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Doumparatzi M, Sotiriou P, Deligiannis A, Kouidi E. Electrocardiographic characteristics of pediatric and adolescent football players. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:179-184. [PMID: 38708327 PMCID: PMC11067734 DOI: 10.1016/j.smhs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 05/07/2024] Open
Abstract
Electrocardiographic characteristics of children and adolescents present differences compared to adults. The aim of our work was to study electrocardiograms (ECGs) of football male players from childhood to late adolescence and examine if the ECG parameters are influenced by systematic exercise. One thousand fifty-four football players participated and formed four groups. Group A included 89 players aged 5-7 years, group B 353 players aged 8-11 years, group C consisted of 355 football players 12-15 yearsold and group D of 257 players with 16-18 years of age. All participants underwent preparticipation screening, including 12-lead surface ECG. Heart rate (HR), PR, RR, QRS, QT, QTc intervals, QT dispersion (QTdisp) and QRS axis were calculated. All ECGs were evaluated according to the current preparticipation cardiac screening guidelines, that refer to athletes aged 12-35 years and do not include pediatric players. Eleven percent of the participants presented an ECG finding. Group D obtained the lowest values of HR, QTc and the highest of PR, RR, QRS, QT intervals and QTdisp, whereas no differences in QRS axis were reported. Incomplete Right Bandle Branch Block (RBBB) was the most frequent ECG peculiarity, detected in 7.3% of the participants. Years of training were statistically significantly correlated to HR, PR, RR, QRS and QT intervals. In conclusion, guidelines for ECG interpretation of athletes in childhood, early and late adolescence are needed.
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Affiliation(s)
- Maria Doumparatzi
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Panagiota Sotiriou
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Asterios Deligiannis
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Evangelia Kouidi
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
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2
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Turska-Kmieć A, Neunhaeuserer D, Mazur A, Dembiński Ł, del Torso S, Grossman Z, Barak S, Hadjipanayis A, Peregud-Pogorzelski J, Kostka T, Bugajski A, Huss G, Kowalczyk-Domagała M, Wyszyńska J. Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes. Front Pediatr 2023; 11:1125958. [PMID: 37425260 PMCID: PMC10323832 DOI: 10.3389/fped.2023.1125958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.
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Affiliation(s)
- Anna Turska-Kmieć
- Department of Cardiology, Children’s Memorial Health Institute, Warsaw, Poland
- Polish PaediatricSociety, Warsaw, Poland
- Working Group on Sports Cardiology, Polish Cardiac Society, Warsaw, Poland
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, University of Padova Department of Medicine, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Artur Mazur
- Polish PaediatricSociety, Warsaw, Poland
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - Łukasz Dembiński
- Polish PaediatricSociety, Warsaw, Poland
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Stefano del Torso
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Childcare Worldwide, Padova, Italy
| | - Zachi Grossman
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Maccabi Health Services, Pediatric Clinic, Tel Aviv, Israel
| | - Shimon Barak
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adamos Hadjipanayis
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
| | - Jarosław Peregud-Pogorzelski
- Polish PaediatricSociety, Warsaw, Poland
- Department of Paediatrics, Paediatric Oncology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
- The Polish Society of Sports Medicine, Wroclaw, Poland
| | - Andrzej Bugajski
- The Polish Society of Sports Medicine, Wroclaw, Poland
- Department of Physiotherapy, College of Physiotherapy, Wroclaw, Poland
| | - Gottfried Huss
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Kinder-Permanence Hospital Zollikerberg, Zollikerberg, Switzerland
| | - Monika Kowalczyk-Domagała
- Department of Cardiology, Children’s Memorial Health Institute, Warsaw, Poland
- Working Group on Paediatric Cardiology, Polish Cardiac Society, Warsaw, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszów University, Rzeszów, Poland
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Prakash K, Swarnakari KM, Bai M, Manoharan MP, Raja R, Jamil A, Csendes D, Gutlapalli SD, Desai A, Desai DM, Hamid P. Sudden Cardiac Arrest in Athletes: A Primary Level of Prevention. Cureus 2022; 14:e30517. [PMID: 36415444 PMCID: PMC9674198 DOI: 10.7759/cureus.30517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
Abstract
Primary prevention of sudden cardiac arrest (SCA) refers to the use of pharmacological or interventional therapy and healthy lifestyle modifications to prevent sudden cardiac death (SCD) in patients who have not experienced symptomatic, life-threatening persistent ventricular tachycardia or ventricular fibrillation or SCA but are considered to be at a higher risk. This review provides an overview of the physiological heart changes and distinct electrical manifestations, the etiology of SCA, and screening methods and interventions for the prevention of SCA in athletes. The American College of Cardiology and the American Heart Association (AHA) Guidelines recommend screening with a 14-point history and physical examination. In most cases, a thorough clinical evaluation along with an ECG is sufficient for screening. Athletes with heart diseases leading to SCD are urged not to compete. Further decisions are taken following the European Society of Cardiology and the AHA's current workout recommendations. Early detection of cardiac disease allows for individualized risk evaluation and treatment, which has been shown to reduce mortality rates in athletes.
