Flavio D'Ascenzi1, Francesca Anselmi1, Sergio Mondillo1, Gherardo Finocchiaro2, Stefano Caselli3, María Sanz-De La Garza4, Christian Schmied5, Paolo Emilio Adami6, Maurizio Galderisi7, Yehuda Adler8,9,10, Antonis Pantazis11, Josef Niebauer12, Hein Heidbuchel13,14, Michael Papadakis2, Paul Dendale14. 1. Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy. 2. Cardiology Clinical Academic Group, St George's University of London, UK. 3. Cardiovascular Centre Zürich, Hirslanden Klinik im Park, Zürich, Switzerland. 4. Cardiovascular Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Spain. 5. Department of Cardiology, University Heart Centre Zurich, University of Zurich, Switzerland. 6. Health and Science Department, International Association of Athletics Federation - IAAF, Monaco, France. 7. Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. 8. College of Law and Business, Ramat Gan, Israel. 9. Sackler Faculty of Medicine, Tel Aviv University, Israel. 10. Mayanei Hayeshua Medical Center, Bnei Brak, Israel. 11. Harefield Hospital, London, UK. 12. Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria. 13. Department of Cardiology, University Hospital Antwerp, and Antwerp University, Belgium. 14. Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Abstract
AIMS: Pre-participation evaluation (PPE) is recommended to prevent sudden cardiac death in athletes. Although imaging is not advocated as a first-line screening tool, there is a growing interest in the use of echocardiography in PPE of athletes. This survey aimed to map the use of imaging in the setting of PPE and explore physician beliefs and potential barriers that may influence individual practices. METHODS: An international survey of healthcare professionals was performed across ESC Member Countries. Percentages were reported based on the number of respondents per question. RESULTS: In total, 603 individuals from 97 countries participated in the survey. Two-thirds (65%) of respondents use echocardiography always or often as part of PPE of competitive athletes and this practice is not influenced by the professional or amateur status of the athlete. The majority (81%) of respondents who use echocardiography as a first-line screening tool perform the first echocardiogram during adolescence or at the first clinical evaluation, and 72% repeat it at least once in the athletes' career, at 1-5 yearly intervals. In contrast, cardiac magnetic resonance is reserved as a second-line investigation of symptomatic athletes. The majority of the respondents did not report any barriers to echocardiography, while several barriers were identified for cardiac magnetic resonance. CONCLUSIONS: Echocardiography is frequently used as a first-line screening tool of athletes. In the absence of scientific evidence, before such practice is recommended, large studies using echocardiography in the PPE setting are necessary. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Pre-participation evaluation (PPE) is recommended to prevent sudden cardiac death in athletes. Although imaging is not advocated as a first-line screening tool, there is a growing interest in the use of echocardiography in PPE of athletes. This survey aimed to map the use of imaging in the setting of PPE and explore physician beliefs and potential barriers that may influence individual practices. METHODS: An international survey of healthcare professionals was performed across ESC Member Countries. Percentages were reported based on the number of respondents per question. RESULTS: In total, 603 individuals from 97 countries participated in the survey. Two-thirds (65%) of respondents use echocardiography always or often as part of PPE of competitive athletes and this practice is not influenced by the professional or amateur status of the athlete. The majority (81%) of respondents who use echocardiography as a first-line screening tool perform the first echocardiogram during adolescence or at the first clinical evaluation, and 72% repeat it at least once in the athletes' career, at 1-5 yearly intervals. In contrast, cardiac magnetic resonance is reserved as a second-line investigation of symptomatic athletes. The majority of the respondents did not report any barriers to echocardiography, while several barriers were identified for cardiac magnetic resonance. CONCLUSIONS: Echocardiography is frequently used as a first-line screening tool of athletes. In the absence of scientific evidence, before such practice is recommended, large studies using echocardiography in the PPE setting are necessary. Published on behalf of the European Society of Cardiology. All rights reserved.