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Li S, Qin C, Zhang H, Maimaitiming M, Shi J, Feng Y, Huang K, Bi Y, Wang M, Zhou Q, Jin Y, Zheng ZJ. Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR. JAMA Netw Open 2024; 7:e247909. [PMID: 38669021 PMCID: PMC11053379 DOI: 10.1001/jamanetworkopen.2024.7909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/23/2024] [Indexed: 04/29/2024] Open
Abstract
Importance The lack of evidence-based implementation strategies is a major contributor to increasing mortality due to out-of-hospital cardiac arrest (OHCA) in developing countries with limited resources. Objective To evaluate whether the implementation of legislation is associated with increased bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use and improved clinical outcomes for patients experiencing OHCA and to provide policy implications for low-income and middle-income settings. Design, Setting, and Participants This observational cohort study analyzed a prospective city registry of patients with bystander-witnessed OHCA between January 1, 2010, and December 31, 2022. The Emergency Medical Aid Act was implemented in Shenzhen, China, on October 1, 2018. An interrupted time-series analysis was used to assess changes in outcomes before and after the law. Data analysis was performed from May to October 2023. Exposure The Emergency Medical Aid Act stipulated the use of AEDs and CPR training for the public and provided clear legal guidance for OHCA rescuing. Main Outcomes and Measures The primary outcomes were rates of bystander-initiated CPR and use of AEDs. Secondary outcomes were rates of prehospital return of spontaneous circulation (ROSC), survival to arrival at the hospital, and survival at discharge. Results A total of 13 751 patients with OHCA (median [IQR] age, 59 [43-76] years; 10 011 men [72.83%]) were included, with 7858 OHCAs occurring during the prelegislation period (January 1, 2010, to September 30, 2018) and 5893 OHCAs occurring during the postlegislation period (October 1, 2018, to December 31, 2022). The rates of bystander-initiated CPR (320 patients [4.10%] vs 1103 patients [18.73%]) and AED use (214 patients [4.12%] vs 182 patients [5.29%]) increased significantly after legislation implementation vs rates before the legislation. Rates of prehospital ROSC (72 patients [0.92%] vs 425 patients [7.21%]), survival to arrival at the hospital (68 patients [0.87%] vs 321 patients [5.45%]), and survival at discharge (44 patients [0.56%] vs 165 patients [2.80%]) were significantly increased during the postlegislation period. Interrupted time-series models demonstrated a significant slope change in the rates of all outcomes. Conclusions and Relevance These findings suggest that implementation of the Emergency Medical Aid Act in China was associated with increased rates of CPR and public AED use and improved survival of patients with OHCA. The use of a systemwide approach to enact resuscitation initiatives and provide legal support may reduce the burden of OHCA in low-income and middle-income settings.
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Affiliation(s)
- Siwen Li
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Chongzhen Qin
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Hongjuan Zhang
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Junyi Shi
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - YiKai Feng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Kepei Huang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yanxin Bi
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Minmin Wang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Qiang Zhou
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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Martinez M, Kim JH, Friedman EM, Chung EH. Cardiac player health and safety: a call to action. Br J Sports Med 2024:bjsports-2023-107119. [PMID: 38378260 DOI: 10.1136/bjsports-2023-107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/22/2024]
Affiliation(s)
| | | | | | - Eugene H Chung
- Cardiology, Harvard Medical School, Boston, Massachusetts, USA
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants. PHYSICIAN SPORTSMED 2023; 51:564-571. [PMID: 36281474 DOI: 10.1080/00913847.2022.2136984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years. METHODS During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used. RESULTS The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%). CONCLUSION In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Corrado D, Cipriani A, Zorzi A. Shocking insights on resuscitation after sports-related cardiac arrest. Eur Heart J 2023; 44:193-195. [PMID: 36419208 DOI: 10.1093/eurheartj/ehac659] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII. Phys Ther Sport 2023; 59:136-143. [PMID: 36535111 DOI: 10.1016/j.ptsp.2022.12.007] [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: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. DESIGN Cross-sectional study. SETTING 2016-2020 Cape Town Cycle Tour. PARTICIPANTS Consenting race entrants. MAIN OUTCOME MEASURES 62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses. RESULTS Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)]. CONCLUSION A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, South Africa.
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, South Africa; Statistics and Population Studies Department, University of the Western Cape, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
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Cunha Filho GARD, Arliani GG, Yamada AF, Cohen M, Ejnisman B, Andreoli CV. MEDICAL PLANNING FOR MASS GATHERING SPORTS EVENTS IN BRAZIL. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012021_0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .
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Bassi MD, Farina JM, Bombau J, Fitz Maurice M, Bortman G, Nuñez E, Márquez M, Bornancini N, Baranchuk A. Sudden Cardiac Arrest in Basketball and Soccer Stadiums, the Role of Automated External Defibrillators: A Review. For the BELTRAN Study (BaskEtbaLl and soccer sTadiums: Registry on Automatic exterNal defibrillators). Arrhythm Electrophysiol Rev 2023; 12:e03. [PMID: 36845166 PMCID: PMC9945480 DOI: 10.15420/aer.2022.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023] Open
Abstract
Sudden cardiac arrest (SCA) during sports events has a dramatic impact on stadium-goers and the public and is often associated with poor outcomes unless treated with an automated external defibrillator (AED). Despite this, stadiums vary in AED use. This review aims to identify the risks and incidences of SCA, and the use of AEDs in soccer and basketball stadiums. A narrative review of all relevant papers was conducted. Athletes across all sports face an SCA risk of 1:50,000 athlete-years, with the greatest risk of SCA in young male athletes (1:35,000 person-years) and black male athletes (1:18,000 person-years). Africa and South America have the poorest soccer SCA outcomes at 3% and 4% survival. AED use on-site improves survival greater than defibrillation by emergency services. Many stadiums do not have AEDs implemented into medical plans and the AEDs are often unrecognisable or are obstructed. Therefore, AEDs should be used on-site, use clear signalling, have certified trained personnel, and be incorporated into stadiums' medical plans.
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Affiliation(s)
- Mario D. Bassi
- Department of Medicine, Kingston Health Science Centre, Queen’s University, Kingston, Ontario, Canada
| | - Juan M. Farina
- Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, Arizona, US
| | - Jorge Bombau
- Internal Medicine, National University of La Plata, Argentina
| | - Mario Fitz Maurice
- Department of Cardiology, Hospital de Agudos Bernardino Rivadavia, Buenos Aires, Argentina
| | | | - Elaine Nuñez
- Servicio de Cardiología, Cedimat Centro Cardiovascular, Santo Domingo, República Dominicana
| | - Manlio Márquez
- Department of Electrophysiology, Centro Médico ABC (American British Cowdray), Ciudad de México, México
| | - Norberto Bornancini
- Department of Cardiology, Hospital General de Agudos “General Manuel Belgrano”, Buenos Aires, Argentina
| | - Adrian Baranchuk
- Department of Medicine, Kingston Health Science Centre, Queen’s University, Kingston, Ontario, Canada,Division of Cardiology, Queen’s University, Kingston, Ontario, Canada
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Abela M, Grech V, Sammut MA. Automated external defibrillators and basic life support practices in secondary schools: a nationwide study. Cardiol Young 2022; 33:1-4. [PMID: 36373237 DOI: 10.1017/s1047951122003572] [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] [Indexed: 11/16/2022]
Abstract
AIM Cardiac arrest prevention in schools has recently gained momentum. The survival benefit in schools who have access to defibrillators is clear, with far better survival outcomes in children or adults who sustain a cardiac arrest on school grounds. The main objectives of this study were to assess sudden cardiac arrest prevention in Maltese schools, specifically the availability of defibrillators and staff competence in delivering resuscitation. METHODOLOGY AND RESULTS An online-based questionnaire was distributed to all secondary schools across the Maltese archipelago. Data were collected, tabulated, and analysed using SPSS V.23. Most schools (n = 40, 74.1%) completed the questionnaire. Two schools documented a cardiac arrest in the past 10 years. 87.5% agreed that cardiac arrest prevention is an important health topic. Most have a defibrillator on the premises (n = 37, 92.5%). Only one defibrillator is usually available (n = 27, 75.0%). Despite the majority claiming its ease of accessibility (n = 35, 97.2%), most were not available on every floor (n = 37, 97.2%). Only one-third were close to a sporting facility (n = 11, 30.6%). Schools do not organise regular resuscitation courses (n = 21, 58.3%), with eight schools having five or more certified staff members (23.5%). The number of defibrillators did not influence the frequency of resuscitation courses at school (p = 0.607), and there was no association with the number of certified individuals (p = 0.860). CONCLUSION Defibrillators are not readily available at secondary schools and are often installed in low-risk areas. Most schools have only one staff member certified in resuscitation. These factors should be addressed with urgency.
