OBJECTIVE: To evaluate the clinical usefulness of complete preparticipation cardiovascular screening in a large cohort of sports participants. DESIGN: Cross sectional study of data over a five year period. SETTING: Institute of Sports Medicine in Florence, Italy. PARTICIPANTS: 30,065 (23,570 men) people seeking to obtain clinical eligibility for competitive sports. MAIN OUTCOME MEASURES: Results of resting and exercise 12 lead electrocardiography. RESULTS: Resting 12 lead ECG patterns showed abnormalities in 1812 (6%) participants, with the most common abnormalities (>80%) concerning innocent ECG changes. Exercise ECG showed an abnormal pattern in 1459 (4.9%) participants. Exercise ECG showed cardiac anomalies in 1227 athletes with normal findings on resting ECG. At the end of screening, 196 (0.6%) participants were considered ineligible for competitive sports. Among the 159 participants who were disqualified at the end of the screening for cardiac reasons, a consistent proportion (n=126, 79.2%) had shown innocent or negative findings on resting 12 lead ECG but clear pathological alterations during the exercise test. After adjustment for possible confounders, logistic regression analysis showed that age >30 years was significantly associated with an increased risk of being disqualified for cardiac findings during exercise testing. CONCLUSIONS: Among people seeking to take part in competitive sports, exercise ECG can identify those with cardiac abnormalities. Follow-up studies would show if disqualification of such people would reduce the incidence of CV events among athletes.
OBJECTIVE: To evaluate the clinical usefulness of complete preparticipation cardiovascular screening in a large cohort of sports participants. DESIGN: Cross sectional study of data over a five year period. SETTING: Institute of Sports Medicine in Florence, Italy. PARTICIPANTS: 30,065 (23,570 men) people seeking to obtain clinical eligibility for competitive sports. MAIN OUTCOME MEASURES: Results of resting and exercise 12 lead electrocardiography. RESULTS: Resting 12 lead ECG patterns showed abnormalities in 1812 (6%) participants, with the most common abnormalities (>80%) concerning innocent ECG changes. Exercise ECG showed an abnormal pattern in 1459 (4.9%) participants. Exercise ECG showed cardiac anomalies in 1227 athletes with normal findings on resting ECG. At the end of screening, 196 (0.6%) participants were considered ineligible for competitive sports. Among the 159 participants who were disqualified at the end of the screening for cardiac reasons, a consistent proportion (n=126, 79.2%) had shown innocent or negative findings on resting 12 lead ECG but clear pathological alterations during the exercise test. After adjustment for possible confounders, logistic regression analysis showed that age >30 years was significantly associated with an increased risk of being disqualified for cardiac findings during exercise testing. CONCLUSIONS: Among people seeking to take part in competitive sports, exercise ECG can identify those with cardiac abnormalities. Follow-up studies would show if disqualification of such people would reduce the incidence of CV events among athletes.
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Authors: Antonio Pelliccia; Fernando M Di Paolo; Filippo M Quattrini; Cristina Basso; Franco Culasso; Gloria Popoli; Rosanna De Luca; Antonio Spataro; Alessandro Biffi; Gaetano Thiene; Barry J Maron Journal: N Engl J Med Date: 2008-01-10 Impact factor: 91.245
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