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Ekomy HM, Abogo JM, Begouabe H, Kinga A, Eboue BA, Ekouaghe LPA, Karmakar J, Obiang CS. Medical Checks for Professional Football Players in Franceville, Gabon. Niger Postgrad Med J 2024; 31:62-68. [PMID: 38321798 DOI: 10.4103/npmj.npmj_235_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
THE AIM OF THE STUDY To describe the clinical and non-clinical characteristics of Gabon footballers in the Haut-Ogooue Polyclinic in Franceville, Gabon, during visits, to assess whether they are not contraceptive to sports. PATIENTS AND METHODS A descriptive and analytical cross-sectional study was conducted in the city of Franceville, Gabon, in May 2022. The first and second divisions of footballers were subjected to medical examinations to determine whether they had any contraindications for playing sports, including clinical examinations, rest electrocardiograms (ECG), rest cardiac ultrasounds, chest X-rays, Rick-Dickson and biological checks. RESULTS The average age of 88 footballers (22-25 years) was 23 years. Blood pressure (BP) is abnormal in 19% of players, and alcohol and tobacco consumption is reported in 70% and 30%, respectively. Exercise adaptation was also closely associated with age (P = 0.00137724; P = 0.008974301), football position (P = 0.009957548; P = 0.006646182) and alcohol consumption (P = 0.000531971). Electrical and biological changes were 16% and 86.79%, respectively. Sinus bradycardia and first-degree atrioventricular block are the most common ECG abnormalities. Metabolic, inflammatory, infectious, electrolyte and anaemia syndromes were found in 22.64%, 24.53%, 19.81%, 7.55% and 12.26%, respectively. Midfielders and defenders have shown the greatest changes in biological parameters. CONCLUSION Medical checks are essential to determine if sports are contraindicated, as they can help identify physiological and pathological conditions and improve the monitoring of athletes.
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Affiliation(s)
- Hervé Martial Ekomy
- Department of Occupational Health, Masuku University of Science and Technology, USTM, Franceville, Gabon
| | - Joefred Mbogho Abogo
- Department of Biology, Masuku University of Science and Technology, USTM, Franceville, Gabon
- Department of Laboratory of Research in Biochemistry, Masuku University of Science and Technology, USTM, Franceville, Gabon
| | - Herman Begouabe
- Department of Biology, Masuku University of Science and Technology, USTM, Franceville, Gabon
| | - Armel Kinga
- Department of Cardiologie, Polyclinic of Haut-Ogooue, Masuku University of Science and Technology, USTM, Franceville, Gabon
- Department of Medicine, Amissa Bongo University Hospital Centre, Franceville, Gabon
| | - Brice Angwe Eboue
- Department of Occupational Health, University of Health Sciences, Libreville, Gabon
| | | | - Jayanta Karmakar
- Department of Biology, Masuku University of Science and Technology, USTM, Franceville, Gabon
| | - Cedric Sima Obiang
- Department of Biology, Masuku University of Science and Technology, USTM, Franceville, Gabon
- Department of Laboratory of Research in Biochemistry, Masuku University of Science and Technology, USTM, Franceville, Gabon
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Lear A, Patel N, Mullen C, Simonson M, Leone V, Koshiaris C, Nunan D. Incidence of sudden cardiac arrest and death in young athletes and military members: a systematic review and meta-analysis. J Athl Train 2021; 57:431-443. [PMID: 34038947 PMCID: PMC9205551 DOI: 10.4085/1062-6050-0748.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The goals of this review are to evaluate the quality of the evidence on the incidence of sudden cardiac arrest and death (SCA/D) in athletes and military members; and to estimate annual incidence of SCA/D. DATA SOURCES MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19-7/29/19. STUDY SELECTION Studies which reported incidence of SCA/D or both in athletes, or military members under age 40 were eligible for inclusion. 40 studies were identified for inclusion Data Extraction: Risk of bias was assessed using a validated, customized tool for prevalence studies in all included studies. 12 were found to be low ROB, with the remaining 28 moderate or high ROB. Data was extracted for narrative review, and meta-analysis. DATA SYNTHESIS Random-effects meta-analysis was performed in studies judged to be low risk of bias in two separate categories: 5 studies on regional or national level data including athletes at all levels, and both sexes included 130 events of SCD, with a total of 11,272,560 athlete years showing a cumulative incidence rate of 0.98 [95%CI: 0.62, 1.53] per 100,000 athlete years, with high heterogeneity with I2 of 78%; 3 Studies on competitive athletes aged 14 to 25 were combined, and included 183 events, and 17,798758 athlete years showing an incidence rate of 1.91[95%CI: 0.71; 5.14] per 100,000 athlete years with high heterogeneity with I2 of 97%. The remaining low risk of bias studies were in military members, and were not synthesized. CONCLUSION The worldwide incidence of SCD is a rare event. Low risk of bias studies indicate incidence to be below 2 per 100,000 athlete years. Overall, the quality of the evidence available is low, but there are high quality individual studies to inform the question of incidence levels. PROSPERO Registration: CRD42019125560.