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Affiliation(s)
- Mark Abela
- Department of Cardiology, Mater Dei Hospital, Malta
- Cardiology, University of Malta, Malta
| | - Victor Grech
- Depatment of Paediatrics, Mater Dei Hospital, Malta
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 822] [Impact Index Per Article: 411.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Guettler N, Nicol ED, Sammito S. Exercise ECG for Screening in Military Aircrew. Aerosp Med Hum Perform 2022; 93:666-672. [DOI: 10.3357/amhp.6051.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: The exercise electrocardiogram (ExECG), or stress test, is a widely used screening tool in occupational medicine designed to detect occult coronary artery disease, and assess performance capacity and cardiovascular fitness. In some guidelines, it is recommended
for high-risk occupations in which occult disease could possibly endanger public safety. In aviation medicine, however, there is an ongoing debate on the use and periodicity of ExECG for screening of aircrew.METHOD: In the German Armed Forces, aircrew applicants and active-duty
aircrew undergo screening ExECG. We analyzed 7646 applicant ExECGs (5871 from pilot and 1775 from nonpilot applicants) and 17,131 ExECGs from 3817 active-duty pilots. All were performed at the German Air Force Centre of Aerospace Medicine (GAFCAM) and analyzed for ECG abnormalities, performance
capacity, blood pressure, and heart rate response.RESULTS: Only 15/5871 (0.2%) of pilot applicants required further investigation and none were ultimately disqualified for aircrew duties due to their ExECG results. Of the nonpilot applicants, 22/1775 (1.2%) required further diagnostic
work-up due to their ExECG findings, with only 1 ultimately disqualified. From active-duty pilots, 84/17,131 (0.5%) ExECGs revealed findings requiring further investigation, with only 2 pilots ultimately disqualified from flying duties.DISCUSSION: The extremely low yield of ExECG
findings requiring further evaluation and/or disqualification for aircrew duties suggest its use is questionable and not cost-effective as a screening tool in this cohort. It may be enough to perform ExECG on clinical indication alone.Guettler N, Nicol ED, Sammito S. Exercise ECG
for screening in military aircrew. Aerosp Med Hum Perform. 2022; 93(9):666–672.
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Robles AG, Palamà Z, Nesti M, Tunzi RM, Delise P, Cavarretta E, Penco M, Romano S, Sciarra L. Sport Related Sudden Death: The Importance of Primary and Secondary Prevention. J Clin Med 2022; 11:jcm11164683. [PMID: 36012921 PMCID: PMC9410008 DOI: 10.3390/jcm11164683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 12/02/2022] Open
Abstract
Sports are a double-edged sword. On the one hand, cardiovascular benefits from sports activity are well-known, and on the other hand, sports may increase the risk of sudden cardiac death (SCD) in subjects with known or unknown cardiovascular diseases. SCD is rare but has a very strong emotional issue. There are many examples involving famous professional athletes, but this is only scratching the surface of a widespread phenomenon that also involves amateur athletes. The importance of safely performing physical activity appears clear in both professional and amateur athletes. In particular, the former undergo a pre-participation screening for SCD primary prevention with different recommendations in each country. On the other hand, a medical examination is not mandatory for non-professional athletes and, therefore, for people who practice sports as an amateur. Widespread distribution of automatic external defibrillators and people trained for cardiopulmonary resuscitation are necessary to promote secondary prevention of SCD. We briefly report a case series of athletes with aborted SCD during sports activity in order to underline and discuss in this review the previously highlighted issues.
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Affiliation(s)
- Antonio Gianluca Robles
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Zefferino Palamà
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Martina Nesti
- Cardiovascular and Neurological Department, Ospedale San Donato, 52100 Arezzo, Italy
| | | | - Pietro Delise
- Division of Cardiology, Hospital ‘P. Pederzoli’, 37019 Peschiera del Garda, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Maria Penco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Silvio Romano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: ; Tel.: +39-0862434740; Fax: +39-0862433425
| | - Luigi Sciarra
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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Chronic Disease, Allergies, and Increased Years of Running Are Risk Factors Predicting Gradual Onset Running-Related Injuries in Ultramarathon Runners-SAFER XIX Study in 29 585 Race Entrants. Clin J Sport Med 2022; 32:e422-e429. [PMID: 34117154 DOI: 10.1097/jsm.0000000000000949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/16/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To identify risk factors that predict gradual onset running-related injuries (GORRIs) in ultramarathon runners entering a mass community-based event. DESIGN Descriptive cross-sectional study. SETTING Two Oceans 56 km ultramarathon 2012 to 2015. PARTICIPANTS Race entrants (n = 42 003) completed a compulsory pre-race medical history questionnaire; 29 585 (70.4%) of entrants consented. DEPENDENT/OUTCOME VARIABLE A history of GORRIs in the past 12 months among race entrants. MAIN OUTCOME MEASURES In a multi-variate model, runner demographics, training variables (years of recreational running, weekly running distance, training running speed), history of chronic disease (composite score), and history of allergies were included as factors predicting GORRIs. Prevalence (%) and prevalence ratios (PR, 95% CIs) are reported. RESULTS The lifetime prevalence of GORRIs in ultramarathon runners was 24.4%. Independent factors predicting GORRIs were: higher chronic disease composite score (PR = 2.05 times increase risk for every 2 additional chronic diseases; P < 0.0001), history of allergies (PR = 1.66; P < 0.0001), increased years of recreational running (PR = 1.07 times increased risk for every 5 year increase in running; P < 0.0001), lower average weekly running distance (PR = 0.98 times decreased risk for every 15 km increase weekly running distance; P < 0.0001), and slower average training running speed (PR = 0.96 times decreased risk for every km/h increase in training running speed; P < 0.0001). CONCLUSIONS Novel risk factors predicting GORRIs are increased number of chronic diseases and a history of allergies. These factors, together with training variables (years of recreational running, weekly running distance, and training running speed) can be targeted to develop and implement injury prevention, treatment, and rehabilitation interventions in ultramarathon runners.
