Age-dependent diagnostic yield of echocardiography as a second-line diagnostic investigation in athletes with abnormalities at preparticipation screening.
Details
Serval ID
serval:BIB_ED0C2F662000
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Age-dependent diagnostic yield of echocardiography as a second-line diagnostic investigation in athletes with abnormalities at preparticipation screening.
Journal
Journal of cardiovascular medicine
ISSN
1558-2035 (Electronic)
ISSN-L
1558-2027
Publication state
Published
Issued date
01/10/2021
Peer-reviewed
Oui
Volume
22
Number
10
Pages
759-766
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Systematic pre-participation screening of subjects practicing sports activity has the potential to identify athletes at risk of sudden cardiac death. However, limited evidence are present concerning the yield of echocardiography as a second-line exam in athletes with abnormal pre-participation screening.
Consecutive athletes were screened (2011-2017) in a community-based sports medicine center in Tuscany, with familial history, physical examination and ECG. Patients with abnormal/>1 borderline ECG findings, symptoms/signs of cardiovascular diseases, cardiovascular risk factors or family history of juvenile/genetic cardiac disease underwent echocardiography.
A total of 30109 athletes (age 21 [15;31]) were evaluated. Of these, 6234 (21%) were aged 8-11 years, 18309 (61%) 12-18 years, 4442 (15%) 19-35 years, 1124 (4%) >35 years. A total of 2569 (9%) athletes were addressed to echocardiography. Referral rates increased significantly with age (5% in preadolescents to 38% in master athletes, P< 0.01). Subclinical heart diseases were found in 290/30109 (0.8%) and were common >35 years (135/1124, 11%), but rare at 19-35 years (91/4442, 2%), very rare <18 years (64/24 543, 0.2%; P< 0.01). Seventy-four (0.3%) athletes were disqualified because of the structural alterations identified, 29 (0.1%) with cardiac structural diseases at risk for sudden death.
Italian community-based pre-participation screening showed an age-dependent yield, with a three-fold increase in referral in athletes >35 years. Subclinical structural abnormalities potentially predisposing to sudden death were rare (0.01%), mostly in post-pubertal and senior athletes. Age-specific pre-participation screening protocols may help optimize resources and improve specificity.
Consecutive athletes were screened (2011-2017) in a community-based sports medicine center in Tuscany, with familial history, physical examination and ECG. Patients with abnormal/>1 borderline ECG findings, symptoms/signs of cardiovascular diseases, cardiovascular risk factors or family history of juvenile/genetic cardiac disease underwent echocardiography.
A total of 30109 athletes (age 21 [15;31]) were evaluated. Of these, 6234 (21%) were aged 8-11 years, 18309 (61%) 12-18 years, 4442 (15%) 19-35 years, 1124 (4%) >35 years. A total of 2569 (9%) athletes were addressed to echocardiography. Referral rates increased significantly with age (5% in preadolescents to 38% in master athletes, P< 0.01). Subclinical heart diseases were found in 290/30109 (0.8%) and were common >35 years (135/1124, 11%), but rare at 19-35 years (91/4442, 2%), very rare <18 years (64/24 543, 0.2%; P< 0.01). Seventy-four (0.3%) athletes were disqualified because of the structural alterations identified, 29 (0.1%) with cardiac structural diseases at risk for sudden death.
Italian community-based pre-participation screening showed an age-dependent yield, with a three-fold increase in referral in athletes >35 years. Subclinical structural abnormalities potentially predisposing to sudden death were rare (0.01%), mostly in post-pubertal and senior athletes. Age-specific pre-participation screening protocols may help optimize resources and improve specificity.
Keywords
Adult, Age Factors, Athletes, Child, Death, Sudden, Cardiac/etiology, Death, Sudden, Cardiac/prevention & control, Echocardiography/methods, Electrocardiography/methods, Heart Diseases/diagnosis, Heart Diseases/epidemiology, Humans, Italy/epidemiology, Male, Mass Screening/methods, Medical History Taking/methods, Physical Examination/methods, Risk Assessment/methods, Sports/classification, Sports/physiology, Young Adult
Pubmed
Web of science
Create date
10/09/2021 17:27
Last modification date
03/02/2024 8:13