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Affiliation(s)
- Aaron Lear
- Cleveland Clinic Akron General, Akron, OH USA
| | | | | | | | - Vince Leone
- Northeast Ohio Medical University (NEOMED), Akron, OH USA
| | | | - David Nunan
- University of Oxford, Oxford, UK Twitter: @dnunan79
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3
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Incidence of major adverse cardiac events in men wishing to continue competitive sport following percutaneous coronary intervention. Arch Cardiovasc Dis 2019; 112:226-233. [PMID: 30612894 DOI: 10.1016/j.acvd.2018.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND The new North American guidelines for participation in competitive sport in patients with coronary artery disease (CAD) are less restrictive than previous guidelines. AIM To evaluate the incidence of major adverse cardiac events (MACE) in men with CAD who practise intensive physical activity after a stenting procedure. MACE included in-stent restenosis (SR), stent thrombosis (ST), new coronary stenosis (NCS), myocardial infarction, heart failure, cardiac arrest or cardiac death. METHODS Asymptomatic men with CAD and a coronary stent who practised regular (>4h/week) sport were included in this retrospective multicentre observational study. All patients presented with left ventricular ejection fraction≥50%, no residual stenosis, and no inducible ischaemia or arrhythmias. Three groups were compared: those undertaking moderate leisure-time sport (MLS), intensive leisure-time sport (ILS) or competitive sport (CS). During follow-up, all patients had a yearly routine cardiology evaluation. RESULTS A total of 108 men with CAD (57.3±9.1 years) were included: 29 MLS, 58 ILS, and 21 CS. During follow-up (57.6±46.0 months) the incidence of MACE was 15.7% (SR=5, SR+NCS=4, ST=4, NCS=4) and occurred during physical exertion in 59% of patients. ST was more frequent in the CS (n=3) than in the MLS (n=1) or ILS (n=0) groups, especially in patients with bare-metal stents. CONCLUSIONS The incidence of MACE was 15.7%, and only ST was significantly more frequent in CS patients than in MLS or ILS patients. Our data support the new US guidelines for exercise eligibility in men with CAD.
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Chevalier L, Doutreleau S, Carré F, Sosner P, Abbot M, Jaussaud J. Awareness and education about cardiovascular events and sport are essential: Results of a French multicenter survey. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Chevalier L, Guy JM, Doutreleau S. [Place of the exercise stress test at the sportsman]. Ann Cardiol Angeiol (Paris) 2018; 67:361-364. [PMID: 30301545 DOI: 10.1016/j.ancard.2018.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
Is the stress test still part of the useful examinations in the detection of risk heart disease in sports subjects? Should we continue to use it as a surveillance examination in coronary sports patients? Meta-analysis, considering a ST subshift of more than 1mm as a criterion for positivity, underline the low prevalence of abnormal examinations and a significant rate of false-positives. But for the diagnosis of coronary artery disease, it is mainly the evolution of the ST segment to effort or recovery and the occurrence of stress arrhythmias that detect true positivity. When coronary risk is more important (presence of risk factors, resumption of sport, intense and prolonged efforts), it seems lawful to recommend such a review on a regular basis among men over 40 years of age with two risk factors but Also among veterans taking up sport after a period of prolonged inactivity. For the asymptomatic coronary athlete the stress test remains at the centre of the final decision for the resumption of a sport in competition irrespective of the method of revascularization. Of course the stress test, even inevitable, remains flawed in the detection of coronary artery disease in the asymptomatic athlete. However, it provides additional information on the condition of being maximal, and attaching importance to arrhythmias, the tensional profile and the maximum power developed in addition to the ST segment's only study.
