Gonzalo Grazioli1, Beatriz Merino1, Silvia Montserrat1, Bàrbara Vidal1, Manel Azqueta1, Carles Pare1, Georgia Sarquella-Brugada2, Xavier Yangüas3, Ramon Pi3, Lluis Til4, Jaume Escoda5, Josep Brugada1, Marta Sitges6. 1. Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. 2. Servicio de Cardiología, Hospital Sant Joan de Déu, Universitat de Barcelona, Sant Joan Despí, Barcelona, Spain. 3. Servei Médic, Futbol Club Barcelona, Barcelona, Spain. 4. Servei Médic, Futbol Club Barcelona, Barcelona, Spain; GIRSANE, Consorci Sanitari de Terrassa-Centre d'Alt Rendiment, Sant Cugat del Vallès, Barcelona, Spain. 5. Área de Medicina, Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain. 6. Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. Electronic address: msitges@clinic.ub.es.
Abstract
INTRODUCTION AND OBJECTIVES: Despite the established diagnostic value of the electrocardiogram in preparticipation screening of athletes, some cardiac structural changes can be missed, particularly in early disease stages. The aim of this study was to evaluate the prevalence of cardiac structural changes via the systematic use of echocardiography in preparticipation screening of competitive athletes. METHODS: Professional athletes or participants in a competitive athletic program underwent a screening that included family and personal medical history, physical examination, electrocardiography, exercise testing, and Doppler echocardiography. RESULTS: A total of 2688 athletes (67% men; mean age [standard deviation], 21 [10] years) were included. Most of the echocardiographic evaluations (92.5%) were normal and only 203 (7.5%) showed changes; the most frequent change was left ventricular hypertrophy, seen in 50 athletes (1.8%). Cessation of athletic activity was indicated in 4 athletes (0.14%): 2 for hypertrophic cardiomyopathy (electrocardiography had shown changes that did not meet diagnostic criteria), 1 pectus excavatum with compression of the right ventricle, and 1 significant pulmonary valve stenosis; the rest of the changes did not entail cessation of athletic activity and only indicated periodic monitoring. CONCLUSIONS: Although rare, some cardiac structural changes can be missed on physical examination and electrocardiography; in contrast, they are easily recognized with echocardiography. These findings suggest the use of echocardiography in at least the first preparticipation screening of competitive athletes to improve the effectiveness of programs aimed at preventing sudden death in athletes.
INTRODUCTION AND OBJECTIVES: Despite the established diagnostic value of the electrocardiogram in preparticipation screening of athletes, some cardiac structural changes can be missed, particularly in early disease stages. The aim of this study was to evaluate the prevalence of cardiac structural changes via the systematic use of echocardiography in preparticipation screening of competitive athletes. METHODS: Professional athletes or participants in a competitive athletic program underwent a screening that included family and personal medical history, physical examination, electrocardiography, exercise testing, and Doppler echocardiography. RESULTS: A total of 2688 athletes (67% men; mean age [standard deviation], 21 [10] years) were included. Most of the echocardiographic evaluations (92.5%) were normal and only 203 (7.5%) showed changes; the most frequent change was left ventricular hypertrophy, seen in 50 athletes (1.8%). Cessation of athletic activity was indicated in 4 athletes (0.14%): 2 for hypertrophic cardiomyopathy (electrocardiography had shown changes that did not meet diagnostic criteria), 1 pectus excavatum with compression of the right ventricle, and 1 significant pulmonary valve stenosis; the rest of the changes did not entail cessation of athletic activity and only indicated periodic monitoring. CONCLUSIONS: Although rare, some cardiac structural changes can be missed on physical examination and electrocardiography; in contrast, they are easily recognized with echocardiography. These findings suggest the use of echocardiography in at least the first preparticipation screening of competitive athletes to improve the effectiveness of programs aimed at preventing sudden death in athletes.
Authors: Antonio Oliva; Vincenzo M Grassi; Oscar Campuzano; Maria Brion; Vincenzo Arena; Sara Partemi; Monica Coll; Vincenzo L Pascali; Josep Brugada; Angel Carracedo; Ramon Brugada Journal: Int J Legal Med Date: 2016-09-21 Impact factor: 2.686
Authors: Paolo Angelini; Benjamin Y Cheong; Veronica V Lenge De Rosen; Alberto Lopez; Carlo Uribe; Anthony H Masso; Syed W Ali; Barry R Davis; Raja Muthupillai; James T Willerson Journal: Tex Heart Inst J Date: 2018-08-01