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Affiliation(s)
- Keerthana Prakash
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kiran Maee Swarnakari
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meena Bai
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohana Priya Manoharan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Rabab Raja
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aneeque Jamil
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Denise Csendes
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sai Dheeraj Gutlapalli
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aditya Desai
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, University of California Riverside School of Medicine, Riverside, USA
| | - Darshi M Desai
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Cavarretta E, Sciarra L, Biondi-Zoccai G, Maffessanti F, Nigro A, Sperandii F, Guerra E, Quaranta F, Fossati C, Peruzzi M, Pingitore A, Stasinopoulos DM, Rigby RA, Adorisio R, Saglietto A, Calò L, Frati G, Pigozzi F. Age-Related Electrocardiographic Characteristics of Male Junior Soccer Athletes. Front Cardiovasc Med 2022; 8:784170. [PMID: 35187105 PMCID: PMC8850359 DOI: 10.3389/fcvm.2021.784170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/22/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction Very limited data exist on normal age-related ECG variations in adolescents and no data have been published regarding the ECG anomalies induced by intensive training, which are relevant in pre-participation screening for sudden cardiac death prevention in the adolescent athletic population. The purpose of this study was to establish normal age-related electrocardiographic measurements (P wave duration, PR interval, QRS duration, QT, and QTc interval) grouped according to 2-year age intervals. Methods A total of 2,151 consecutive healthy adolescent Soccer athletes (trained for a mean of 7.2 ± 1.1 h per week, 100% male Caucasians, mean age 12.4 ± 1.4 years, range 7–18) underwent pre-participation screening, which included ECG and transthoracic echocardiography in a single referral center. Results Their heart rate progressively slowed as age increased (p < 0.001, ranging from 80.8 ± 13.2 to 59.5 ± 10.2 bpm), as expected. The P wave, PR interval, and QRS duration significantly increased in older age classes (p = 0.019, p = 0.001, and p < 0.001, respectively), and after Bonferroni's correction, the difference remained significant in all age classes for QRS duration. The QTc interval diminished progressively with increasing age (p = 0.003) while the QT interval increased progressively (p < 0.001). Conclusions Significant variations in the normal ECG characteristics of young athletes exist between different age groups related to increasing age and training burden, thus, age-specific reference values could be adopted, as already done for echocardiographic measurements, and may help to further discriminate potentially pathologic conditions.
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Affiliation(s)
- Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
- *Correspondence: Elena Cavarretta
| | - Luigi Sciarra
- Department of Clinical Medicine, Public Health, Life and Environment Sciences, L'Aquila University, L'Aquila, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | | | - Antonia Nigro
- Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, Rome, Italy
| | - Fabio Sperandii
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Emanuele Guerra
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Federico Quaranta
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Mariangela Peruzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | - Annachiara Pingitore
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | | | | | - Rachele Adorisio
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Saglietto
- Division of Cardiology, Department of Medical Sciences, “Città della Salute e della Scienza di Torino” Hospital, University of Turin, Turin, Italy
| | - Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
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Rodriguez-López AM, Javier G, Carmen P, Esteban P, Luisa GC, Tomas F, Josefa HM, Luis F. Athlete Heart in Children and Young Athletes. Echocardiographic Findings in 331 Cases. Pediatr Cardiol 2022; 43:407-412. [PMID: 34586455 DOI: 10.1007/s00246-021-02736-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/10/2021] [Indexed: 11/25/2022]
Abstract
The changes of the athlete's heart are not well defined and characterized in children. We aimed to describe the morphological changes of the heart related to sport in young athletes. We evaluated a group of 331 young athletes under 18 years (mean 11.9 ± 3.2) who practice tennis: 58 (16.52%), football: 118 (33.62%), basketball: 16 (4.56%), athletics: 40 (11.4%), and swimming: 99 (28.21%). Type of sport, years of practice, and duration of the training were collected. All children underwent echocardiography with the following M-mode parameters: left atrium diameter (LAD), interventricular septum (IVS), and left ventricle posterior Wall (LVPW), diastolic diameter of the left ventricle (LVDD), and right ventricle outflow tract (RVOT). The major finding of our study was that 20% of the children had a Z score > 2 for the IVS and that increased to 30% for the children playing tennis or swimming. Also, other changes like LA and RVOT dilatation were observed in about 10 and 14% of the cases, respectively. Taken together, these figures indicate that cardiac remodeling is frequent in children. Further studies are needed to establish consensus-based criteria of athlete's heart in young children.
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Affiliation(s)
- Ana M Rodriguez-López
- Department of Cardiology, Hospiten Sur, Tenerife, Spain.