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Affiliation(s)
- L Chevalier
- Clinique du sport, 33370 Bordeaux-Mérignac, France
| | - J M Guy
- Center de réadaptation cardiorespiratoire de la loire, 33370 Saint-Priest-en-Jarez, France.
| | - S Doutreleau
- Service de médecine du sport et explorations fonctionnelles, CHU, 33370 Grenoble, France
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Vicent L, Ariza-Solé A, González-Juanatey JR, Uribarri A, Ortiz J, López de Sá E, Sans-Roselló J, Querol CT, Codina P, Sousa-Casasnovas I, Martínez-Sellés M. Exercise-related severe cardiac events. Scand J Med Sci Sports 2018; 28:1404-1411. [DOI: 10.1111/sms.13037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- L. Vicent
- Cardiology Department; Hospital Universitario Gregorio Marañón; Madrid Spain
| | - A. Ariza-Solé
- Cardiology Department; Hospital Universitario de Bellvitge; Barcelona Spain
| | | | - A. Uribarri
- Cardiology Department; Hospital Universitario; Salamanca Spain
| | - J. Ortiz
- Cardiology Department; Hospital Universitario Clinic; Barcelona Spain
| | - E. López de Sá
- Cardiology Department; Hospital Universitario La Paz; Madrid Spain
| | - J. Sans-Roselló
- Cardiology Department; Hospital Universitario Sant Pau; Barcelona Spain
| | - C. T. Querol
- Cardiology Department; Hospital Universitario; Lleida Spain
| | - P. Codina
- Cardiology Department; Hospital Universitario de Bellvitge; Barcelona Spain
| | - I. Sousa-Casasnovas
- Cardiology Department; Hospital Universitario Gregorio Marañón; Madrid Spain
| | - M. Martínez-Sellés
- Cardiology Department; Hospital Universitario Gregorio Marañón; Madrid Spain
- Universidad Complutense; Universidad Europea; Madrid Spain
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7
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Chevalier L, Kervio G, Doutreleau S, Mathieu JP, Guy JM, Mignot A, Corneloup L, Passard F, Laporte T, Girard-Girod A, Hennebert O, Bernadet P, Vincent-Chevalier MP, Gencel L, Carré F. The medical value and cost-effectiveness of an exercise test for sport preparticipation evaluation in asymptomatic middle-aged white male and female athletes. Arch Cardiovasc Dis 2017; 110:149-156. [DOI: 10.1016/j.acvd.2016.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/19/2016] [Accepted: 06/01/2016] [Indexed: 01/02/2023]
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8
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Gräni C, Chappex N, Fracasso T, Vital C, Kellerhals C, Schmied C, Saguner AM, Trachsel LD, Eser P, Michaud K, Wilhelm M. Sports-related sudden cardiac death in Switzerland classified by static and dynamic components of exercise. Eur J Prev Cardiol 2016; 23:1228-36. [DOI: 10.1177/2047487316632967] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/27/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Christoph Gräni
- Department of Cardiology, Inselspital, University Hospital Bern, Switzerland
| | - Nina Chappex
- University Center of Legal Medicine, Lausanne and Geneva, University of Lausanne, Switzerland
| | - Tony Fracasso
- University Center of Legal Medicine, Lausanne and Geneva, University of Geneva, Switzerland
| | - Cristina Vital
- Department of Cardiology, Inselspital, University Hospital Bern, Switzerland
| | | | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, Switzerland
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, Switzerland
| | - Lukas D Trachsel
- Department of Cardiology, Inselspital, University Hospital Bern, Switzerland
| | - Prisca Eser
- Department of Cardiology, Inselspital, University Hospital Bern, Switzerland
| | - Katarzyna Michaud
- University Center of Legal Medicine, Lausanne and Geneva, University of Lausanne, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, University Hospital Bern, Switzerland
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9
