Clinical research studyCardiovascular Screening with Electrocardiography and Echocardiography in Collegiate Athletes
Section snippets
Study Population and Definitions
Consecutive male and female varsity athletes enrolled at the University of Kansas (Lawrence, KS) were prospectively screened. After informed consent, comprehensive medical and family history and physical examination were performed in all subjects in accordance with American Heart Association (AHA)/American College of Cardiology (ACC) recommendations.7 All subjects also underwent standard 12-lead ECGs and 2-dimensional echocardiography. This study was approved by the Saint Luke's Hospital of
Results
During 2004-2009, 964 consecutive athletes (ages 18-21 years, 52% female, 19% black) were enrolled (Table 2). Athletes represented 14 competitive sporting events, most commonly football (n = 240, 24.9%), rowing (n = 171, 17.7%), and track and field (n = 156, 16.2%). Among all subjects, 83 (8.6%) reported a family history of premature death, and 142 (14.7%) reported symptoms. Female subjects were more likely to have experienced symptoms, whereas males were more likely to have a history of hypertension
Discussion
In this consecutive cohort of collegiate athletes undergoing preparticipation screening with comprehensive medical and family history, 12-lead ECG, and 2-dimensional echocardiography, ECG findings were abnormal in one third and distinctly abnormal in 10%. Distinct ECG abnormalities were more common in males than females as well as black than white athletes. The relationship between race and distinctly abnormal ECG patterns persisted after multivariable adjustment for sex and body mass index.
Conclusions
In a cohort of consecutive collegiate competitive athletes undergoing comprehensive preparticipation screening, distinct ECG abnormalities were present in 10% and were more common in males as well as black athletes. Black race was an independent predictor of distinctly abnormal ECG patterns. Noninvasive screening using ECG and 2-dimensional echocardiography identified 9 athletes with important cardiovascular conditions, 2 of whom were excluded from participation. The presence of a distinctly
References (24)
- et al.
Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology
J Am Soc Echocardiogr
(2005) - et al.
Relation of race to electrocardiographic patterns in elite American football players
J Am Coll Cardiol
(2008) RS-T segment elevation in mid- and left precordial leads as a normal variant
Am Heart J
(1953)Observations on the juvenile pattern of adult negro males
Am J Med
(1955)- et al.
Electrocardiographic observations in professional football players
Am J Cardiol
(2002) - et al.
Ethnic differences in electrocardiographic left ventricular hypertrophy in young and middle-aged employed American men
Am J Cardiol
(1994) - et al.
Results of screening a large group of intercollegiate competitive athletes for cardiovascular disease
J Am Coll Cardiol
(1987) Saving athletes' lives a reason to find common ground?
J Am Coll Cardiol
(2008)- et al.
Electrocardiograms should be included in preparticipation screening of athletes
Circulation
(2007) - et al.
Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006
Circulation
(2009)
Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program
JAMA
Screening for hypertrophic cardiomyopathy in young athletes
N Engl J Med
Cited by (82)
The International Criteria for Electrocardiogram Interpretation in Athletes: Common Pitfalls and Future Directions
2023, Cardiology ClinicsCitation Excerpt :The initial ESC 2005 criteria provided a list of “abnormal” ECG findings in athletes that warranted further evaluation. A series of National Collegiate Athletic Association articles using these criteria found high rates of abnormal ECGs and false-positive rates (>10%),14–17 which led to increased scrutiny of how ECG screening may lead to unnecessary secondary testing and significant costs on the medical system. The ESC subsequently proposed new criteria in 2010 that introduced the concept of “common/training-related” ECG patterns, in contrast to more concerning “uncommon/training-unrelated” findings.7
Echocardiogram in athlete’s heart
2023, Athlete's Heart: A Multimodal Approach - From Physiological to Pathological Cardiac AdaptationsBlood pressure characteristics of collegiate female athletes: A call for more focused attention on young women's health
2022, American Heart Journal Plus: Cardiology Research and PracticePre-participation medical evaluation in competitive athletes: the experience of an international multisport club
2022, Apunts Sports MedicineRecommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes: A Report from the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Computed Tomography and the Society for Cardiovascular Magnetic Resonance
2020, Journal of the American Society of Echocardiography
Funding: This work was supported by a grant from the Saint Luke's Hospital Foundation (Kansas City, Mo).
Conflict of Interest: Dr. Magalski and Ms. McCoy jointly hold a pending provisional patent on the echocardiography protocol used in this study. All remaining authors reported that they have no conflicts of interest.
Authorship: All authors had access to the data and participated in writing the manuscript.