Salvatore Carbone1,2, James H O'Keefe3,4, Carl J Lavie5. 1. Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, Virginia, USA. 2. VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA. 3. Department of Cardiovascular Diseases, University of Missouri-Kansas City, Kansas City, Missouri, USA. 4. Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA. 5. John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana, USA.