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Goodman JM, Burr JF, Banks L, Thomas SG. The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events. Can J Cardiol 2016; 32:523-32. [PMID: 27017149 DOI: 10.1016/j.cjca.2016.01.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increased physical activity (PA) is associated with improved quality of life and reductions in cardiovascular (CV) morbidity and all-cause mortality in the general population in a dose-response manner. However, PA acutely increases the risk of adverse CV event or sudden cardiac death (SCD) above levels expected at rest. We review the likelihood of adverse CV events related to exercise in apparently healthy adults and strategies for prevention, and contextualize our understanding of the long-term risk reduction conferred from PA. METHODS A systematic review of the literature was performed using electronic databases; additional hand-picked relevant articles from reference lists and additional sources were included after the search. RESULTS The incidence of adverse CV events in adults is extremely low during and immediately after PA of varying types and intensities and is significantly lower in those with long-standing PA experience. The risk of SCD and nonfatal events during and immediately after PA remains extremely low (well below 0.01 per 10,000 participant hours); increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, occult CV disease is present and SCD is typically the first clinical event. CONCLUSIONS Exercise acutely increases the risk of adverse CV events, with greater risk associated with vigorous intensity. The risks of an adverse CV event during and immediately after exercise are outweighed by the health benefits of vigorous exercise performed regularly. A key challenge remains the identification of occult structural heart disease and inheritable conditions that increase the chances of lethal arrhythmias during exercise.
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Affiliation(s)
- Jack M Goodman
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada; UHN/Mt Sinai Division of Cardiology, Heart and Stroke/Richard Lewar Centres of Excellence in Cardiovascular Research, Toronto, Ontario, Canada.
| | - Jamie F Burr
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Laura Banks
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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10
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Chatard JC, Mujika I, Goiriena JJ, Carré F. Screening young athletes for prevention of sudden cardiac death: Practical recommendations for sports physicians. Scand J Med Sci Sports 2015; 26:362-74. [PMID: 26432052 DOI: 10.1111/sms.12502] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/13/2022]
Abstract
Regular intensive exercise in athletes increases the relative risk of sudden cardiac death (SCD) compared with the relatively sedentary population. Most cases of SCD are due to silent cardiovascular diseases, and pre-participation screening of athletes at risk of SCD is thus of major importance. However, medical guidelines and recommendations differ widely between countries. In Italy, the National Health System recommends pre-participation screening for all competitive athletes including personal and family history, a physical examination, and a resting 12-lead electrocardiogram (ECG). In the United States, the American College of Cardiology and the American Heart Association recommend a pre-participation screening program limited to the use of specific questionnaires and a clinical examination. The value of a 12-lead ECG is debated based on issues surrounding cost-efficiency and feasibility. The aim of this review was to focus on (i) the incidence rate of cardiac diseases in relation to SCD; (ii) the value of conducting a questionnaire and a physical examination; (iii) the value of a 12-lead resting ECG; (iv) the importance of other cardiac evaluations in the prevention of SCD; and (v) the best practice for pre-participation screening.