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Yeung P, Phulka J, Morrison B, Moulson N, McKinney J. Automated external defibrillator and emergency action plan preparedness amongst masters athletes. PHYSICIAN SPORTSMED 2022; 51:240-246. [PMID: 35088628 DOI: 10.1080/00913847.2022.2036079] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Sudden cardiac arrest/death (SCA/D) is the leading medical cause of death in athletes. Masters athletes (≥35 years old) are increasing in numbers and are responsible for the vast majority of sport-related SCDs. Automated external defibrillators (AEDs) and emergency action plans (EAPs) have been shown to unequivocally reduce SCD, however, their prevalence in masters athletics remains unknown. We sought to identify the perceived AED accessibility and EAP preparedness amongst a group of masters athletes. METHODS A 40-item survey was sent to 735 master athletes identified through the Masters Athlete Screening Study. Participants were athletes with no known significant cardiac history. The survey inquired on the availability and location of AEDs within exercise settings, the presence of EAPs, and participants' cardiac concerns. RESULTS Sixty-eight percent of athletes completed the survey. Ninety-seven percent and 99% of athletes believed CPR and AEDs were effective at saving lives, respectively. Thirty-eight percent of athletes were aware of an AED in proximity to where they exercise, with 40% aware of one available during competition events, and 28% during training events. Only 10% of athletes were aware of an EAP active in their place of exercise. Half of the athletes perceive their risk of cardiac arrest during exercise to be ≤0.5 in 100,000. CONCLUSIONS These findings indicate that nearly all athletes believe CPR and AED are effective at saving lives, but only a minority are aware of an AED near their place of exercise, with even fewer aware of an active EAP. Master athletes underestimate their own risk for exercise-related cardiac events, affirming the importance of educating masters athletes on their increased cardiac risk and the importance of EAPs.
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Affiliation(s)
- Phillip Yeung
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jobanjit Phulka
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Barbara Morrison
- Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
| | - Nathaniel Moulson
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - James McKinney
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.,SportsCardiologyBC, University of British Columbia, Vancouver, British Columbia, Canada
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14
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Evolution of Incidence, Management, and Outcomes Over Time in Sports-Related Sudden Cardiac Arrest. J Am Coll Cardiol 2022; 79:238-246. [DOI: 10.1016/j.jacc.2021.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 12/11/2022]
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15
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Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. Br J Sports Med 2021; 56:410-416. [PMID: 34853034 DOI: 10.1136/bjsports-2021-104623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA). DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020. STUDY ELIGIBILITY CRITERIA Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained. METHODS Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated. RESULTS A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%-96%), middle-aged (median: 51, IQR: 39-56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%-86%). Bystander CPR was initiated in a median of 71% (IQR: 59%-87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%-42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%-49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA. CONCLUSION Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.
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Affiliation(s)
- Nicholas Grubic
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada .,Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Braeden Hill
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Dermot Phelan
- Sports Cardiology Center, Atrium Health Sanger Heart and Vascular Institute, Charlotte, North Carolina, USA
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Dorian
- Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada
| | - Amer M Johri
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
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16
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Abstract
Hereditary diseases under the age of 35 are the most common underlying heart disease, leading to sudden cardiac death (SCD) in competitive sports, while in older people, atherosclerotic coronary artery disease (CAD) is the main cause. The following preventive measures are recommended: (a) The pre-participation cardiovascular screening, (b) the genetic testing, (c) the use of implantable cardioverter-defibrillator (ICD), (d) the prohibition of doping in sports, (e) the prevention of 'exercise-induced' cardiac complications, (f) the reduction of high-risk factors for CAD, and (g) the use of cardiopulmonary resuscitation. The cost-effectiveness of the electrocardiograms in the pre-participation screening programs remains questionable. Genetic testing is recommended in borderline cases and positive family history. Athletes with ICD can, under certain conditions, participate in competitive sports. Excessive endurance exercise appears to harm the endothelium, promotes inflammatory processes and leads to fibrosis in the myocardium, and calcium deposition in the coronary vessels. Cardiac arrest may be reversed if cardiopulmonary resuscitation is performed and a defibrillator is immediately used. Thus, equipping all fields with automatic external defibrillators are recommended.
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Affiliation(s)
- Asterios Deligiannis
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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17
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Panhuyzen-Goedkoop NM, Wellens HJ, Verbeek ALM, Piek JJ, Peters RJG. Immediate Bystander Cardiopulmonary Resuscitation to Sudden Cardiac Arrest During Sports is Associated with Improved Survival-a Video Analysis. SPORTS MEDICINE-OPEN 2021; 7:50. [PMID: 34292409 PMCID: PMC8298728 DOI: 10.1186/s40798-021-00346-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/08/2021] [Indexed: 11/21/2022]
Abstract
Background Sudden cardiac arrest (SCA) during sports can be the first symptom of yet undetected cardiovascular conditions. Immediate chest compressions and early defibrillation offer SCA victims the best chance of survival, which requires prompt bystander cardiopulmonary resuscitation (CPR). Aims To determine the effect of rapid bystander CPR to SCA during sports by searching for and analyzing videos of these SCA/SCD events from the internet. Methods We searched images.google.com, video.google.com, and YouTube.com, and included any camera-witnessed non-traumatic SCA during sports. The rapidity of starting bystander chest compressions and defibrillation was classified as < 3, 3–5, or > 5 min. Results We identified and included 29 victims of average age 27.6 ± 8.5 years. Twenty-eight were males, 23 performed at an elite level, and 18 participated in soccer. Bystander CPR < 3 min (7/29) or 3–5 min (1/29) and defibrillation < 3 min was associated with 100% survival. Not performing chest compressions and defibrillation was associated with death (14/29), and > 5 min delay of intervention with worse outcome (death 4/29, severe neurologic dysfunction 1/29). Conclusions Analysis of internet videos showed that immediate bystander CPR to non-traumatic SCA during sports was associated with improved survival. This suggests that immediate chest compressions and early defibrillation are crucially important in SCA during sport, as they are in other settings. Optimal use of both will most likely result in survival. Most videos showing recent events did not show an improvement in the proportion of athletes who received early resuscitation, suggesting that the problem of cardiac arrest during sports activity is poorly recognized.
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Affiliation(s)
- Nicole M Panhuyzen-Goedkoop
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands. .,Sports Medical Centre Papendal, Arnhem, the Netherlands.
| | | | - André L M Verbeek
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jan J Piek
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Ron J G Peters
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
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18
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Viljoen CT, Sewry N, Schwellnus MP, Janse van Rensburg DC, Swanevelder S, Jordaan E. Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study. Wilderness Environ Med 2021; 32:293-301. [PMID: 34266742 DOI: 10.1016/j.wem.2021.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events. METHODS In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative "chronic disease composite score"), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo. RESULTS This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%). CONCLUSIONS Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.
