Cardiovascular Screening with Electrocardiography and Echocardiography in Collegiate Athletes - 19/08/11
, Marcia McCoy, RN, MSN a, Michael Zabel, MD b, Lawrence M. Magee, MD c, Joseph Goeke, MD a, Michael L. Main, MD a, Linda Bunten, RN, BSN a, Kimberly J. Reid, MS a, Brian M. Ramza, MD, PhD a
Requests for reprints should be addressed to Anthony Magalski, MD, Saint Luke's Mid America Heart and Vascular Institute, Saint Luke's Cardiovascular Consultants, Inc., 4330 Wornall Road, Suite 2000, Kansas City, MO 64111Abstract |
Background |
Current guidelines for preparticipation screening of competitive athletes in the US include a comprehensive history and physical examination. The objective of this study was to determine the incremental value of electrocardiography and echocardiography added to a screening program consisting of history and physical examination in college athletes.
Methods |
Competitive collegiate athletes at a single university underwent prospective collection of medical history, physical examination, 12-lead electrocardiography, and 2-dimensional echocardiography. Electrocardiograms (ECGs) were classified as normal, mildly abnormal, or distinctly abnormal according to previously published criteria. Eligibility for competition was determined using criteria from the 36th Bethesda Conference on Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities.
Results |
In 964 consecutive athletes, ECGs were classified as abnormal in 334 (35%), of which 95 (10%) were distinctly abnormal. Distinct ECG abnormalities were more common in men than women (15% vs 6%, P<.001) as well as black compared with white athletes (18% vs 8%, P<.001). Echocardiographic and electrocardiographic findings initially resulted in exclusion of 9 athletes from competition, including 1 for long QT syndrome and 1 for aortic root dilatation; 7 athletes with Wolff-Parkinson-White patterns were ultimately cleared for participation. (Four received further evaluation and treatment, and 3 were determined to not need treatment.) After multivariable adjustment, black race was a statistically significant predictor of distinctly abnormal ECGs (relative risk 1.82, 95% confidence interval, 1.22-2.73; P=.01).
Conclusions |
Distinctly abnormal ECGs were found in 10% of athletes and were most common in black men. Noninvasive screening using both electrocardiography and echocardiography resulted in identification of 9 athletes with important cardiovascular conditions, 2 of whom were excluded from competition. These findings offer a framework for performing preparticipation screening for competitive collegiate athletes.
Le texte complet de cet article est disponible en PDF.Keywords : Athlete's heart, Echocardiography, Electrocardiography, Structural heart disease
Plan
| Funding: This work was supported by a grant from the Saint Luke's Hospital Foundation (Kansas City, Mo). |
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| Conflict of Interest: Dr. Magalski and Ms. McCoy jointly hold a pending provisional patent on the echocardiography protocol used in this study. All remaining authors reported that they have no conflicts of interest. |
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| Authorship: All authors had access to the data and participated in writing the manuscript. |
Vol 124 - N° 6
P. 511-518 - juin 2011 Retour au numéro
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