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Affiliation(s)
- J-C Chatard
- Laboratory of Exercise Physiology, Faculty of Medicine Jacques Lisfranc, University of Lyon-Saint-Etienne, Saint-Etienne, France
| | - I Mujika
- Department of Physiology, Faculty of Medicine and Odontology, University of the Basque Country, Leioa, Basque Country, Spain.,School of Kinesiology and Health Research Center, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - J J Goiriena
- Department of Physiology, Faculty of Medicine and Odontology, University of the Basque Country, Leioa, Basque Country, Spain
| | - F Carré
- Laboratory of Exercise Physiology, Faculty of Medicine, University of Rennes, Rennes, France
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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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12
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Sreeram N, Menzel C, Udink ten Cate FEA. Controversies in arrhythmias and arrhythmic syndromes of active children and young adults. Expert Rev Cardiovasc Ther 2015; 13:183-92. [DOI: 10.1586/14779072.2015.1000308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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13
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Menafoglio A, Di Valentino M, Porretta AP, Foglia P, Segatto JM, Siragusa P, Pezzoli R, Maggi M, Romano GA, Moschovitis G, Gallino A. Cardiovascular evaluation of middle-aged individuals engaged in high-intensity sport activities: implications for workload, yield and economic costs. Br J Sports Med 2014; 49:757-61. [DOI: 10.1136/bjsports-2014-093857] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2014] [Indexed: 01/02/2023]
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14
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Sekendiz B, Gass G, Norton K, Finch CF. Cardiac emergency preparedness in health/fitness facilities in Australia. PHYSICIAN SPORTSMED 2014; 42:14-9. [PMID: 25419884 DOI: 10.3810/psm.2014.11.2087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health/fitness facilities are popular venues for physical activity, where increasingly more individuals at risk of cardiovascular events exercise to achieve positive health outcomes. The aim of our study was to analyze cardiac emergency preparedness in health/fitness facilities in Queensland, Australia. DESIGN Cross-sectional survey of health/fitness facilities in Queensland. METHODS A risk management questionnaire was administered over 7 months, July 2009 to January 2010, using an online or paper-based version. The data are presented as the proportion of survey respondents giving specific responses to questionnaire items related to cardiac emergency preparedness, especially the provision of automated external defibrillators (AEDs). RESULTS Fifty-two health/fitness facility managers responded to the survey. Most of the surveyed facilities conducted pre-activity screening (92%). Of those with a written emergency plan (79%), only 37% physically rehearsed their emergency response systems at regular intervals. Ninety-five percent of the facilities had fitness employees with a current first aid/cardiopulmonary resuscitation certificate and training. Of the 10 (19%) facilities with an on-site AED, only 6 had staff qualified to use the AED in an emergency, and only 6 had the AED as part of a public access defibrillator program. CONCLUSION This is the first study to report that cardiac emergency preparedness is not optimal in the health/fitness facilities in Australia. Development of policies and procedures for training health/fitness professionals in emergency procedures is needed to minimize the risk when exercise-induced cardiac events occur at health/fitness facilities.
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Affiliation(s)
- Betul Sekendiz
- Lecturer in Exercise and Sport Management School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia.
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15
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Abstract
Non-traumatic sudden death related to sport is a rare but always dramatic event. Its causes are mainly cardiovascular. Prevention of sudden death depends on effective medical examination involving history, physical examination and resting ECG, as education of athletes who must follow the rules for safe sport practice and lastly training for emergency actions of the population.
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Affiliation(s)
- François Carré
- CHU Pontchaillou, Université Rennes 1, Inserm U1099, service explorations fonctionnelles, rue Henri-le-Guillou, 35033 Rennes cedex, France.
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16
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Massoure PL, Camus O, Chenilleau MC, Gil JM, Fourcade L. [Cardiac disease at risk in the young athlete]. Presse Med 2014; 43:840-7. [PMID: 24856863 DOI: 10.1016/j.lpm.2014.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 02/05/2014] [Indexed: 01/02/2023] Open
Abstract
Physical training significantly reduces all cause mortality in the general population. Eligibility for competitive sport participation in athletes with cardiovascular diseases is based on recommendations. Incidence of sudden cardiac death in young athletes is low (0.5 to 2/100,000 athletes/year). The most common cardiac diseases at risk are hypertrophic cardiomyopathies, congenital coronary arteries abnormalities, arrhythmogenic right ventricular cardiomyopathy and acute myocarditis. Pre-participation screening is based on the cardiovascular evaluation, including ECG (repeated every 3years since the age of 12 and every 5years since the age of 20 to the age of 35). Some events are unpredictable (idiopathic ventricular fibrillation, sudden death related to congenital coronary arteries abnormalities or commotio cordis). A better access to public defibrillation is needed.