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Affiliation(s)
- Carel T Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centres, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Martin P Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, Pretoria, South Africa; Sport and Exercise Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dina C Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa; Statistics and Population Studies Department, University of the Western Cape, Western Cape, South Africa
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19
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Epidemiology, clinical characteristics and severity of gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIII. Phys Ther Sport 2020; 46:113-119. [DOI: 10.1016/j.ptsp.2020.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
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20
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History of chronic disease is a novel intrinsic risk factor associated with gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIV. Phys Ther Sport 2020; 46:137-144. [DOI: 10.1016/j.ptsp.2020.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/25/2022]
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21
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(Sudden cardiac arrest/death during sports). COR ET VASA 2020. [DOI: 10.33678/cor.2020.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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Vasić D, Novaković M, Božič Mijovski M, Barbič Žagar B, Jug B. Short-Term Water- and Land-Based Exercise Training Comparably Improve Exercise Capacity and Vascular Function in Patients After a Recent Coronary Event: A Pilot Randomized Controlled Trial. Front Physiol 2019; 10:903. [PMID: 31379605 PMCID: PMC6646683 DOI: 10.3389/fphys.2019.00903] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 06/28/2019] [Indexed: 12/11/2022] Open
Abstract
Background We hypothesized that a 2-week twice daily aquatic endurance plus calisthenics exercise training program: (i) increases aerobic exercise capacity (peak oxygen uptake/ V ˙ O2peak), (ii) improves endothelium-dependent flow-mediated vasodilation (FMD), and (iii) reduces circulating markers of low-grade inflammation and hemostasis, as compared to land-based endurance plus calisthenics exercise training or no exercise in patients undergoing short-term residential cardiac rehabilitation after a recent coronary artery disease (CAD) event. Methods Patients with a recent myocardial infarction or revascularization procedure were randomized into two interventional groups and a control group. The interventional groups underwent supervised aerobic endurance plus calisthenics exercise training either in thermo-neutral water or on land at moderate intensity (60-80% of the peak heart rate achieved during symptom-limited graded exercise testing) for 30 min twice daily for 2 weeks (i.e., 24 sessions). The control group was deferred from supervised exercise training for the 2-week duration of the intervention, but was advised low-to-moderate intensity physical activity at home while waiting. At baseline and after the intervention period, all participants underwent estimation of aerobic exercise capacity, brachial artery flow-mediated dilatation (FMD, measured ultrasonographically at rest and during reactive hyperemia after 4.5 min of forearm cuff inflation), markers of cardiac dysfunction (NT-proBNP), inflammation (hsCRP, IL-6, IL-8, IL-10), cell adhesion (ICAM, P-selectin), and hemostasis (fibrinogen, D-dimer). Results A total of 89 patients (mean age 59.9 ± 8.2 years, 77.5% males, V ˙ O2peak at baseline 14.8 ± 3.5 ml kg-1 min-1) completed the study. Both exercise modalities were safe (no significant adverse events recorded) and associated with a significant improvement in V ˙ O2peak as compared to controls: age and baseline V ˙ O2peak-adjusted end-of-study V ˙ O2peak increased to 16.7 (95% CI 16.0-17.4) ml kg-1 min-1 with land-based training (p < 0.001 for change from baseline) and to 18.6 (95% CI 17.9-19.3) ml kg-1 min-1 with water-based training (p < 0.001 for change from baseline), but not in controls (14.9 ml kg-1 min-1; 95% CI 14.2-15.6; p = 0.775 for change from baseline). FMD also increased in both intervention groups (from 5.5 to 8.8%, p < 0.001 with land-based, and from 7.2 to 9.2%, p < 0.001 with water-based training, respectively), as compared to controls (p for change 0.629). No significant changes were detected in biomarkers of inflammation, cell adhesion or hemostasis, whereas levels of NT-proBNP (marker of cardiac dysfunction) decreased in the water-based training group (p = 0.07 vs. controls). Conclusion Endurance plus calisthenics exercise training in thermo-neutral water is safe, and improves aerobic exercise capacity and vascular function in patients undergoing short-term residential cardiac rehabilitation after a recent CAD event. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02831829.
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Affiliation(s)
- Danijela Vasić
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Terme Krka, Šmarješke Toplice, Slovenia
| | - Marko Novaković
- Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
| | - Mojca Božič Mijovski
- Laboratory for Haemostasis and Atherothrombosis, Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
| | | | - Borut Jug
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
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23
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Panhuyzen-Goedkoop NM. Prevention of cardiovascular events in amateur athletes begins with a healthy lifestyle at school age. Eur J Prev Cardiol 2019; 26:1519-1521. [PMID: 31161937 DOI: 10.1177/2047487319853907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nicole M Panhuyzen-Goedkoop
- 1 Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, Meibergdreef, Amsterdam, the Netherlands.,2 Department of Sports Cardiology, Sports Medical Centre Papendal, Papendallaan, the Netherlands
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24
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Outcome of exercise-related out-of-hospital cardiac arrest is dependent on location: Sports arenas vs outside of arenas. PLoS One 2019; 14:e0211723. [PMID: 30707745 PMCID: PMC6358107 DOI: 10.1371/journal.pone.0211723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/20/2019] [Indexed: 11/19/2022] Open
Abstract
Background The chance of surviving an out-of-hospital cardiac arrest (OHCA) seems to be increased if the cardiac arrests occurs in relation to exercise. Hypothetically, an exercise-related OHCA at a sports arena would have an even better prognosis, because of an increased likelihood of bystander cardiopulmonary resuscitation (CPR) and higher availability of automated external defibrillators (AEDs). The purpose of the study was to compare survival rates between exercise-related OHCA at sports arenas versus outside of sports arenas. Methods Data from all treated exercise-related OHCA outside home reported to the Swedish Register of Cardiopulmonary Resuscitation (SRCR) from 2011 to 2014 in 10 counties of Sweden was analyzed (population 6 million). The registry has in those counties a coverage of almost 100% of all OHCAs. Results 3714 cases of OHCA outside of home were found. Amongst them, 268(7%) were exercise-related and 164 (61.2%) of those occurred at sports arenas. The 30-day survival rate was higher for exercise-related OHCA at sports arenas compared to outside (55.7% vs 30.0%, p<0.0001). OHCA-victims at sports arenas were younger (mean age±SD 57.6±16.3 years compared to 60.9±17.0 years, p = 0.05), less likely female (4.3% vs 12.2%, p = 0.02) and had a higher frequency of shockable rhythm (73.0% vs 54.3%, p = 0.004). OHCAs at arenas were more often witnessed (83.9% vs 68.9%, p = 0.007), received bystander CPR to a higher extent (90.0% vs 56.8%, p<0.0001) and the AED-use before EMS-arrival was also higher in this group (29.8% vs 11.1%, p = 0.009). Conclusion The prognosis is markedly better for exercise-related OHCA occurring at sports arenas compared to outside. Victims of exercise-related OHCA at sports arenas are more likely to receive bystander CPR and to be connected to a public AED. These findings support an increased use of public AEDs and implementation of Medical Action Plans (MAP), to possibly increase survival of exercise-related OHCA even further.
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25
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Sirico F, Fernando F, Di Paolo F, Adami PE, Signorello MG, Sannino G, Bianco A, Cerrone A, Baioccato V, Filippi N, Ferrari U, Tuzi M, Nurzynska D, Di Meglio F, Castaldo C, D'Ascenzi F, Montagnani S, Biffi A. Exercise stress test in apparently healthy individuals - where to place the finish line? The Ferrari corporate wellness programme experience. Eur J Prev Cardiol 2019; 26:731-738. [PMID: 30674206 DOI: 10.1177/2047487318825174] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The aim of our study was to assess the clinical significance of the exercise stress testing endpoints, namely 85% of maximal theoretical heart rate (MTHR), metabolic equivalent of task, and rating of perceived exertion (RPE), and their relation to electrocardiographic (ECG) changes in a healthy adult population. METHODS A cross-sectional study was conducted on 408 males and 52 females (mean age 39.4 ± 8.6 years) who performed the maximal cycle ergometer exercise stress test until volitional exhaustion, reporting the RPE score at 85% of MTHR and at peak exercise. Metabolic equivalents of task were indirectly calculated from the maximum workload and compared with the predicted values. Sitting torso-lead ECG and blood pressure were recorded at rest, during exercise and during recovery. RESULTS Of 460 participants, 73% exceeded 85% of MTHR. The RPE score represented the overall most significant endpoint of exercise stress testing, with the median value of 17 at peak exercise. ECG events were detected in 23/124 (18.5%) who reached ≤ 85% of MTHR and in 61/336 (18.2%) who achieved >85% of MTHR ( p = 0.92). In the latter group, 54% of ECG changes occurred at < 85% of MTHR and 46% at > 85% of MTHR ( p = 0.51). If the exercise stress testing had been interrupted at ≤ 85% of MTHR, almost half of the ECG events would have remained undetected and 35% of the cardiovascular abnormalities observed at the diagnostic follow-up would have remained undiagnosed. CONCLUSION Terminating exercise stress testing before volitional exhaustion and an RPE score of 17 limits the test accuracy and reduces the possibility to detect cardiovascular abnormalities in apparently healthy adult populations.
