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Sports in Patients with Heart Disease: What Should Be Recommended? Abstract. Sports is recommended in the European guidelines for the prevention and initial treatment of many cardiovascular diseases as well as the metabolic syndrome. However, the individually recommended intensity and duration of physical activity that unfolds the maximal protective effects in terms of prevention, largely differs. Indeed, a J-curve relationship with regard to exercise training has been postulated, with the assumption that too much sports is equally harmful or potentially even more harmful than too little sports. In this review, we try to answer the question of how much and which sports is optimal for cardiac patients.