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Affiliation(s)
| | - Olivier Camus
- Hôpital Laveran, service de cardiologie, 13384 Marseille cedex 13, France
| | | | - Jean-Marie Gil
- Hôpital Laveran, service de cardiologie, 13384 Marseille cedex 13, France
| | - Laurent Fourcade
- Hôpital Laveran, service de cardiologie, 13384 Marseille cedex 13, France
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17
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[Myocardial infarction related to sport. Acute clinical and coronary angiographic characteristics in 16 cases]. Ann Cardiol Angeiol (Paris) 2013; 62:398-403. [PMID: 24183497 DOI: 10.1016/j.ancard.2013.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Determination of clinical and angiographic characteristics of myocardial infarctions related to sport. METHODS Retrospective study of acute coronary syndromes with ST elevation related to sport treated with interventional cardiology from 2006 to 2013. RESULTS Sixteen patients were included. They are mostly men (15/16), aged 24-65 years (over 35 years old in 13 cases) with few cardiovascular risk factors, most frequently heredity or smoking. Myocardial infarctions usually occur during the practice of sports (13/16), with serious rhythmic complications in three of the cases. On angiography, most patients have single vessel disease (12/16). CONCLUSION Myocardial infarction related to sports affects a male population aged over 35 years old with few cardiovascular risk factors, most often single vessel disease, making the preventative screening uneasy. Other studies investigating larger populations, assessing previous clinical events (symptoms, results of stress tests), evaluating the impact of competition and integrating sudden deaths would improve the screening and the treatment of sport-related myocardial infarctions.
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18
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Berdowski J, de Beus MF, Blom M, Bardai A, Bots ML, Doevendans PA, Grobbee DE, Tan HL, Tijssen JGP, Koster RW, Mosterd A. Exercise-related out-of-hospital cardiac arrest in the general population: incidence and prognosis. Eur Heart J 2013; 34:3616-23. [DOI: 10.1093/eurheartj/eht401] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Suárez-Mier MP, Aguilera B, Mosquera RM, Sánchez-de-León MS. Pathology of sudden death during recreational sports in Spain. Forensic Sci Int 2013; 226:188-96. [DOI: 10.1016/j.forsciint.2013.01.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 09/12/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022]
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Knechtle B, Rüst CA, Rosemann T, Lepers R. Age-related changes in 100-km ultra-marathon running performance. AGE (DORDRECHT, NETHERLANDS) 2012; 34:1033-1045. [PMID: 21796378 PMCID: PMC3682063 DOI: 10.1007/s11357-011-9290-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Accepted: 07/08/2011] [Indexed: 05/27/2023]
Abstract
The aims of this study were (1) to investigate the participation and performance trends at the '100 km Lauf Biel' in Switzerland from 1998 to 2010, and (2) to compare the age-related changes in 100-km running performance between males and females. For both sexes, the percent of finishers significantly (P < 0.01) decreased for the 18-29 and the 30-39-year age groups, while it significantly (P < 0.01) increased for the 40-49 and the 50-59-year age groups over the studied period. From 1998 to 2010, the mean age of the top ten finishers increased by 0.4 years per annum for both females (P = 0.02) and males (P = 0.003). The running time for the top ten finishers remained stable for females, while it significantly (P = 0.001) increased by 2.4 min per annum for males. There was a significant (P < 0.001) age effect on running times for both sexes. The best 100-km running times was observed for the age comprised between 30 and 49 years for males, and between 30 and 54 years for females, respectively. The age-related decline in running performance was similar until 60-64 years between males and females, but was greater for females compared to males after 65 years. Future studies should investigate the lifespan from 65 to 75 years to better understand the performance difference between male and female master ultra-marathoners.
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Affiliation(s)
- Beat Knechtle
- Facharzt FMH für Allgemeinmedizin, Gesundheitszentrum St. Gallen, Vadianstrasse 26, St. Gallen, Switzerland.