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Affiliation(s)
- Felice Sirico
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy.,2 University of Naples Federico II, Department of Public Health, Italy
| | - Fredrick Fernando
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Fernando Di Paolo
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Paolo Emilio Adami
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | | | - Giuseppe Sannino
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Antonio Bianco
- 2 University of Naples Federico II, Department of Public Health, Italy
| | | | | | - Nicola Filippi
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Umberto Ferrari
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Manuel Tuzi
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Daria Nurzynska
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Franca Di Meglio
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Clotilde Castaldo
- 2 University of Naples Federico II, Department of Public Health, Italy
| | - Flavio D'Ascenzi
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | | | - Alessandro Biffi
- 1 Med-Ex, Medicine & Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
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Johri AM, Poirier P, Dorian P, Fournier A, Goodman JM, McKinney J, Moulson N, Pipe A, Philippon F, Taylor T, Connelly K, Baggish AL, Krahn A, Sharma S. Canadian Cardiovascular Society/Canadian Heart Rhythm Society Joint Position Statement on the Cardiovascular Screening of Competitive Athletes. Can J Cardiol 2019; 35:1-11. [DOI: 10.1016/j.cjca.2018.10.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022] Open
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Delhomme C, Njeim M, Varlet E, Pechmajou L, Benameur N, Cassan P, Derkenne C, Jost D, Lamhaut L, Marijon E, Jouven X, Karam N. Automated external defibrillator use in out-of-hospital cardiac arrest: Current limitations and solutions. Arch Cardiovasc Dis 2018; 112:217-222. [PMID: 30594573 DOI: 10.1016/j.acvd.2018.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/20/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
Abstract
Out-of-hospital sudden cardiac arrest (OHCA) is a major public health issue, with a survival rate at hospital discharge that remains below 10% in most cities, despite huge investments in this domain. Early basic life support (BLS) and early defibrillation using automated external defibrillators (AEDs) stand as key elements for improving OHCA survival rate. Nevertheless, the use of AEDs in OHCA remains low, for a variety of reasons, including the number, accessibility and ease of locating AEDs, as well as bystanders' awareness of BLS manœuvres and of the need to use AEDs. Several measures have been proposed to improve the rate of AED use, including optimization of AED deployment strategies as well as the use of drones to bring the AEDs to the OHCA scene and of mobile applications to locate the nearest AED. If they are to be effective, these measures should be combined with large communication campaigns on OHCA, and wide-scale education of the public in BLS and AEDs, to reduce the burden of OHCA.
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Affiliation(s)
- Clémence Delhomme
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Mario Njeim
- Hôtel-Dieu de France Hospital, BP 166830 Beirut, Lebanon; Saint Joseph University, 11042020 Beirut, Lebanon
| | - Emilie Varlet
- Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Louis Pechmajou
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Nordine Benameur
- Sudden Death Expertise Centre, Lille University Hospital, 59000 Lille, France; SAMU 59, Emergency Department, Lille University Hospital, 59000 Lille, France
| | - Pascal Cassan
- International Federation of Red Cross and Red Crescent Societies, 75014 Paris, France
| | | | | | | | - Eloi Marijon
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Sudden Death Expertise Centre, 75015 Paris, France; Cardiology Department, Georges Pompidou European Hospital, 75015 Paris, France; Paris Descartes University, 75006 Paris, France.
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Wing K, Bailey HJ, Gronek P, Podstawski R, Clark CCT. A preliminary audit of medical and aid provision in English Rugby union clubs: compliance with Regulation 9. Ir J Med Sci 2018; 188:1093-1101. [PMID: 30368644 DOI: 10.1007/s11845-018-1913-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/10/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Governing bodies are largely responsible for the monitoring and management of risks associated with a safe playing environment, yet adherence to regulations is currently unknown. The aim of this study was to investigate and evaluate the current status of medical personnel, facilities, and equipment in Rugby Union clubs at regional level in England. METHODS A nationwide cross-sectional survey of 242 registered clubs was undertaken, where clubs were surveyed online on their current medical personnel, facilities, and equipment provision, according to regulation 9 of the Rugby Football Union (RFU). RESULTS Overall, 91 (45. 04%) surveys were returned from the successfully contacted recipients. Of the completed responses, only 23.61% (n = 17) were found to be compliant with regulations. Furthermore, 30.56% (n = 22) of clubs were unsure if their medical personnel had required qualifications; thus, compliance could not be determined. There was a significant correlation (p = -0.029, r = 0.295) between club level and numbers of practitioners. There was no significant correlation indicated between the number of practitioners/number of teams and number of practitioners/number of players. There were significant correlations found between club level and equipment score (p = 0.003, r = -0.410), club level and automated external defibrillator (AED) access (p = 0.002, r = -0.352) and practitioner level and AED access (p = 0.0001, r = 0.404). Follow-up, thematic analysis highlighted widespread club concern around funding/cost, awareness, availability of practitioners and AED training. CONCLUSION The proportion of clubs not adhering overall compliance with Regulation 9 of the RFU is concerning for player welfare, and an overhaul, nationally, is required.
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Affiliation(s)
- Kirsten Wing
- Sport, Exercise and Well-Being Research Arena, Hartpury University, Gloucester, GL19 3BE, UK
| | - Hollie J Bailey
- Sport, Exercise and Well-Being Research Arena, Hartpury University, Gloucester, GL19 3BE, UK
| | - Piotr Gronek
- Laboratory of Genetics, Department of Dance and Gymnastics, University School of Physical Education in Poznań, Poznań, Poland
| | - Robert Podstawski
- Department of Physical Education and Sport, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Cain C T Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK. .,Engineering Behaviour Analytics in Sports and Exercise (E-BASE) Research Group, Swansea University, Wales, SA1 8EN, UK.
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Toresdahl BG, Asif IM, Rodeo SA, Ling DI, Chang CJ. Cardiovascular screening of Olympic athletes reported by chief medical officers of the Rio 2016 Olympic Games. Br J Sports Med 2018; 52:1097-1100. [DOI: 10.1136/bjsports-2018-099029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/03/2022]
Abstract
ObjectiveThe IOC recommends periodic cardiovascular screening of athletes, but the adoption of these recommendations is unknown. The purpose of this investigation was to evaluate and compare cardiovascular screening practices of countries participating in the Rio 2016 Olympic Games.MethodsA list of chief medical officers (CMOs) was compiled by the IOC during the 2016 Olympic Games. CMOs were requested to complete an online survey about cardiovascular screening of their countries’ Olympic athletes. Comparisons of screening practices were made by categorising countries by continent, gross domestic product (GDP) per capita and size of athlete delegation.ResultsCMOs for 117/207 (56.5%) countries participating in the 2016 Olympic Games were identified. 94/117 countries (80.3%) completed the survey, representing 45.4% of all countries and 8805/11 358 (77.5%) of all 2016 Olympic athletes. Most of the countries surveyed (70.2%) perform annual cardiovascular screening. Among the survey respondents, all or most athletes from each country were screened at least once with the following components: personal history (86.2% of countries), family history (85.1%), physical examination (87.2%), resting ECG (74.5%), echocardiogram (31.9%) and stress test (30.8%). Athletes were more likely to be screened with ECG in countries with relatively larger athlete delegation (OR 2.05, 95% CI 1.10 to 3.80, p=0.023) and with higher GDP per capita (OR 1.69, 95% CI 1.11 to 2.57, p=0.014).ConclusionMost of the responding countries perform annual cardiovascular screening of Olympic athletes, but there are differences in the components used. Athletes from countries with larger athlete delegations and higher GDP per capita were more likely to be screened with ECG.
