Cardiovascular health, part 1: preparticipation cardiovascular screening

Prevalence of Cardiovascular Disorders Among Iranian Elite Athletes

BACKGROUND

Athletes' health is an important issue and for promoting it, pre-participation examination (PPE) is widely performed by responsible bodies around the world.

OBJECTIVES

This study was to determine prevalence of cardiovascular disorders among athletes participating in the Asian games and answering the question whether the electrocardiogram (ECG) is a necessary part of pre-participation examination (PPE) for prevention of sudden cardiac death.

MATERIALS AND METHODS

All athletes participated at Asian games came to sports medicine federation for a PPE including a comprehensive questionnaire, physical examination and ECG. In this retrospective study all profiles of 338 athletes have been studied as well as their electrocardiograms. Multiple logistic regressions as well as Firth's bias reduction were used with R statistical software and SPSS. For predicting the changes in ECG, receiver operating characteristic (ROC) curve has done.

RESULTS

Among 388 athletes, 80 (20.6%) were female and 308 (79.4%) male with mean age of 23.2 + 8 years. Nine athletes (2.3%) were smokers, 28 of them (7.2%) experienced chest pain and discomfort, 45 of them (13.3%) had palpitations and 28 (7.2%) had history of anemia. Study of their electrocardiograms showed that long Q-T interval was not seen for anyone, but evidence of left ventricular hypertrophy was seen in 12 (3.1%), inverted T wave in 6 (1.5%), and right bundle branch block in 45 (13.3%).

CONCLUSIONS

PPE provides very important information of athletes' health. This study has shown that there was not any significant relation between current examination and electrocardiogram changes but regarding the ECG changes we recommend it as a routine part of PPE.

Cardiovascular screening practices in collegiate student-athletes

OBJECTIVE

To evaluate screening practices and preparticipation evaluation (PPE) forms used to identify, or raise suspicion of, cardiovascular abnormalities in collegiate student-athletes.

DESIGN

Phone and e-mail survey.

SETTING

National Collegiate Athletic Association (NCAA) Division I universities.

PARTICIPANTS

All 347 NCAA Division I universities were invited to participate in 2010-2011; 257 universities (74%) elected to participate.

MAIN OUTCOME MEASURES

Information about the preparticipation screening process was obtained from team physicians and/or certified athletic trainers. PPE forms were evaluated for the inclusion of the 12 specific American Heart Association (AHA) recommendations for cardiovascular screening of competitive athletes from the 2007 AHA Council on Nutrition, Physical Activity, and Metabolism consensus panel endorsed by the American College of Cardiology Foundation.

RESULTS

All 257 participating universities (100%) required preparticipation screening for freshman and transfer athletes, and 83 universities (32%) required an annual PPE for returning athletes. The PPE was performed on campus at 85% of the universities, whereas 15% of universities allowed the PPE to be completed by the athlete's choice of physician before he or she arrived on campus. Eleven universities (4%) used the recently updated American College of Sports Medicine 4th edition PPE. Sixteen universities (6%) used the American College of Sports Medicine 3rd edition PPE. The remaining 260 universities (90%) did not use either of these forms. Of the 257 Division I universities, only 21 universities (8%) met the AHA recommendations by including all 12 cardiovascular screening items on their PPE forms.

CONCLUSION

The majority (92%) of NCAA Division I universities do not use PPE forms that meet the AHA recommendations for cardiovascular screening; therefore, they may not be effectively screening collegiate student-athletes for cardiovascular abnormalities that could lead to sudden cardiac death.