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Mort subite chez le sportif. ANNALES FRANCAISES DE MEDECINE D URGENCE 2012. [DOI: 10.1007/s13341-012-0185-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Körperliche Aktivität und kardiovaskuläre Erkrankungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:17-23. [DOI: 10.1007/s00103-011-1390-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Exercise related cardiac arrest in amateur athletes on the tennis court. Resuscitation 2011; 82:1004-7. [DOI: 10.1016/j.resuscitation.2011.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 02/28/2011] [Accepted: 03/20/2011] [Indexed: 11/23/2022]
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Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H, Toussaint JF, Desnos M, Rieu M, Benameur N, Le Heuzey JY, Empana JP, Jouven X. Sports-related sudden death in the general population. Circulation 2011; 124:672-81. [PMID: 21788587 DOI: 10.1161/circulationaha.110.008979] [Citation(s) in RCA: 312] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although such data are available for young competitive athletes, the prevalence, characteristics, and outcome of sports-related sudden death have not been assessed previously in the general population. METHODS AND RESULTS A prospective and comprehensive national survey was performed throughout France from 2005 to 2010, involving subjects 10 to 75 years of age. Case detection for sports-related sudden death, including resuscitated cardiac arrest, was undertaken via national ambulance service reporting and Web-based screening of media releases. The overall burden of sports-related sudden death was 4.6 cases per million population per year, with 6% of cases occurring in young competitive athletes. Sensitivity analyses used to address suspected underreporting demonstrated an incidence ranging from 5 to 17 new cases per million population per year. More than 90% of cases occurred in the context of recreational sports. The age of subjects was relatively young (mean ± SD 46 ± 15 years), with a predominance of men (95%). Although most cases were witnessed (93%), bystander cardiopulmonary resuscitation was only commenced in 30.7% of cases. Bystander cardiopulmonary resuscitation (odds ratio 3.73, 95% confidence interval 2.19 to 6.39, P<0.0001) and initial use of cardiac defibrillation (odds ratio 3.71, 95% confidence interval 2.07 to 6.64, P<0.0001) were the strongest independent predictors for survival to hospital discharge (15.7%, 95% confidence interval 13.2% to 18.2%). CONCLUSIONS Sports-related sudden death in the general population is considerably more common than previously suspected. Most cases are witnessed, yet bystander cardiopulmonary resuscitation was only initiated in one third of cases. Given the often predictable setting of sports-related sudden death and that prompt interventions were significantly associated with improved survival, these data have implications for health services planning.
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Affiliation(s)
- Eloi Marijon
- Paris Cardiovascular Research Center, INSERM U970, Hôpital européen Georges Pompidou, Paris CEDEX 15, France.
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Goodman JM, Thomas SG, Burr J. Evidence-based risk assessment and recommendations for exercise testing and physical activity clearance in apparently healthy individuals1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process. Appl Physiol Nutr Metab 2011; 36 Suppl 1:S14-32. [DOI: 10.1139/h11-048] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Increased physical activity (PA) is associated with improved health and quality of life in the general population. A dose–response effect is evident between increasing levels of PA participation and a lower relative risk for cardiovascular disease and all-cause mortality. However, there is also clear evidence that PA acutely increases the risk of an adverse cardiovascular (CV) event and sudden cardiac death (SCD) significantly above levels expected at rest. Adverse CV events during PA may be triggered acutely by the physiological stress of exercise. This investigation will review the available literature describing the CV risks of exercise testing and PA participation in apparently healthy individuals. A systematic review of the literature was performed using electronic databases, including Medline, CINAHL, SPORT discus, EMBASE, Cochrane DSR, ACP Journal Club, and DARE; additional relevant articles were hand-picked and the final grouping was used for the review using the AGREE process to assess the impact and quality of the selected articles. Six hundred and sixteen relevant articles were reviewed with 51 being identified as describing adverse CV events during exercise and PA. Data suggests the risks of fatal and nonfatal events during maximal exercise testing in apparently healthy individuals rarely occur (approximately <0.8 per 10 000 tests or 1 per 10 000 h of testing). The incidence of adverse CV events is extremely low during PA of varying types and intensities, with data limited almost exclusively to fatal CV events, as nonfatal events are rarely reported. However, this risk is reduced by 25%–50% in those individuals who have prior experience with increased levels of PA, particularly vigorous PA. Throughout a wide age range, the risk of SCD and nonfatal events during PA remain extremely low (well below 0.01 per 10 000 participant hours), but both increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, undetected pre-existing disease is present and SCD is typically the first clinical event. The risks of an adverse CV event during exercise testing and PA are rare and are outweighed by the health benefits. Given this risk-benefit relationship, the PAR-Q is an appropriate method to identify those at higher risk across a wide age span and should be used in conjunction with appropriate clinical guidelines for guiding individuals towards graduated PA. There are not adequate data to describe the risks of PA in those individuals considered to be at higher risk but without cardiovascular disease.