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Nilson F, Börjesson M. Mortality in long-distance running races in Sweden - 2007-2016. PLoS One 2018; 13:e0195626. [PMID: 29630680 PMCID: PMC5891071 DOI: 10.1371/journal.pone.0195626] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/25/2018] [Indexed: 12/01/2022] Open
Abstract
Background During the last decade, an increasing popularity of marathons has been seen. Although running has been shown to have considerable positive health effects, the risk of sudden death, most often due to sudden cardiac arrests, is also a risk runners expose themselves to. Whilst there are some studies on the mortality amongst long-distance runners, much of the evidence is dated. Given the increased popularity in running during the 21st century as well as the improvements in medical care at marathons, more knowledge is required on the mortality risk. Materials and method Publicly available racing and news databases were used to identify the number of entrants and finishers in half to full marathons in Sweden between 2007 and 2016 and the number of deaths that occurred in conjunction with the races. Results A total of 1,156,271 runners entered a long distance (21-42km) running race in Sweden between 2007 and 2016, and 834,412 runners finished the races (72.2%). A large majority of the finishers (677,050 (81%)) competed in distances under a full marathon. Two deaths occurred during the time period, meaning that the death rate was 0.24 (95% confidence interval 0.04–0.79) per 100,000 finishers. Conclusions This study can show that death rates in long distance running races between 2007 and 2016 in Sweden are very low, compared to previous studies. When added to the existing literature, the combined picture suggests a general downward trend in the risk of death during marathons since the 1980s.
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Affiliation(s)
- Finn Nilson
- Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden
- * E-mail:
| | - Mats Börjesson
- Department of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Food, Nutrition and Sport Science, Sahlgrenska University Hospital, Gothenburg, Sweden
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Affiliation(s)
- Gaetano Thiene
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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Sessa F, Anna V, Messina G, Cibelli G, Monda V, Marsala G, Ruberto M, Biondi A, Cascio O, Bertozzi G, Pisanelli D, Maglietta F, Messina A, Mollica MP, Salerno M. Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY) 2018; 10:166-177. [PMID: 29476045 PMCID: PMC5842851 DOI: 10.18632/aging.101386] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/09/2018] [Indexed: 02/01/2023]
Abstract
Sudden cardiac death (SCD) represents about 25% of deaths in clinical cardiology. The identification of risk factors for SCD is the philosopher's stone of cardiology and the identification of non-invasive markers of risk of SCD remains one of the most important goals for the scientific community.The aim of this review is to analyze the state of the art around the heart rate variability (HRV) as a predictor factor for SCD.HRV is probably the most analyzed index in cardiovascular risk stratification technical literature, therefore an important number of models and methods have been developed.Nowadays, low HRV has been shown to be independently predictive of increased mortality in post- myocardial infarction patients, heart failure patients, in contrast with the data of the general population.Contrariwise, the relationship between HRV and SCD has received scarce attention in low-risk cohorts. Furthermore, in general population the attributable risk is modest and the cost/benefit ratio is not always convenient.The HRV evaluation could become an important tool for health status in risks population, even though the use of HRV alone for risk stratification of SCD is limited and further studies are needed.
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Affiliation(s)
- Francesco Sessa
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
- Equal contribution
| | - Valenzano Anna
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
- Equal contribution
| | - Giovanni Messina
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Giuseppe Cibelli
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Vincenzo Monda
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Gabriella Marsala
- Struttura Complessa di Farmacia, Azienda Ospedaliero-Universitaria, Foggia, Italy
| | - Maria Ruberto
- CRD Center, Santa Maria del Pozzo, Somma Vesuviana (NA), Italy
| | - Antonio Biondi
- University of Catania, Department of Surgery, Catania, Italy
| | - Orazio Cascio
- University of Catania, Department of Anatomy, Catania, Italy
| | - Giuseppe Bertozzi
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Daniela Pisanelli
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Francesca Maglietta
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Antonietta Messina
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Maria P. Mollica
- Università degli Studi di Napoli Federico II, Department of Experimental Medicine, Naples, Italy
| | - Monica Salerno
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
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Panhuyzen-Goedkoop NM, Wellens HJ, Piek JJ. Early recognition of sudden cardiac arrest in athletes during sports activity. Neth Heart J 2018; 26:21-25. [PMID: 29196876 PMCID: PMC5758452 DOI: 10.1007/s12471-017-1061-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sudden cardiac arrest (SCA) in athletes is an unexpected life-threatening event, which is often not recognised early and cardiopulmonary resuscitation (CPR) is not always initiated immediately. We describe key features to rapidly recognise non-traumatic SCA in athletes during sports activity. METHODS We reviewed videos and images of athletes suffering from non-traumatic SCA during sports activity. We searched Google images, Google videos and YouTube.com using the keywords 'sudden cardiac death athlete' and 'resuscitation athlete'. We analysed (1) the athlete's performance before syncope, (2) the athlete's performance at the start of syncope, (3) the position of the body, and (4) the athlete's facial expressions before CPR. We analysed our data by describing these four features to answer our research question. RESULTS We analysed the sequence of events in six well-known soccer players in whom a camera-witnessed non-traumatic SCA occurred during their athletic activity. All six athletes showed no changes before syncope. Four became unstable while standing and unexpectedly collapsed falling on their back. Two suddenly 'dropped dead' and fell face down. All six had their eyes wide open with a fixed gaze and fixed pupils. CONCLUSIONS Sudden unexpected loss of consciousness in an athlete in action and a fixed gaze eye position are key features of SCA. Immediate cardiac massage should follow. The described features to immediately recognise SCA in athletes during sports activity should be taught to everyone involved in athletic activity leading to earlier recognition of SCA followed by earlier CPR.
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Affiliation(s)
- N M Panhuyzen-Goedkoop
- AMC Heart Center, Academic Medical Center, Amsterdam, The Netherlands.
- Sports Medical Center Papendal Arnhem, Arnhem, The Netherlands.
- Radboud University Medical Center, Nijmegen, The Netherlands.
| | - H J Wellens
- Cardiovascular Research Center, Maastricht, The Netherlands
| | - J J Piek
- AMC Heart Center, Academic Medical Center, Amsterdam, The Netherlands
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Narayanan K, Bougouin W, Sharifzadehgan A, Waldmann V, Karam N, Marijon E, Jouven X. Sudden Cardiac Death During Sports Activities in the General Population. Card Electrophysiol Clin 2017; 9:559-567. [PMID: 29173402 DOI: 10.1016/j.ccep.2017.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Regular exercise reduces cardiovascular and overall mortality. Participation in sports is an important determinant of cardiovascular health and fitness. Regular sports activity is associated with a smaller risk of sudden cardiac death (SCD). However, there is a small risk of sports-related SCD. Sports-related SCD accounts for approximately 5% of total SCD. SCD among athletes comprises only a fraction of all sports-related SCD. Sport-related SCD has a male predominance and an average age of affliction of 45 to 50 years. Survival is better than for other SCD. This review summarizes links between sports and SCD and discusses current knowledge and controversies.