- Department of Cardiology, Hospiten Bellevue, Tenerife, Spain.
| | - González Javier
- Service of Sport Medicine Ayuntamiento del Puerto de la Cruz, Hospital Universitario de Canarias, Tenerife, Spain
| | - Padrón Carmen
- Department of Paediatric, Hospiten Sur, Tenerife, Spain
| | | | | | - Febles Tomas
- Department of Cardiology, Hospiten Sur, Tenerife, Spain
| | | | - Febles Luis
- Department of Cardiology, Hospiten Bellevue, Tenerife, Spain
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Albiński M, Saubade M, Menafoglio A, Meyer P, Capelli B, Perrin T, Trachsel L, Hagemeyer D, Casagrande D, Wilhelm M, Benaim C, Pirrello T, Albrecht S, Schmied C, Mivelaz Y, Tercier S, Baggish A, Gabus V. Diagnostic yield and cost analysis of electrocardiographic screening in Swiss paediatric athletes. J Sci Med Sport 2021; 25:281-286. [PMID: 34895837 DOI: 10.1016/j.jsams.2021.11.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Athletes performing sports on high level are at increased risk for sudden cardiac death. This includes paediatric athletes, even though data on screening strategies in this age group remain scarce. This study aimed to assess electrocardiogram interpretation criteria in paediatric athletes and to evaluate the cost of screening. METHODS National, multicentre, retrospective, observational study on 891 athletes of paediatric age (<18 years) evaluated by history, physical examination and 12-lead electrocardiogram. The primary outcome measure was abnormal electrocardiogram findings according to the International Recommendations for Electrographic Interpretation in Athletes. The secondary outcome measure was cost of screening. RESULTS 19 athletes (2.1%) presented abnormal electrocardiogram findings requiring further investigations, mainly abnormal T-wave inversion. These 19 athletes were predominantly males, performing endurance sports with a mean volume of 10 weekly hours for a mean duration of 6 years of training. Further investigations did not identify any relevant pathology. All athletes were cleared for competition with regular follow-up. Total costs of the screening were 108,860 USD (122 USD per athlete). CONCLUSIONS Our study using the International Recommendations for Electrographic Interpretation in Athletes identified a low count of abnormal findings in paediatric athletes, yet raising substantially the cost of screening. Hence, the utility of electrocardiogram-inclusive screening of paediatric athletes remains to be elucidated by longitudinal data.
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Affiliation(s)
- M Albiński
- Division of Paediatrics, Lausanne University Hospital, Switzerland.
| | - M Saubade
- Centre of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Switzerland; Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland; SportAdo Centre, Department of Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - A Menafoglio
- Department of Cardiology, San Giovanni Hospital Bellinzona, Switzerland
| | - P Meyer
- Service of Cardiology, University Hospital Geneva, Switzerland
| | - B Capelli
- Department of Cardiology, Cardiocentro Ticino, Switzerland
| | - T Perrin
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - L Trachsel
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - D Hagemeyer
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - D Casagrande
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - M Wilhelm
- Department of Cardiology, Inselspital, University Hospital Bern, Bern University, Switzerland
| | - C Benaim
- Centre of Sports Medicine, Division of Physical and Rehabilitation Medicine, Lausanne University Hospital, Switzerland
| | - T Pirrello
- Swiss Federal Institute of Sports, Switzerland
| | - S Albrecht
- Swiss Federal Institute of Sports, Switzerland
| | - C Schmied
- Department of Cardiology, University Heart Centre Zurich, University of Zurich, Switzerland
| | - Y Mivelaz
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital, Switzerland
| | - S Tercier
- SportAdo Centre, Department of Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - A Baggish
- Division of Cardiology, Massachusetts General Hospital, United States of America
| | - V Gabus
- Department of Cardiology, Lausanne University Hospital, Switzerland
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Zhou G. ATHLETE's CARDIOVASCULAR FUNCTION TEST IN DIFFERENT SPORTS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127072021_0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: There have been many reports on athletes’ cardiovascular function, but there are very few methods used to evaluate the case. Objective: This article studies the relationship between sports fatigue and the cardiovascular response of athletes so that athletes can exercise and train more scientifically and safely. Methods: The paper selected some national athletes from 2017 to 2020 to carry out the VO2max, step test, YoYo test, 12-minute running, and other tests related to the cardiovascular function. Results: Athletes can promote the improvement of their cardiovascular function when they perform aerobic exercise training. Conclusion: Public physical education and amateur physical training should focus on the development of aerobic endurance. This can improve athletes’ cardiovascular function. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- M Carmen Adamuz
- Sports Medicine Department, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar
| | - Domingo Pascual Figal
- Head of Cardiology Department, Hospital Virgen de la Arrixaca, University of Murcia, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Murcia, Spain.
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