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Affiliation(s)
- Jack M. Goodman
- Department of Exercise Sciences, Faculty of Physical Education and Health, University of Toronto, Toronto, ON, Canada
| | - Scott G. Thomas
- Department of Exercise Sciences, Faculty of Physical Education and Health, University of Toronto, Toronto, ON, Canada
| | - Jamie Burr
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, BC, Canada
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Leisure sport activity as a trigger for acute coronary events in men without known coronary artery disease. Herz 2011; 36:637-42. [DOI: 10.1007/s00059-011-3450-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 03/05/2011] [Indexed: 10/18/2022]
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Borjesson M, Serratosa L, Carre F, Corrado D, Drezner J, Dugmore DL, Heidbuchel HH, Mellwig KP, Panhuyzen-Goedkoop NM, Papadakis M, Rasmusen H, Sharma S, Solberg EE, van Buuren F, Pelliccia A. Consensus document regarding cardiovascular safety at sports arenas: Position stand from the European Association of Cardiovascular Prevention and Rehabilitation (EACPR), section of Sports Cardiology. Eur Heart J 2011; 32:2119-24. [DOI: 10.1093/eurheartj/ehr178] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mosterd A, Senden JP, Engelfriet P. Preventing sudden cardiac death in athletes: finding the needle in the haystack or closing the barn door? ACTA ACUST UNITED AC 2011; 18:194-6. [DOI: 10.1177/1741826710389374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Arend Mosterd
- Department of Cardiology, Meander Medical Center, Amersfoort, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
- Department of Cardiology, University Medical Center, Utrecht, The Netherlands
| | - Jeff P Senden
- Department of Cardiology, Meander Medical Center, Amersfoort, The Netherlands
| | - Peter Engelfriet
- Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Corrado D, Schmied C, Basso C, Borjesson M, Schiavon M, Pelliccia A, Vanhees L, Thiene G. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes? Eur Heart J 2011; 32:934-44. [PMID: 21278396 DOI: 10.1093/eurheartj/ehq482] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Sudden cardiac arrest is most often the first clinical manifestation of an underlying cardiovascular disease and usually occurs in previously asymptomatic athletes. The risk benefit ratio of physical exercise differs between young competitive athletes and middle-age/senior individuals engaged in leisure-time sports activity. Competitive sports are associated with an increase in the risk of sudden cardiovascular death (SCD) in susceptible adolescents and young adults with underlying cardiovascular disorders. In middle-age/older individuals, physical activity can be regarded as a 'two-edged sword': vigorous exertion increases the incidence of acute coronary events in those who did not exercise regularly, whereas habitual physical activity reduces the overall risk of myocardial infarction and SCD. Although cardiovascular pre-participation evaluation offers the potential to identify athletes with life-threatening cardiovascular abnormalities before onset of symptoms and may reduce their risk of SCD, there is a significant debate among cardiologists about efficacy, impact of false-positive results and cost-effectiveness of routine screening. This review presents an appraisal of the available data and criticisms concerning screening programmes aimed to prevent SCD of either young competitive athletes or older individuals engaged in leisure-time sports activity.
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Affiliation(s)
- Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Science, University of Padua Medical School, Via Giustiniani, 2-35121 Padova, Italy.
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Sanchez-Gonzalez MA, Wieder R, Kim JS, Vicil F, Figueroa A. Creatine supplementation attenuates hemodynamic and arterial stiffness responses following an acute bout of isokinetic exercise. Eur J Appl Physiol 2011; 111:1965-71. [DOI: 10.1007/s00421-011-1832-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 01/07/2011] [Indexed: 01/27/2023]
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Sax A, Clarens C, Delagardelle C, Urhausen A. Sudden cardiac death and sport in Luxembourg: Incitement for a public health strategy. Resuscitation 2010. [DOI: 10.1016/j.resuscitation.2010.09.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brion R. La mort subite des jeunes sportifs. Sci Sports 2010. [DOI: 10.1016/j.scispo.2010.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bilan cardiovasculaire dans la visite de non contre-indication à la pratique du sport en compétition. Sci Sports 2010. [DOI: 10.1016/j.scispo.2010.10.005] [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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Systolic and early diastolic left ventricular velocities assessed by tissue Doppler imaging in 100 top-level handball players. ACTA ACUST UNITED AC 2009; 17:342-8. [PMID: 20560167 DOI: 10.1097/hjr.0b013e32833333de] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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