predisposing Heart Conditions. Late Breaking Clinical Trial presentation. American College of Cardiology Scientific Sessions 2023.
Cardiac Screening, Big Data from the NFL and NBA. American Irish Medical Summit. Dublin, Ireland. August 24th, 2023
Current Cardiac Evaluations and Safety for Teams, Individuals and Leagues What is the Current Practice Around the World? NBA Combine, Chicago May 19th, 2023.
Leadership
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Dermot M. Phelan, MD, PhD, FASE, FACC
The Gragg Endowed Chair in Cardiovascular Medicine Medical Director, Hypertrophic Cardiomyopathy Center Medical Director, The Gragg Center for Cardiovascular Performance Medical Director, Cardiovascular Imaging