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Affiliation(s)
- Kumar Narayanan
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Cardiology Department, Maxcure Hospitals, Hitec City, Hyderabad 500081, India
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France
| | - Ardalan Sharifzadehgan
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Victor Waldmann
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Nicole Karam
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France.
| | - Xavier Jouven
- Paris Cardiovascular Research Center-INSERM U970 (PARCC), Paris, France; Paris Sudden Death Expertise Center (SDEC), European Georges Pompidou Hospital, 56 rue Leblanc, Paris 75987, France; Paris Descartes University, Rue de l'Ecole de Médecine, Paris 75006, France; Cardiology Department, European Georges Pompidou Hospital, 20, Rue Leblanc, Paris 75015, France
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Karam N, Narayanan K, Bougouin W, Benameur N, Beganton F, Jost D, Lamhaut L, Perier MC, Cariou A, Celermajer DS, Marijon E, Jouven X. Major regional differences in Automated External Defibrillator placement and Basic Life Support training in France: Further needs for coordinated implementation. Resuscitation 2017; 118:49-54. [DOI: 10.1016/j.resuscitation.2017.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/20/2017] [Accepted: 07/04/2017] [Indexed: 11/12/2022]
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Malhotra A, Dhutia H, Gati S, Yeo TJ, Finnochiaro G, Keteepe-Arachi T, Richards T, Walker M, Birt R, Stuckey D, Robinson L, Tome M, Beasley I, Papadakis M, Sharma S. Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England. Br J Sports Med 2017; 53:813-817. [DOI: 10.1136/bjsports-2016-097440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 11/04/2022]
Abstract
AimTo assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England.MethodsA written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues.Results79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2.ConclusionsThe majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions.
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Kiyohara K, Nishiyama C, Kiguchi T, Nishiuchi T, Hayashi Y, Iwami T, Kitamura T. Exercise-Related Out-of-Hospital Cardiac Arrest Among the General Population in the Era of Public-Access Defibrillation: A Population-Based Observation in Japan. J Am Heart Assoc 2017; 6:e005786. [PMID: 28611095 PMCID: PMC5669182 DOI: 10.1161/jaha.117.005786] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/02/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Exercise can trigger sudden cardiac arrest. Early initiation of cardiopulmonary resuscitation and automated external defibrillator use by laypersons could maximize the survival rate following exercise-related out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS OHCA data between 2005 and 2012 were obtained from a prospective population-based OHCA registry in Osaka Prefecture. Patients with OHCA of presumed cardiac origin and occurring before emergency medical service personnel arrival were included. The incidence trends of exercise-related OHCA over the 8-year study period were assessed. Among patients with bystander-witnessed, exercise-related OHCA, the trends in the initiation of bystander cardiopulmonary resuscitation, public-access defibrillation, and outcome were evaluated. The primary outcome was 1-month survival with favorable neurological outcome, defined as cerebral performance category 1 or 2. During the study period, 0.7% of OHCAs of cardiac origin (222/31 030) were exercise related. The incidence of exercise-related OHCA increased from 1.8 (per million population per year) in 2005 to 4.3 in 2012. Of these, 83.8% (186/222) were witnessed by bystanders. Among the patients with bystander-witnessed, exercise-related OHCA, the proportion that received bystander cardiopulmonary resuscitation (50.0% in 2005 and 86.2% in 2012) and public-access defibrillation (7.1% in 2005 and 62.1% in 2012) significantly increased during the study period. Furthermore, the rate of 1-month survival with favorable neurological outcome among these patients significantly improved (from 28.6% in 2005 to 58.6% in 2012). CONCLUSIONS The incidence rate of exercise-related OHCA was low in the study population. The increase in bystander cardiopulmonary resuscitation and public-access defibrillation rates were associated with improved outcome among patients with bystander-witnessed, exercise-related OHCA.
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Affiliation(s)
- Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Chika Nishiyama
- Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, Kyoto, Japan
| | | | - Tatsuya Nishiuchi
- Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasuyuki Hayashi
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, Osaka, Japan
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace 2015; 17:1601-87. [PMID: 26318695 DOI: 10.1093/europace/euv319] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015; 36:2793-2867. [PMID: 26320108 DOI: 10.1093/eurheartj/ehv316] [Citation(s) in RCA: 2530] [Impact Index Per Article: 281.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
MESH Headings
- Acute Disease
- Aged
- Anti-Arrhythmia Agents/therapeutic use
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/therapy
- Autopsy/methods
- Cardiac Resynchronization Therapy/methods
- Cardiomyopathies/complications
- Cardiomyopathies/therapy
- Cardiotonic Agents/therapeutic use
- Catheter Ablation/methods
- Child
- Coronary Artery Disease/complications
- Coronary Artery Disease/therapy
- Death, Sudden, Cardiac/prevention & control
- Defibrillators
- Drug Therapy, Combination
- Early Diagnosis
- Emergency Treatment/methods
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Heart Transplantation/methods
- Heart Valve Diseases/complications
- Heart Valve Diseases/therapy
- Humans
- Mental Disorders/complications
- Myocardial Infarction/complications
- Myocardial Infarction/therapy
- Myocarditis/complications
- Myocarditis/therapy
- Nervous System Diseases/complications
- Nervous System Diseases/therapy
- Out-of-Hospital Cardiac Arrest/therapy
- Pregnancy
- Pregnancy Complications, Cardiovascular/therapy
- Primary Prevention/methods
- Quality of Life
- Risk Assessment
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/therapy
- Sports/physiology
- Stroke Volume/physiology
- Terminal Care/methods
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/therapy
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Solberg EE, Borjesson M, Sharma S, Papadakis M, Wilhelm M, Drezner JA, Harmon KG, Alonso JM, Heidbuchel H, Dugmore D, Panhuyzen-Goedkoop NM, Mellwig KP, Carre F, Rasmusen H, Niebauer J, Behr ER, Thiene G, Sheppard MN, Basso C, Corrado D. Sudden cardiac arrest in sports – need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Prev Cardiol 2015; 23:657-67. [DOI: 10.1177/2047487315599891] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- EE Solberg
- Diakonhjemmet Hospital, Department of Medicine, Oslo, Norway
| | - M Borjesson
- Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska University Hospital
| | - S Sharma
- St George’s University of London, UK
| | | | - M Wilhelm
- University Clinic for Cardiology, Cardiovascular Prevention, Rehabilitation & Sports Medicine, Inselspital, Bern, Switzerland
| | - JA Drezner
- Department of Family Medicine, University of Washington, Seattle, USA
| | - KG Harmon
- Department of Family Medicine, University of Washington, Seattle, USA
| | - JM Alonso
- Aspetar, Qatar Orthopedics and Sports Medicine Hospital, Sports Medicine Department, Doha, Qatar
| | - H Heidbuchel
- Cardiology – Arrhythmology, University Hospital Leuven, Belgium
| | - D Dugmore
- Department of Sports medicine, Perform Sports medicine centre, Burton upon Trent, UK
| | - NM Panhuyzen-Goedkoop
- Radboud University Nijmegen MC, The Netherlands; Sports Medical Centre Papendal Arnhem, The Netherlands
| | - K-P Mellwig
- Department of Cardiology, Heart and Diabetes Centre NRW, Ruhr University of Bochum, Bad Oeynhausen, Germany
| | - F Carre
- Pontchaillou Hospital, Rennes, France; INSERM U1099, Rennes, France
| | - H Rasmusen
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - ER Behr
- St George’s University of London, UK
| | - G Thiene
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | | | - C Basso
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - D Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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Marijon E, Bougouin W, Karam N, Beganton F, Lamhaut L, Perier MC, Benameur N, Tafflet M, Beal G, Hagege A, Le Heuzey JY, Desnos M, Spaulding C, Carré F, Dumas F, Celermajer DS, Cariou A, Jouven X. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities. Am Heart J 2015; 170:339-345.e1. [PMID: 26299232 DOI: 10.1016/j.ahj.2015.03.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities). METHODS AND RESULTS This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P < .0001). Patients with SCA in sports facilities were younger (42.1 vs 51.3 years, P < .0001) and less frequently had known cardiovascular diseases (P < .0001). The events were more often witnessed (99.8% vs 84.9%, 0.0001), and bystander cardiopulmonary resuscitation was more frequently initiated (35.4% vs 25.9%, P = .003). Delays of intervention were significantly shorter when SCA occurred in sports facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P < .0001). Better survival in sports facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134). CONCLUSIONS Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival.
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Affiliation(s)
- Eloi Marijon
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Intensive Care Unit, Cochin Hospital, Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France
| | - Lionel Lamhaut
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Intensive Care Unit and SAMU 75, Necker Enfants-Malades Hospital, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Nordine Benameur
- Lille 2 University Hospital, University of Lille, Emergency Department and SAMU 59, Lille, France
| | - Muriel Tafflet
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Guillaume Beal
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Albert Hagege
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Jean-Yves Le Heuzey
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Michel Desnos
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Christian Spaulding
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Francois Carré
- Rennes 1 University, Pontchaillou Hospital, INSERM UMR, Rennes, France
| | - Florence Dumas
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | | | - Alain Cariou
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France.
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Abstract
A 'paradox of sport' is that in addition to the undisputed health benefits of physical activity, vigorous exertion may transiently increase the risk of acute cardiac events. In general, the risk of sudden cardiac death (SCD) approximately doubles during physical activity and is 2- to 3-fold higher in athletes compared to nonathletes. The incidence of SCD in young athletes is in fact very low, at around 1-3 per 100,000, but attracts much public attention. Variations in incidence figures may be explained by the methodology used for data collection and more importantly by differences between subpopulations of athletes. The incidence of SCD in older (≥ 35 years) athletes is higher and may be expected to rise, as more and older individuals take part in organized sports. SCD is often the first clinical manifestation of a potentially fatal underlying cardiovascular disorder and usually occurs in previously asymptomatic athletes. In the young (<35 years), SCD is mainly due to congenital/inherited cardiac abnormalities, whilst coronary artery disease (CAD) is the most common cause in older athletes. Cardiac screening including family/personal history, physical examination and resting electrocardiogram (ECG) may identify individuals at risk and has the potential to decrease the risk of SCD in young athletes. Screening including the ECG has a high sensitivity for underlying disease in young athletes, but the specificity needs to be improved, whereas the sensitivity of screening without the use of ECG is very low. The screening modality recommended for young athletes is of limited value in older athletes, who should receive individualized screening with cardiac stress testing for patients with high risk of underlying CAD. As cardiovascular screening will never be able to identify all athletes at risk, adequate preparedness is vital in case of a potentially fatal event at the sporting arena/facility. Firstly, we will review the magnitude of the problem of SCD in athletes of different ages, as well as the aetiology. Secondly, we will focus on how to prevent SCD in athletes of all ages, reviewing cardiovascular screening recommendations as well as emergency preparedness and arena safety.
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Affiliation(s)
- C Schmied
- Cardiovascular Center, Clinic for Cardiology, University Hospital Zurich, Zurich, Switzerland
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Lin H, Zhang Y, Xu Y, Liu T, Xiao J, Luo Y, Xu X, He Y, Ma W. Large daily stock variation is associated with cardiovascular mortality in two cities of Guangdong, China. PLoS One 2013; 8:e68417. [PMID: 23874619 PMCID: PMC3713028 DOI: 10.1371/journal.pone.0068417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 05/28/2013] [Indexed: 11/18/2022] Open
Abstract
Objective The current study aimed to examine the effects of daily change of the Shenzhen Stock Exchange Index on cardiovascular mortality in Guangzhou and Taishan, China. Methods Daily mortality and stock performance data during 2006–2010 were collected to construct the time series for the two cities. A distributed lag non-linear model was utilized to examine the effect of daily stock index changes on cardiovascular mortality after controlling for potential confounding factors. Results We observed a delayed non-linear effect of the stock index change on cardiovascular mortality: both rising and declining of the stock index were associated with increased cardiovascular deaths. In Guangzhou, the 15–25 lag days cumulative relative risk of an 800 index drop was 2.08 (95% CI: 1.38–3.14), and 2.38 (95% CI: 1.31–4.31) for an 800 stock index increase on the cardiovascular mortality, respectively. In Taishan, the cumulative relative risk over 15–25 days lag was 1.65 (95% CI: 1.13–2.42) for an 800 index drop and 2.08 (95% CI: 1.26–3.42) for an 800 index rising, respectively. Conclusions Large ups and downs in daily stock index might be important predictor of cardiovascular mortality.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yanjun Xu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yuan Luo
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaojun Xu
- Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Yanhui He
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangzhou, China
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- * E-mail:
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44
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Recent Developments in the Genetics of Cardiomyopathies. CURRENT GENETIC MEDICINE REPORTS 2013. [DOI: 10.1007/s40142-012-0002-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sharma S, Papadakis M. Improved survival rates from commotio cordis: A case for automatic external defibrillator provision during high-risk sports. Heart Rhythm 2013; 10:224-5. [DOI: 10.1016/j.hrthm.2012.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Indexed: 10/27/2022]
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Carmont M. Advances in sports nutrition, exercise and medicine: Olympic issues, the legacy and beyond. BMC Med 2012; 10:79. [PMID: 22812481 PMCID: PMC3406995 DOI: 10.1186/1741-7015-10-79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 07/19/2012] [Indexed: 02/28/2023] Open
Abstract
In the run up to the London 2012 Olympics, this editorial introduces the cross-journal article collection Advances in Sports Nutrition, Exercise and Medicine http://www.biomedcentral.com/series/asnem.
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Heidbuchel H, Papadakis M, Panhuyzen-Goedkoop N, Carré F, Dugmore D, Mellwig KP, Rasmusen HK, Solberg EE, Borjesson M, Corrado D, Pelliccia A, Sharma S. Position paper: proposal for a core curriculum for a European Sports Cardiology qualification. Eur J Prev Cardiol 2012; 20:889-903. [DOI: 10.1177/2047487312446673] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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48
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Vanhees L, Rauch B, Piepoli M, van Buuren F, Takken T, Börjesson M, Bjarnason-Wehrens B, Doherty P, Dugmore D, Halle M. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III). Eur J Prev Cardiol 2012; 19:1333-56. [DOI: 10.1177/2047487312437063] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - B Rauch
- Centre for Ambulatory Cardiac and Angiologic Rehabilitation, Ludwigshafen, Germany
| | - M Piepoli
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - T Takken
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Börjesson
- Sahlgrenska University Hospital/Ostra, Goteborg, Sweden
| | | | | | - D Dugmore
- Wellness International Medical Centre, Stockport, UK
| | - M Halle
- University Hospital ‘Klinikum rechts der Isar’, Technische Universitaet Muenchen, Munich, Germany
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Vanhees L, Geladas N, Hansen D, Kouidi E, Niebauer J, Reiner Ž, Cornelissen V, Adamopoulos S, Prescott E, Börjesson M. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II). Eur J Prev Cardiol 2011; 19:1005-33. [DOI: 10.1177/1741826711430926] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - N Geladas
- University of Athens, Athens, Greece
| | - D Hansen
- University Hasselt, Diepenbeek, Belgium
| | - E Kouidi
- Aristotle University, Thessaloniki, Greece
| | - J Niebauer
- Paracelsus Medical University, Salzburg, Austria
| | - Ž Reiner
- University Hospital Center Zagreb, Zagreb, Croatia
| | | | | | - E Prescott
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - M Börjesson
- Sahlgrenska University Hospital/Ostra, Goteborg, Sweden
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